RMIN 4000 UGA Edmunds Exam 4

tort

Legal wrong for which the court allows a remedy in the form of monetary damages

categories of tort

intentional, strict liability, and negligence

intentional torts

Intentional act or omission resulting in harm or injury to another person or damage to their property

examples of intentional tort

libel, slander, invasion of privacy, assault, patent infringements

strict liability

Liability imposed regardless of negligence or fault (damage from animals, hazardous activities)

negligence tort

Failure to exercise the standard of care required by law to protect others from an unreasonable risk of harm

standard of care

not the same for each wrongful act; based on the care required by a reasonably prudent person

elements of negligence

existence of a legal duty owed, breach of legal duty, damage or injury, and proximate cause between act and damage

compensatory damages

compensate the injured party for the harm suffered (special and general)

special damages

lost work earnings, medical bills, property repair costs

general damages

Loss of a companion, disfigurement, pain and suffering

contributory negligence

Injured person cannot collect if their care falls below the standard of care required for their protection or they are 1% responsible

comparative negligence

Financial burden of injury is shared by both parties according to respective degrees of fault

pure rule

reward is reduced in proportion to your fault

last clear chance rule

Plaintiff who is endangered by his or her own negligence can still recover damages from the defendant if the defendant has a last clear chance to avoid the accident but fails to do so (car crash)

assumption of risk

A person who understands and recognizes the danger inherent in a particular activity cannot recover damages in the event of an injury (foul ball at game)

imputed negligence

under certain conditions, the negligence of one person can be attributed to another person or organization (liquor bar liable for drunk customer's harm)

requirements of res ipsa loquitur

does not normally occur in absence of negligence, defendant has exclusive control over the instrumentality causing the accident, and injured party has not contributed to the accident

licensee

one who enters or remains on property with permission. Owner required to warn them of any unsafe conditions

invitee

one that is invited onto premises for benefit of occupant. owner has obligation to inspect premises and eliminate any dangerous conditions

respondeat superior

employer held liable for negligent acts of employees while acting on behalf of employer

when are parents held liable for their child?

child uses dangerous weapon, child acting as agent for parents, and a minor operating the family car

what types of vehicle are covered under a PAP

private passenger vehicle, station wagon, sports utility vehicle (SUV), and pickup truck or van (weighs <10,000 pounds and not for business use)

Insurance Services Office (ISO)

a provider of statistical, actuarial, underwriting, claims information, and analytics with compliance and fraud identification tools

definition of "your covered auto"

Any auto shown in declarations, a "newly acquired auto", a "trailer" owned by the named insured, or a temporary substitute vehicle

PAP liability coverage

Protects a covered person against suit or claim arising out of ownership or operation of a covered vehicle. covers damages and defense costs

Split-Limit Coverage

liability coverage that allows for separate coverage limits for bodily injury and property damage, split-coverage limits per person, or both. (injury per person/injury per accident/property damage per accident)

combined single limit

liability coverage for bodily injury and property damage in one limit

compulsory insurance laws

Require motorists to carry at least a minimum amount of liability insurance before the vehicle can be licensed or registered (GA minimum is 25k/50/25)

who are insured persons under liability coverage?

Named insured and resident family members, persons using named insured's covered auto WITH permission, person or org. legally responsible for insured use of covered auto on their behalf, and those legally responsible for named insured or family's use of any other auto or trailer

exclusions to Auto liability coverage

intentional injury or harm; property owned or transported; property rented, used, or in insured's care; used as a public or livery conveyance; vehicles used in a business; vehicles with fewer than four wheels; using a vehicle without reasonable belief the person is entitled to do so

other liability coverage provisions

out of state coverage ( policy limits match state you are in) and multiple policy loss (primary liability coverage follows the vehicle, insurer pays pro rata share of loss)

PAP medical payments coverage

Covers reasonable medical expenses incurred by an insured in an accident. Coverage is not based on fault. covers within 3 years from date of accident. limits range from 1k-10k per person

who has medical payments coverage under PAP

The named insured and family members

(While occupying any motor vehicle and as pedestrians when struck by a motor vehicle) and other person occupying a covered auto or owned vehicle

Auto medical payment coverage exclusions

Occupying any vehicle with fewer than four wheels, public of livery conveyance, using the vehicle as a residence, or vehicle used during the course of employment (would likely be covered under workers' comp.)

important medical payment coverage provisions

if more than one policy covers a loss: The insurer pays its pro rata share of the loss for an owned vehicle, and insurance coverage is excess over any other insurance for a non-owned vehicle

what does uninsured motorists coverage protect against?

Covers bodily injury caused by: an uninsured motorist, a hit and run driver, or a negligent driver whose insurance company is insolvent. Also could cover property damage if uninsured is responsible (and depends on the state)

who has uninsured motorists coverage under PAP?

The named insured and family members, another person while occupying the auto, and any person legally entitled to recover damages

what vehicles are considered to be uninsured vehicles?

A motor vehicle or trailer for which no bodily injury liability insurance policy applies at the time of accident, an insured vehicle with less coverage than the amount required by the state's financial responsibility law, a hit and run vehicle, or a vehicle covered by an insurer that denies coverage or becomes insolvent

exclusions to uninsured motorist coverage

Uninsured motor vehicles owned by the insured to a family member, the insured settles a claim without the insurer's consent, vehicle is used as a public or livery conveyance, when workers' comp. Benefits are applicable, there is no reasonable belief the person is entitled to use that vehicle, and no coverage for punitive damages

auto damage coverage

covers direct and accidental loss to a covered auto or non-owned auto

auto collision coverage

the upset of your covered auto or non-owned auto or its impact with another vehicle or object. also covers non-owned and temporary subs (paid regardless of fault, icy roads, hit door on pole)

other-than-collision coverage examples

Glass breakage, contact with animal, theft, hail, earthquake, riot

exclusions to auto damage coverage

Use as a public or livery conveyance, wear and tear damage or breakdown, electronics that are not permanently installed, trailer, camper body or motorhome, or custom furnishings and equipment

auto loss settlement

total loss (ACV), partial loss (pay $ to replace with like quality), deductibles (some lower for glass), and diminution in value (loss in market/resale value, could be owed to insurer)

Temporary Transportation Expenses

provides coverage for rental car usage (up to a daily and total limit) and covers vehicle damages due to comprehensive or Collision loss. towing and labor expenses coverage may be added by endoresement

gap insurance

available by endorsement, pays the difference between the amount insurer owes and the amount owed on a loan or lease

duties after an accident or loss

notify insurance company, cooperate with insurer, send copies of legal notices to insurer, and notify police if a hit and run vehicle is involved or owned auto is stolen

general PAP provisions

policy changes, fraud, suit against insurer, policy termination

PAP Part F general provisions:

coverage in US, Puerto Rico, and Canada

PAP termination provisions

named insured can cancel at any time. cancelled after 60 days if premium is not paid, license of any insured is suspended, or policy is obtained with misrepresentation

PAP nonrenewal

insured must give 20 day notice before end of policy period

PAP automatic termination

if insured declines the insurer's offer to renew

no-fault auto insurance

after an accident involving bodily injury, each party collects from their own insurer regardless of fault (motorists can still sue driver for property damage)

rating variable for personal auto insurance

Territory or garaging location, age/gender/marital status, vehicle use, type of vehicle, driving record, # of vehicles, limits/deductibles, insurance/credit score, good student discount, driver ed., and multi policy discount

Section I of homeowners insurance coverages

dwelling, other structures, personal property, and loss of use

who is covered by homeowners insurance?

named insured and spouse, resident relatives, other person under 21, and full-time student away from home

Coverage A:Dwelling

Covers the dwelling (house) on the residence premises, structures attached to the dwelling, materials intended for construction, and no coverage for land

Coverage B: Other Structures

covers other structures on the residence premises set apart from the dwelling by clear space (detached garage or tool shed, rented out structures excluded)

Coverage C: personal property

covers personal property owned or used by an insured while it is anywhere in the world. storage coverage is limited to 10% or $1000, whichever is greater

what personal property is not covered in Coverage C?

property insured elsewhere, animals birds and fish, motor vehicles, aircraft, property of tenants, property in a rented apartment, business data, credit cards, and water or steam

Coverage D: Loss of use

Provides protection when the residence premises cannot be used because of a covered loss (includes additional living expenses, fair rental value, and prohibited use - civil authority)

Additional coverages under Section I

debris removal of damaged property, reasonable repairs, trees and other plants, fire department service charge, unauthorized credit card use, loss assessment, collapse, ordinance or law, graves markers or landlord's furnishings

HO-3 Section I

A and B has open perils and C has named perils

exclusions to Coverages A and B

Collapse, freezing of pipes, theft of materials, vandalism if vacant more than 60 days, mold or rot unless caused by loss, wear and tear, and animals

named perils of Coverage C

Fire or lightning, hail, explosion, vandalism, theft, volcano, accidental damage, riot, smoke, and aircraft

homeowner’s insurance exclusions applying to coverages A,B, and C

law, Earth movement, war, neglect, flood, intentional loss, nuclear hazard, government action, and weather actions

section I conditions

deductible (flat or %, coast states is higher for hail/wind, highest is applied), duties after loss (prompt notice, police, protect, cooperate with insurer), lost settlement (buildings-RC with 80% coins., personal property-ACV), appraisal, other insurance, suit against insurer (2 years), and concealment/fraud

appraisal

used when insured and insurer agree that loss is covered but disagree as to loss amount

Homeowners Section I and II conditions

cancellation and nonrenewal Provisions similar to PAP

Homeowners Insurance Section II coverages

personal liability and medical payments to others

Coverage E: Personal Liability

Protects an insured when a claim or suit for damages is brought because of bodily injury or property damage allegedly caused by an insured's negligence (pays amount found legally liable up to limit and defense costs) (EX: dog bites neighbor)

Coverage F: Medical Payments to Others

Pays the reasonable expenses of another person who is accidentally injured while on an insured location, by the activities of an insured or residence employee, or animal owned by or in the care of insured (must be incurred within 3 years of accident) (EX: dog bites house guest, guest breaks arm on property)

exclusions to coverages E and F

motor vehicle liability (unless stored, use for handicapped, or service purpose), watercraft/aircraft/hovercraft liability, expected or intended injury, business activities, transmission of communicable disease, sexual molestation, corporal punishment, abuse, or

controlled substance

exclusions to Section II Coverage E - liability

contractual liability, property owned by insured, workers compensation, and bodily injury to an insured

exclusions to coverage F - medical payments of others

injury to Residence employee off insured location, workers compensation, and person regularly residing on the insured location

common endorsements to homeowners policy

Inflation guard, personal property replacement cost, scheduled personal property, personal injury, watercraft, or backup of sewer and drain

rating variables

Construction type

Geographic location

Fire protection class

Replacement cost

HO policy form type

Year of construction

Deductible

Insurance score

Roof factors

homeowners policy forms

HO-2 Broad, HO-3 special, HO-4 contents broad (renters), HO-5 comprehensive, and HO-6 Unit-owners (condo)

Personal Umbrella Liability Insurance

Provides protection against a catastrophic lawsuit or judgement. limits in excess of primary policy limits (minimum underlying limits required by underwriter)

broad coverage of personal umbrella liability

Bodily injury and property damage, personal liability, and additional coverages

including defense costs

umbrella liability provides broad coverage over:

auto, homeowners, boats, and RVs/ATVs

retained umbrella limit

minimum underlying limits, deductible or self insured retention in policy if covered umbrella loss is not covered by an underlying policy

umbrella exclusions

expected/intended injury

Certain personal injury losses

Rental of premises

Business liability

Professional services

Aircraft, watercraft and ATV unless has underlying coverage

No reasonable belief

Vehicles in racing

Disease, molestation, controlled substances

Directors and officers - with exceptions (non-profit)

Property in the insured's care, custody, and control

personal articles floater

type of "marine" coverage with broad coverage on high valued personal property against damage and open perils, and is worldwide with specific valued items (jewelry, fine arts, furs, cameras, instruments, etc.)

is a deductible required for personal articles floater?

no

exclusions of personal articles floater

Wear and tear, gradual deterioration, insects or vermin, war, and nuclear

boatowner's coverage

package policy for damage to boat, liability, medical expenses, and uninsured boaters (deductible usually applies)

cyber coverages

3rd party (E&O, media liability, network security) and 1st party (breach costs, business interruption and failure, cyber extortion, or digital assets)