ASSESSMENT PAPER INSURANCE CLAIMS
ANALYSIS COMPREHENSIVE QUESTIONS AND
ANSWERS VERIFIED A+
◉ 1. Legal Liability. Answer: legally enforceable obligation of a
person or an organization to pay a sum of money (damages) to
another person or organization
◉ 1. Civil law. Answer: classification of law that applies to legal
matters not governed by criminal law and that protects rights and
provides remedies for breaches of duties owed to others
◉ 1. Criminal Law. Answer: branch of the law that imposes penalties
for wrongs against society
◉ 1. Tort. Answer: A wrongful act or an omission, other than a crime
or a breach of contract that involves a legally protected right.
3 categories: 1)negligence, 2) intentional, 3) strict liability
◉ 1. Strict Liability (absolute). Answer: Liability imposed by a court
or by a statute in the absence of fault when harm results from
,activities or conditions that are extremely dangerous, unnatural,
ultra hazardous, extraordinary, abnormal or inappropriate
◉ 1. Breach of contract. Answer: failure, without legal excuse, to
fulfill a contractual promise
◉ 1. Statute. Answer: written law passed by a legislative body, at
either the federal or state level
◉ 1. Common-law system. Answer: legal system in which the body of
law is derived more from court decisions as opposed to statutes or
constitutions
◉ 1. Tort Law. Answer: the branch of civil law that deals with civil
wrongs other than breaches of contract
◉ 1. Statutory Law. Answer: formal laws or statutes enacted by
federal, state or local legislative bodies
◉ 1. tort - 4 elements. Answer: 1. wrongful invasion(breach), 2. of a
legally protected right (duty), 3. resulting in(caused) 4. proximate or
direct damages(damage)
◉ 1. warranty. Answer: a promise made by a seller about its product
,◉ 2. Premise and Operations Liability. Answer: liability for Bodily
Injury and Property Damage caused by: (1) an accident occurring on
the premise owned, leased, rented, (premise liability) (2) an
accident away from the premise caused by the person/organizations
ongoing operations (operations liability)
◉ 2. Products and Completed Operations Liability. Answer: the legal
responsibility of the manufacturer, distributor, and or retailer of a
product to the product customer (1) the product was defective when
it left (2) the defect made the product unreasonably dangerous (3)
the product was the proximate cause of the injury Completed
operations: liability arising out of completed work.
◉ 2. Auto liability. Answer: liability for BI and PD arising from the
ownership, maintenance, or use of autos (but not mobile
equipment)
◉ 2. Negligent entrustment. Answer: loaning a vehicle to someone
who is not fit to drive.
◉ 2. No-fault laws. Answer: provide benefits to injured persons
without the need to prove fault
, ◉ 2. Avoidance, Loss prevention, loss reduction, separation. Answer:
4 risk control techniques
◉ 2. Root causes. Answer: real causes of accidents, rather than
symptoms
◉ 2. Commercial General Liability Coverage Form (CGL). Answer:
coverage form commonly used for insuring an organizations
premises and operations liability loss exposures and
products/completed operations liability loss exposure
◉ 2. Bodily Injury. Answer: Physical Injury to a person, including
sickness disease and death
◉ 2. Contractual Liability Coverage. Answer: coverage for liability
that the insured has assumed under contract
◉ 2. Amendment of Insured Contract Definition Endorsement.
Answer: the endorsement that modifies the CGL form so that
subpart f. of the insured contract definition will not include bodily
injury or property damage caused solely by an indemnitee of the
named insured
◉ 2. Host Liquor Liability. Answer: Coverage for a person or an
organization that serves alcoholic beverages to others, but is not in