Define moral hazard and morale hazard.
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-Moral hazard - arising from nature of insured. Increased carelessness,
incompetence, recklessness etc.
-Morale hazard - Insured's attitude towards his own belongings. They no
longer care about their possessions because they're insured.
,Where are "planned" accidents usually staged?
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anywhere but most likely to occur in a public place, such as a mall,
restaurant, store or supermarket
What are the two requirements of a waiver under a policy?
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Clearly expressed and in writing
List seven questions that may be asked of claimants
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-What was the claimant doing at the time?
-Why was claimant there?
-Did claimant usually take part in activity that led to them being there on
that day?
-How does claimant describe what happened directly after the event?
-What was it that specifically caused injury?
-What part of claimant's body affected?
-Are physical characteristics associated with the event precisely described
by claimant: weather, lighting
List and describe three falsification techniques in Underwriting
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-fronting - parent claiming they are primary driver when it's their kid
-garage flipping - changing address where vehicle is most used
-manipulation - changing rating factors, such as miles driven
Describe how material changes are addressed in common law provinces versus the
civil code of Quebec.
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-Common law: contract may be void as to the part of it affected by the
change
-Quebec: Contracts could be null (not void)
Define aggravated Damages. Give a case law example and a point on it.
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-damages designed to compensate the plaintiff for suffering intangible
damages such as humiliation and distress as a result of the defendant's
actions
-In Warrington v. Great-West Life Assurance Co. the court awarded $10,000
for mental distress
-insurer failed to act in good faith despite receiving reports showing
plaintiff was disabled
Name the following organizations: IBC, ISD, IIC, ACFE, CAFI, IAATI
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, -Insurance Bureau of Canada
-Investigative Services Division
-Insurance Institute of Canada
-Association of Certified Fraud Examiners
-Canadian Association of Fire Investigators
-International Association of Auto Theft Investigators
What is malingering
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The intentional feigning of mental or physical injury to gain insurance
money or to avoid returning to work
List and describe the three basic elements required to qualify an event as insurance
fraud?
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-Act or omission (false or exaggerated statements)
-With a view to (Mens rea - fraudulent intent)
-Illegal benefit (payment of a claim which wouldn't have been paid without
deception)
Why is it important to remove stock involved in a claim? (2 pts)
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-Moral hazard - arising from nature of insured. Increased carelessness,
incompetence, recklessness etc.
-Morale hazard - Insured's attitude towards his own belongings. They no
longer care about their possessions because they're insured.
,Where are "planned" accidents usually staged?
Give this one a try later!
anywhere but most likely to occur in a public place, such as a mall,
restaurant, store or supermarket
What are the two requirements of a waiver under a policy?
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Clearly expressed and in writing
List seven questions that may be asked of claimants
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-What was the claimant doing at the time?
-Why was claimant there?
-Did claimant usually take part in activity that led to them being there on
that day?
-How does claimant describe what happened directly after the event?
-What was it that specifically caused injury?
-What part of claimant's body affected?
-Are physical characteristics associated with the event precisely described
by claimant: weather, lighting
List and describe three falsification techniques in Underwriting
,Give this one a try later!
-fronting - parent claiming they are primary driver when it's their kid
-garage flipping - changing address where vehicle is most used
-manipulation - changing rating factors, such as miles driven
Describe how material changes are addressed in common law provinces versus the
civil code of Quebec.
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-Common law: contract may be void as to the part of it affected by the
change
-Quebec: Contracts could be null (not void)
Define aggravated Damages. Give a case law example and a point on it.
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-damages designed to compensate the plaintiff for suffering intangible
damages such as humiliation and distress as a result of the defendant's
actions
-In Warrington v. Great-West Life Assurance Co. the court awarded $10,000
for mental distress
-insurer failed to act in good faith despite receiving reports showing
plaintiff was disabled
Name the following organizations: IBC, ISD, IIC, ACFE, CAFI, IAATI
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, -Insurance Bureau of Canada
-Investigative Services Division
-Insurance Institute of Canada
-Association of Certified Fraud Examiners
-Canadian Association of Fire Investigators
-International Association of Auto Theft Investigators
What is malingering
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The intentional feigning of mental or physical injury to gain insurance
money or to avoid returning to work
List and describe the three basic elements required to qualify an event as insurance
fraud?
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-Act or omission (false or exaggerated statements)
-With a view to (Mens rea - fraudulent intent)
-Illegal benefit (payment of a claim which wouldn't have been paid without
deception)
Why is it important to remove stock involved in a claim? (2 pts)
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