Risk Management Concepts Overview

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Questions and Answers

Which factor is NOT essential in determining insurance pricing?

  • Market conditions
  • Regulatory guidelines
  • Personal preferences of the insurer (correct)
  • Claim history of the insured

What is the primary purpose of compliance with regulations like EPA, OSHA, and ERISA in the insurance industry?

  • To ensure safety and health in the workplace (correct)
  • To protect the environment from insurance practices
  • To enhance the efficiency of the claims process
  • To increase profitability for insurance companies

Which role is primarily responsible for assessing the risks posed by potential clients?

  • Claims personnel
  • Insurance sales representative
  • Underwriter (correct)
  • Loss control specialist

Which ethical principle is crucial for decision-making in the insurance industry?

<p>Adherence to fiduciary duties (C)</p> Signup and view all the answers

What is a common method used to investigate suspected insurance fraud?

<p>Gathering evidence from social media (A)</p> Signup and view all the answers

What is the first step in the risk management model?

<p>Identify hazards (C)</p> Signup and view all the answers

Which step is NOT part of the enterprise risk management (ERM) model?

<p>Choose control measures (C)</p> Signup and view all the answers

What is a key benefit of creating a risk management program?

<p>It creates valid risk forecasts (D)</p> Signup and view all the answers

What is the primary purpose of risk mapping?

<p>To visualize risks and their impacts (A)</p> Signup and view all the answers

Which type of insurance specifically addresses income loss due to illness or disability?

<p>Disability insurance (C)</p> Signup and view all the answers

What do deductibles in an insurance policy represent?

<p>The initial share of the loss paid by the insured (B)</p> Signup and view all the answers

Which of the following is NOT a feature of permanent insurance?

<p>Renewable annually without evidence of insurability (D)</p> Signup and view all the answers

What is the purpose of long-term care insurance?

<p>To provide care for individuals with chronic illnesses or disabilities (C)</p> Signup and view all the answers

Flashcards

Risk Management Model Components

A structured approach to managing risks, involving identifying hazards, assessing their likelihood and impact, selecting control measures, implementing those controls, and monitoring/reviewing the results.

Enterprise Risk Management (ERM)

A company-wide approach to risk management that considers all potential risks, aiming to align risk-taking with business goals.

Risk Forecasting

Predicting the likelihood and potential impact of future risks to an organization.

Risk Mapping & Profiling

Visually representing potential risks based on their likelihood and impact, allowing a better understanding.

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Cost of Risk

The financial burden associated with risk, including losses, expenses for prevention, and potential settlements.

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Risk Control Tactics

Methods for dealing with risks, such as prevention, reduction, enablement, and enhancement, to minimize losses and maximize opportunities.

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Auto Insurance Coverages

Different types of protection for auto owners in case of accidents or damage to their vehicles.

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Health Insurance Analysis

Considering various needs for health insurance (illness, disability, etc.) and assessing how insurance plays in one's financial plan.

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Insurance contract negotiation

The process of discussing and agreeing on the terms of an insurance policy.

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Insurance fraud investigation

The process of examining suspected insurance fraud to determine if a claim is legitimate or fraudulent.

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Risk aversion in insurance pricing

The tendency for insurance companies to account for potential losses and undesirable risks when setting insurance premiums.

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Insurance claims processing

The procedure for handling a claim made by an insured party

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Fiduciary duty of care

The ethical obligation to act in the best interest of the client, demonstrating competency and due diligence.

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Study Notes

Risk Management

  • Models: Learn the risk management model (hazard identification, risk assessment/prioritization, control selection/implementation, monitoring/review) and the Enterprise Risk Management (ERM) model (goal setting, risk identification, evaluation, treatment, monitoring/review, communication)
  • Adaptability: Adapt models to suit organizational needs.
  • Value Creation: Understand how risk can create value.
  • Risk Program Creation: Learn the process of developing a risk program.
  • Forecasting: Create accurate risk forecasts.
  • Mapping & Profiling: Master risk mapping and profiling techniques.
  • Cost of Risk: Calculate the cost of risk.
  • Control Theories: Apply risk control theories (prevention, reduction, enablement, enhancement).
  • Emergency Planning: Develop emergency response and business continuity plans.
  • Retention & Financing: Understand risk retention and risk financing transfer plans.
  • Reporting: Prepare risk management reports.
  • Legal Aspects: Learn the legal components of the risk management industry.
  • Insurance Recommendations (Young Adults): Know recommended insurance options for young adults.

Property and Liability Insurance

  • Auto Insurance Coverage: Differentiate between different types of auto insurance coverage.
  • Premium Factors: Identify factors increasing or decreasing auto insurance premiums.
  • Minimum/Recommended Coverage: Know minimum and recommended auto insurance coverage amounts in your jurisdiction.
  • Claims Calculation: Calculate claim amounts, considering exclusions and deductibles.
  • Cost Comparison: Compare auto insurance costs with different deductibles and liability limits.
  • Renter's Insurance: Understand renter's insurance benefits.
  • Workers' Compensation: Learn about worker's compensation benefits and payment methods.

Health, Disability, and Life Insurance

  • Insurance Needs: Analyze situations necessitating health, disability, and life insurance.
  • Government Assistance: Identify government programs providing financial assistance due to illness, disability, or premature death (e.g., Social Security).
  • Insurance Sources: Compare various health and disability insurance sources.
  • Long-Term Care Insurance: Understand the purpose and function of long-term care insurance.
  • Financial Planning: Build basic financial plans accounting for benefits and changes over time.

Insurance Knowledge

  • Policy Types & Features: Recognize basic policy types and features.
  • Life Insurance Underwriting: Understand how life insurance companies assess risk.
  • Insurance Types: Define term and permanent insurance.
  • Contract Provisions & Claims: Understand contract provisions, legal doctrines, and claims management.
  • Portfolios & Coverage: Create insurance portfolios and place coverage effectively.
  • Global Markets: Be knowledgeable about global insurance markets.
  • Pricing, Risk, and Regulation: Understand the significance of pricing, risk aversion, and regulations in the insurance industry.
  • Contracts: Negotiate, write, and renew insurance contracts.
  • Regulatory Compliance: Ensure compliance with industry regulations.
  • Legal Concepts: Understand legal concepts in the insurance industry.
  • Insurance Products and Benefits: Describe insurance products and their advantages.
  • Insurance Fraud: Understand the nature and investigation of insurance fraud.
  • Claims Processing: Process claims to meet legal obligations.
  • Compliance Laws: Ensure regulatory compliance with EPA, OSHA, NFPA, ERISA, and COBRA.
  • Business Cycle: Understand the insurance business cycle (agent, underwriter, claims, settlement).

Decision Making

  • Problem Analysis & Global Decisions: Analyze problems and make decisions acknowledging the global context.
  • Benchmarking: Utilize benchmarking to compare data.
  • Risk Optimization: Learn methods to optimize risk-taking decisions within an organization (ERM).
  • Client Risk Analysis: Analyze potential clients' risks for insurance approval/denial decisions.
  • Ethical Decision-Making: Demonstrate ethical decision-making conforming to fiduciary duties (competency and due diligence).

Ethics

  • Confidentiality Agreements: Understand and implement confidentiality agreements.
  • Data Security: Establish data security measures for confidential records.
  • Privacy & Disclosure: Recognize state and federal regulations regarding privacy violations and public disclosure.

Careers

  • Insurance Industry Jobs: Identify various jobs in the insurance industry.
  • Industry Organizations: Recognize industry organizations.
  • Essential Skills: Define essential knowledge and skills for an insurance career path.
  • Roles & Responsibilities: Describe roles (underwriter, sales rep, actuary, claims, loss control).
  • Licensing & Certifications: Describe insurance licensing and certification programs.

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