CAIB 1 - Chapter 1
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Questions and Answers

What is the definition of risk?

The chance of financial loss that an object of insurance is exposed to.

What are the two types of risk?

  • Pure Risk (correct)
  • Speculative Risk (correct)
  • Which of the following is NOT a good way to deal with risk?

  • Control
  • Transfer
  • Avoidance (correct)
  • Retention
  • Insurance is a type of contract.

    <p>True</p> Signup and view all the answers

    What is the definition of a contract?

    <p>An agreement between two or more persons creating an obligation to do or not do something.</p> Signup and view all the answers

    How many elements are required for a contract to be enforceable?

    <p>5</p> Signup and view all the answers

    According to the Insurance Act, when must an applicant return a policy?

    <p>An applicant must know that if they do not promptly return the policy to the insurer, it is possible that courts might rule that they have accepted the policy.</p> Signup and view all the answers

    If there is no insurable interest in the subject matter of the contract, then it is enforceable.

    <p>False</p> Signup and view all the answers

    How does the government ensure the financial stability and solvency of insurance companies?

    <p>The government ensures financial stability and solvency by granting licenses to insurers who meet certain financial standards and continuously monitoring their financial strength and stability through ongoing audits and annual reports.</p> Signup and view all the answers

    What does the Insurance Act mandate about coverage in a fire insurance policy?

    <p>The Insurance Act in each province requires that fire insurance policies must include certain basic coverages, standard exclusions, statutory conditions, and other legislated requirements.</p> Signup and view all the answers

    How do standard exclusions work?

    <p>Standard exclusions remove coverage for specific types of losses that are considered uninsurable or covered by specialized coverages.</p> Signup and view all the answers

    What are the 15 Statutory Conditions applied to contracts?

    <p>The 15 Statutory Conditions are a set of legal provisions that outline the rights, responsibilities, and procedures involved in insurance contracts. They cover various aspects, including misrepresentation, property of others, change of interest, material change, termination, requirements after loss, fraud, who may give notice/proof, salvage, entry/control/abandonment, disagreement of value, when loss is payable, replacement, action, notice, and general conditions.</p> Signup and view all the answers

    What is the difference between "honest mistake" and "fraud"?

    <p>An honest mistake is a genuine error, while fraud is a deliberate attempt to deceive for personal gain.</p> Signup and view all the answers

    What is the purpose of the Material Change Condition?

    <p>The Material Change Condition aims to address any changes in the risk or control of the insured property that occur after the policy is issued and increase the chance of loss.</p> Signup and view all the answers

    What are the ways a contract can be terminated?

    <p>Contracts can be terminated by either the insurer or the insured. The insurer can terminate the contract by providing a certain amount of notice, either registered mail or personally delivered, or the insured can terminate the contract at any time, with no reason required.</p> Signup and view all the answers

    What is the purpose of the "Salvage" Condition?

    <p>The &quot;Salvage&quot; Condition encourages the insured to take reasonable steps to prevent further damage to the damaged property and minimize potential losses, which can help reduce the insurer's overall financial payout.</p> Signup and view all the answers

    What are the main features of "The Appraisal Process" for settling disputes about property value?

    <p>The Appraisal Process involves both insured and insurer each selecting an appraiser to assess the property value, with the final decision resting with the umpire, who is chosen by the two appraisers. Both parties must pay their respective appraiser's fees, with costs shared equally.</p> Signup and view all the answers

    What are the two main types of distribution systems used by insurance companies in Canada?

    <p>Direct Writing System</p> Signup and view all the answers

    The Independent Agency/Brokerage System has no control over the pricing or product selection of insurance policies offered.

    <p>False</p> Signup and view all the answers

    What is the main characteristic of the Direct Writing System?

    <p>The Direct Writing System is characterized by having producers who are employees of the insurer, working exclusively with the insurer's products.</p> Signup and view all the answers

    What are some prominent examples of Direct Writers in Canada?

    <p>Some prominent examples of direct writers in Canada include Co-operators General Insurance Company, Federated Insurance Company of Canada, Prudential of American General Insurance Co. (Canada), and State Farm.</p> Signup and view all the answers

    The Direct Writing System allows producers to sell products for other insurance companies.

    <p>False</p> Signup and view all the answers

    What are the key roles of the Insurance Bureau of Canada (IBC)?

    <p>The Insurance Bureau of Canada (IBC) plays a vital role in collecting insurance statistics, providing actuarial analysis for members, drafting policy forms, managing inter-company agreements, monitoring legislation, and working closely with government agencies to develop insurance legislation. The organization also focuses on providing consumer information, promoting loss prevention, and operating a consumer phone-in service across Canada.</p> Signup and view all the answers

    What is the purpose of the "No Benefit to Bailee" Condition?

    <p>The &quot;No Benefit to Bailee&quot; condition clarifies that insurance policies are designed to protect the interests of the insured, not any parties who may be holding or transporting the insured property for other purposes, like a carrier or bailee.</p> Signup and view all the answers

    Describe the "Pair and Set" Condition.

    <p>The &quot;Pair and Set&quot; condition states that if a part of a set or a paired item is lost or damaged, the insurer is only liable for a reasonable and fair share of the total value of the set, not the entire value, acknowledging that the remaining part still holds value.</p> Signup and view all the answers

    What is a "Deductible" in insurance policies?

    <p>A deductible is an amount that the insured must pay out-of-pocket for each covered loss before receiving any reimbursement from the insurer.</p> Signup and view all the answers

    The "Co-Insurance" clause is a standard feature of all insurance policies.

    <p>False</p> Signup and view all the answers

    Explain the "Removal Coverage" condition in insurance policies and its purpose.

    <p>The &quot;Removal Coverage&quot; condition extends coverage to insured property that is removed from its designated location on the policy, primarily for the purpose of preventing further loss or damage. This includes the insured property being moved to a different location, but the insured must notify the insurer if the property is moved for this purpose and exceed seven days.</p> Signup and view all the answers

    What is the purpose of "Subrogation" in insurance, and how does it work?

    <p>To recover losses from parties responsible for the loss</p> Signup and view all the answers

    An insurer can change a term or condition in a contract without written authorization, especially if it benefits the insured.

    <p>False</p> Signup and view all the answers

    What are the general requirements for "Notice" in insurance contracts?

    <p>Notice in insurance contracts typically involves providing written communication, either delivered personally or sent via registered mail, to the insurer's designated office or the insured's last known address. This could involve situations like policy terminations, appraisal requests, or legal actions against the insurer.</p> Signup and view all the answers

    The "Notice" condition requires all correspondence between the insured and the insurer to be sent via registered mail.

    <p>False</p> Signup and view all the answers

    What is the core purpose of the 15 Statutory Conditions as it relates to insurance policies?

    <p>The 15 Statutory Conditions aim to standardize the procedures and legal frameworks for insurance contracts, ensuring fairness, transparency, and clarity in both the responsibilities of the insurer and the insured's rights.</p> Signup and view all the answers

    What are the two main types of private insurers categorized by their ownership and profit motive?

    <p>The two main types of private insurers are proprietary insurers, which focus on generating a profit, and non-proprietary insurers, which operate on a non-profit basis.</p> Signup and view all the answers

    Study Notes

    ENSURE Training & Education

    • ENSURE is a training and education company.

    CAB 1 General Insurance

    • CAB 1 is a general insurance training program.

    Attendance Poll

    • Students are polled to check facilitator and slide visibility.

    Ensure Training & Education Walkthrough

    • This is a walkthrough of ENSURE training and education.

    The Forgetting Curve

    • Hermann Ebbinghaus identified the forgetting curve, the loss of learned information.
    • The forgetting curve is studied as a way to understand how memory works.

    How do we forget?

    • A graph shows the rate of forgetting over various time periods.
    • The graph demonstrates that forgetting, especially without review, is rapid in the first few hours of learning. Retention goes rapidly down when there is no review; however, review after every phase of learning helps to remember more.

    Overcoming the Curve

    • A graph shows that review sessions help to reduce forgetting. The more review, the lower the amount lost over time, which is evident in the graph.

    What can I do?

    • Students are responsible for their learning and should study the textbook continuously.
    • Consistent review throughout the week is recommended.
    • The forgetting curve is a consideration when planning exam schedules

    Course Expectations

    • Students have two minutes to state expectations for the course in the chat window.

    The Past Mistakes and Successes

    • Students have two minutes to record past studying habits and what hasn't worked for them in the chat window.

    Chapter 1: Intro to General Insurance

    • This chapter introduces general insurance.
    • Section 1: Insurance - A Means of Managing Risk
    • Section 2: The Role of Government in the Insurance Industry
    • Section 3: Distribution of Insurance

    Section 1: Insurance: A Means of Managing Risk

    • Risk is categorized into personal, property, and liability.
    • Personal risk deals with the value of people as assets.
    • Property risk deals with the potential for loss of property.
    • Liability risk relates to the responsibilities for negligent actions.

    Definition of Risk

    • Risk is the potential for financial loss that an insurance object is exposed to.

    How To Deal with Risk

      1. Avoidance of Risk: A poor way to deal with risk, since exposure may translate to another risk.
      1. Controlling of Risk: taking steps to reduce frequency/severity of loss. Ex. installing intrusion detection systems.
      1. Retention of Risk: the corporation/business taking on the financial responsibility to cover losses (ex. railroads)

    Definition of Avoidance

    • Avoidance eliminates any chance for financial loss.

    How To Deal With Risk Cont'd

      1. Controlling of Risk: This includes taking steps to lessen the chance/severity of loss (e.g. intrusion detection systems). Controlling risk also includes a certain amount of loss the business or person cannot control.
      1. Retention of Risk: Large corporations/businesses (e.g., railroads/federal gov't) can afford to cover their losses with their own finances (cheaper than insurance). Other people/businesses, often cannot. Some losses are un-insurable, also.

    Definition Insurance

    • Insurance is the undertaking from one to indemnify another against risk. This indemnity occurs when a certain event happens.

    How To Deal with Risk Cont'd

      1. Transfer of Risk: The most popular method. Insurers transfer the risk and responsibility of loss for a premium.
    • Types of Risk

      1. Speculative Risk: Chance of financial gain/loss (e.g., investing/gambling). Insurers won't cover this.
    • b) Pure Risk: Chance of financial loss, only.

    Formal Contract

    • Insurance companies agree to take on the risks of others.
    • An agreement between two or more people, creating an obligation to do/not do something.

    5 Elements For Contract To Be Enforceable (By Law)

    1. Agreement
    2. Consideration
    3. Legality of Object
    4. Legal Capacity of the Parties to Contract
    5. Genuine Intention

    5 Elements For Contract To Be Enforceable (By Law) - Agreement

    · Prove a proper agreement is reached. · Offer is made · Unequivocal/unconditional acceptance of the offer.

    5 Elements For Contract To Be Enforceable (By Law) - Consideration

    · Exchanging something of value. · Return promise, Act performed, Agreement not to act. · Consideration from insured or consideration from insurer.

    5 Elements For Contract To Be Enforceable (By Law) - Legality of Object

    · A contract that goes against public policy is not enforceable (by law). · Ex. Deliberate killing/maiming, importing drugs, dealing with illegally acquired property or payment for fraudulent claims. Court will rule against trying to enforce these type of contracts

    ·Law enforces contracts of parties recognized as having a legal capacity to contract. ·Incompetents (parties unable to contract). ·Incompetents include minors. ■ Exception: right to contract for life's necessities (food, clothing, lodging) ■ Some contracts the law cannot enforce (minor buying stereo)

    5 Elements For Contract To Be Enforceable (By Law) - Genuine Intention

    ·Enforceable contract: parties intended to enter contract. Must not be affected by fraud.

    15 Statutory Conditions Applied To Contracts- Misrepresentation

    ·Applicant falsely describes property/misrepresents/omits info to prejudice the insurer (contract is void). ·Law requires a proper description. The law assumes insured's knows construction details of the property. An "honest mistake" is not an excuse.

    15 Statutory Conditions Applied To Contracts- Misrepresentation of a material fact

    ·Example of material fact: Details of previous claims, details of prior cancellations or refusals, details of existing property protection systems. ·Law requires all representations must be truthful, and insureds can't fraudulently/knowingly/deliberately deceive/omit or deliberately withhold information.

    15 Statutory Conditions Applied To Contracts- Effect of Misrepresentation

    ·Onus (duty) to prove misrepresentation (if a claim) falls on the insurer (for voiding the policy). Insurer's right: may void policy if misrepresentation is directly linked to the loss. Ex. Insured says their property is heated by electric heat when it's not; the insurer may void the policy

    15 Statutory Conditions Applied To Contracts- Property of Others

    ·Insurers are not liable for loss or damages to property owned by others than the insured, unless stated in the contract.

    15 Statutory Conditions Applied To Contracts- Change of Interest

    ·Insurer: liable for loss or damage after authorized assignment under Bankruptcy Act/change of title. ·Parties to contract may benefit from transfers (e.g., bankruptcy).

    15 Statutory Conditions Applied To Contracts- Material Change

    ·ANY change affecting risk/control.

    • When the insured is made aware of a change, the insurer/local agents must be immediately notified in writing.
    • The insurer can return the unearned portion of any premium and cancel the contract, or inform the insured of the additional premium if the contract continues.

    15 Statutory Conditions Applied To Contracts- Requirements After Loss

    ·Insured must document ALL claims, including a proof of loss form. ·Prove, using documented evidence that the insured property was damaged. ·Insureds may have to provide details (with proof) on how the loss occurred; including an inventory of property and its condition at the time of loss. · Insureds need to notify all applicable parties and provide evidence of any other policies.

    15 Statutory Conditions Applied To Contracts- Filing a Proof of Loss

    • Help verify claimed property hasn't had significant changes since the policy.
    • Any new information may impact coverage for losses
    • Show the location of property at the time of loss.
    • Inventory of undamaged property with qualities and costs (with their actual cash value)

    15 Statutory Conditions Applied To Contracts- Fraud

    • Deliberately trying to deceive to secure a profit.
    • Purpose: to protect the insurer from paying fraudulent insurance claims.
    • Must prove deliberate deception to profit from a situation.

    15 Statutory Conditions Applied To Contracts- Who may give notice/proof

    ·Insurance is absent or unable to give notice.

    • Agent of insured can make this notice. If insured refuses to give notice, the person insurance money is payable to can do so.

    15 Statutory Conditions Applied To Contracts - Salvage

    • Insured must take reasonable steps to prevent further/additional damage, and prevent further damage to other property

    15 Statutory Conditions Applied To Contracts - Entry/Control/Abandonment

    ·Insurer has the right to enter and access the property (with accredited agents) to survey for the determination of loss/damage to the property. ·Insurer can't control or have possession of insured property without their consent. The insured can't abandon the property without consents.

    15 Statutory Conditions Applied To Contracts - Disagreement of value

    • If there's a disagreement on the value of the property/property that was saved or amount of loss, it can be settled (in written demand) with an independent appraisal in accordance for loss calculation) · Steps for resolving disagreements over value via an appraisal.

    15 Statutory Conditions Applied To Contracts - When Loss is Payable

    ·Claims (under contract) must be settled within 60 days of claim being verified (proof of loss).

    15 Statutory Conditions Applied To Contracts - Termination

    • A contract is terminated when the insurer gives 15 days termination notice (registered mail) OR 5 days written notice. (personally given).
    • An insured can terminate at any time, as needed or requested, with or without a reason.
    • The insurer can terminate for non-payment of premium.
    • Short rate premium NEVER less than min retained premium (specified).

    Section 2: Gov'ts Role in Insurance Industry

    • The general insurance industry is regulated by federal and provincial statutes.
    • The intent is to ensure insurance companies are financially competent.
    • Insurers must ensure a portion of any premium paid is available to pay future claims.
    • Insurance acts only operate from premiums earned within a time period.

    Role of Federal Government

    • Federal licensing: only companies meeting financial standards are regulated.
    • When a license is granted the insurer is continuously monitored to ensure solvency and financial stability.

    Role of Provincial Gov't

    • The superintendent of insurance administers the Insurance Act.
    • Main responsibilities include supervising contracts, terms, and conditions, as well as the licensing of insurers, agents, and brokers.
    • The provincial bodies are responsible for supervising the financial stability of companies operating under provincial charters.

    Monitoring Financial Strength/Stability

    • Means to audit ongoing financial strength and stability of licensed insurers.
    • Superintendents verify that insurers can meet future losses before granting licenses
    • The federal gov't performs annual audits to verify ongoing financial strength and stability.

    Insolvency - Insurance Industry Solution

    • Before 1992, insurers had to make large deposits to the federal government.
    • The deposits acted as a reserve to protect consumers if the insurer became insolvent.
    • The Insurance Companies Act of 1992 eliminated deposit requirements.

    Insolvency - Insurance Industry Solution

    • If there is a bankruptcy, the administrative body (PACICC) may pay the claims.
    • This organization assesses insurance companies for contributions required (via their total direct premiums) to cover the claims.

    License Authority

    • Insurance companies must have a license to write business in the province.
    • Classes of insurance written must be allowed under the provincial license

    Regulation of Insurance Contracts

    • Insurance licensing and operations are provincially controlled. Different provinces can have variations regarding types and methods of policies.
    • Policies can vary between provinces regarding how uniform they are.

    Friendly Fire

    • Fire contained in an appropriate receptacle

    Hostile Fire

    • Fire that passes outside the limits assigned, e.g. sparking from fireplace to a rug

    15 Statutory Conditions Applied To Contracts - Definitions

    • Definitions for terms in the section.

    Additional Conditions

    · Addresses what isn't addressed by Statutory Conditions for fire.

    • Notifies authorities of known losses/damage from malicious acts/theft/etc.
    • Insured notifies police of any loss/damage from criminal acts.
    • Provides better chances of recovering lost items

    Additional Conditions

    • Sue and Labour- duty of insurer and insured if property is lost or must be recovered
    • No Benefit to Bailee- insurance will not directly benefit from someone that is entrusted with insuring a property loss. The carrier/bailee cannot benefit

    Additional Conditions- Pair and Set

    • The damage to one item of a set, applies equally to any items damaged or lost.

    Additional Conditions - Parts

    • Damage to parts of property is limited to the damaged part
    • Contents of insurance policies are legislated. Six items are required on every policy
      1. Parties to the contract
      1. Policy period
      1. Loss payable or payee.
      1. Type(s) of coverage.
      1. Rate/premium.
      1. Subject matter of insurance.
    • Policy provisions that have to do with payment and covering losses suffered that need compensation
    • Removal coverage from property insurance, is legislated because of the potential for loss when the property is moved to another location.

    · Policies do not cover the total loss of an item, only a portion proportionate to the deductible and insurable interest of either the insurer or insured, depending on the claim

    • Insurance Acts: no contract's term/condition is waived by the insurer unless the waiver is written/signed by an authorized person. Changes must occur in writing as well.
    • Insurance company underwriters have the authority to change terms/conditions, if they decide to. THIS acceptance is for risks (on insurer’s behalf)
    • Insurance acts says when policies are delivered (not paid for) will bind insurer to the policy, as if the premium were paid.

    Section 3: Distribution of Insurance

    • Two major types of insurers: Private, and Government · Private Insurers: Proprietary or non-proprietary. · Government Insurers: Some provinces (Saskatchewan/Manitoba) may have private or business property insured by the government.

    Two Types of Distribution Systems

      1. Independent Agency/Brokerage System: 7,000+ independent agencies in Canada (majority), 80%+ of property/casualty insurance sold this way.
      1. Direct Writing System: this is an independent system within the direct writing system. Many large firms in Canada utilize this system.

    Features of Agency/Brokerage System

    • Compensation, status with insurer, expiration/ownership by producer, producer services, and other features.

    Important Insurer Associations/Organizers

    • National/provincial brokers' associations, Voluntary organizations, represent brokers, interests.
    • Industry associations/orgs and other services. · Insurance Bureau of Canada (for other services, collecting insurance stats, and industry knowledge, etc.).
    • Insurer’s Advisory Organization (providing risk inspection and advisory rating to insurers).
    • Insurance Crime Prevention Bureau (to help investigate and prosecute insurance crime).

    One-Minute Review

    • Students have two minutes to summarize the most important thing they learned.

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