and CORRECT Answers
How long does an insurance company have to pay a mine subsidence claim? - CORRECT
ANSWER - 120 days after receiving proof of loss
If a black lung employee dies, how long does family have to enter a claim? - CORRECT
ANSWER - 2 years
What is the "value policy law" with regard to insurance? - CORRECT ANSWER - Maximum
payout = policy limit - deductible.
HAVE to pay out the policy limit in the event of a total loss (even if it's not worth it).
What are some features of the Standard Fire Policy under the FAIR Plan? - CORRECT
ANSWER - It's limited to actual property listed (named perils)
Applies only to the location
If property has to be moved to avoid damage, it's auto-covered for 5 days (removal from
premises)
If proximate cause is a named peril then coverage exists
How many days does the insurance company have to give information to an attorney? -
CORRECT ANSWER - 30 calendar days, or max fine of $500
What is a "producer" with regard to insurance? - CORRECT ANSWER - One licensed to sell
property & casualty insurance in WV
What is the purpose of the FAIR plan? - CORRECT ANSWER - To provide insurance to
people not able to get it from the open market
What are some features of the FAIR Plan? - CORRECT ANSWER - All have a standard fire
policy
,Property is physically inspected
Policy term is 1 year
Only perils are fire, lighting, riot, explosion, vehicle smoke, hail, aircraft, wind
Personal max of $200K
Commercial max of $500K
Principle & separation of claims - CORRECT ANSWER - If one part of the claim is not in
dispute, those parts must be paid
Rebating - CORRECT ANSWER - An unfair claims practice in which an agent shares
commission with the buy, or offers a gift
Misrepresentation - CORRECT ANSWER - an unfair claims practice in which an agent
misrepresents the benefit, advantages, or conditions of an insurance policy
What is "representation" with regard to insurance? - CORRECT ANSWER - The stated
condition of the property, per the insured
What is "concealment" with regard to insurance? - CORRECT ANSWER - Lying about the
condition of the property
How much time can pass before an employee can notify an employer of an injury? - CORRECT
ANSWER - Written notice immediately
They must file a claim within 5 days
Can part of a workers comp award be withheld?
If so, for how long? - CORRECT ANSWER - Yes; 77 days with no objection
What is the WV guaranty for? - CORRECT ANSWER - To make payments for insolvent
companies
, Denials and settlements must include what two things? - CORRECT ANSWER - Facts of loss
Policy provisions, exclusions that apply & how they apply to the loss
Standard Fire Policy (SFP) will cover the smallest amount of these - CORRECT ANSWER -
Amount specified on the policy
ACV of property
Amount to repair/replace
Amount of insureds interest
How many days does a policy holder have to file a UMPD claim? - CORRECT ANSWER -
60 days
How many days do you have to send a delay of claim letter? - CORRECT ANSWER - 1st
letter must be sent within between 30-45 calendar days, then every 45 days after that
Insurers must send written notification of a claim within _____ days, unless payment is made
within ______ days OR initial contact note is needed - CORRECT ANSWER - 15
What is the WV comparative negligence doctrine? - CORRECT ANSWER - 49%
comparative
The insurance commissioner can suspend an adjusters license or issue a penalty of up to 1K if -
CORRECT ANSWER - adjuster is not acting within the code of conduct
adjuster participates in a bad faith claim
Under what conditions can the commissioner revoke an insurance company's right to sell
insurance in WV? - CORRECT ANSWER - The company does not pay premium to the WV
Guaranty OR
The commissioner realizes the company is insolvent