2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔Franchise Deductible - ✔✔Requires insurer pay for an entire loss if the loss exceeds
a certain dollar amount. Used with disability income policies and long term care.
✔✔Elimination Period Deductible - ✔✔Used with disability income policies and long -
term care.
✔✔Indemnity - ✔✔Restoring insured to same financial position they were in before loss.
Common exceptions include replacement cost (full value w/o depreciation), Valued
policy (face amount of total loss regardless of actual cash value) and Pro-ratability
(insurer will pay proportional share of the loss.)
✔✔Primary and Excess Indemnity - ✔✔Primary insurer pays first, then once exhausted
the excess insurer pays.
✔✔Coordination fo Benefits - ✔✔When more than one group health insurance policy
covers the same loss.
✔✔Subrogation - ✔✔Gives the insurer the right to collect from a negligent 3rd party
after taking a loss payment to insurer. (prevents from collecting twice)
✔✔Representation - ✔✔Statements made on application that are entirely true
✔✔Misrepresentation - ✔✔Incorrect statements in application that don't affect
insurability.
✔✔Material Misrepresentation - ✔✔Incorrect statements in application that affects
insurability
✔✔Fraud - ✔✔Intentionally hiding information
✔✔Warranty - ✔✔Statements that must be true at the time of loss, not obligated to pay
claim is breached`
✔✔Consideration - ✔✔Exchange of value between two parties in the contract. Insurer
promises to provide indemnity in event of loss, insured promises to pay premiums and
have truthful representations.
✔✔Unilateral Contract - ✔✔Only one party makes a legally enforceable promise.
✔✔Contract of Adhesion - ✔✔Insured must accept contract as is.
, ✔✔Aleatory Contract - ✔✔An unequal value is exchanged between the parties.
✔✔Conditional Contract - ✔✔Contract may be voided if polity conditions aren't met.
✔✔Property and Casualty Declarations - ✔✔-Period coverage
-Policy limits
-Premium
✔✔Life and Health Declarations - ✔✔-Parties of contract
-Policy limit
-Age of unaired at issuance date.
✔✔Insuring agreement - ✔✔Named Peril: Policy only overs specifically listed perils
Open Peril: Policies cover all losses except those listed
✔✔Conditions - ✔✔Duties and responsibilities of the insured and insurer
✔✔Endorsements - ✔✔Modifications to a property or casualty policy must be in writing
& are attached to the insurance
✔✔Riders - ✔✔Modifications to life and health policy that must be in writing and
attached to the policy.
✔✔Mutual Insurers - ✔✔-Nonprofit
-Owned by policy holders
-Managed by board of directors
-Par
-not assessable
✔✔Stock insurers - ✔✔-For profit
-owned by shareholders
-sell non par
-non assessable
✔✔The Commissioner has the following powers... - ✔✔- Conduct and investigation
- Examine documents and records of entity activities w/o court order
- Publish information
- Require Reports
✔✔Who must be licensed? - ✔✔- Producers
- Insurance companies
- Managing general agent