Free Maine Casualty Insurance Practice Questions

Insurance only deals with pure risk: situations where there's a chance of loss or no loss, but no chance of gain (like your house burning down). Speculative risk involves a chance of loss, no loss, OR gain. That's gambling and investing, and insurers won't touch it. If there's an upside, it's not insurable.

Adverse selection is the insurer's headache: the people most likely to have a loss are also the most eager to buy and keep coverage. If underwriting didn't push back, the risk pool would fill up with bad risks and the math would collapse. It's exactly why underwriting and exclusions exist.

Treaty reinsurance is the automatic, blanket deal: the reinsurer agrees in advance to take a whole category of risks. Facultative is the opposite, case-by-case, where the reinsurer can accept or decline each risk individually. Treaty equals automatic and broad; facultative equals optional and specific.

The company giving away (ceding) the risk is the ceding company; the company taking it on is the reinsurer. Easy hook: to 'cede' is to give up, so the one giving up the risk is the ceding company.

A stock insurer is owned by its stockholders (shareholders), who receive taxable dividends when the company profits. Policyholders are just customers. Contrast that with a mutual insurer, which is owned by its policyholders. Stock equals stockholders; mutual equals members/policyholders.

An admitted (or authorized) insurer holds a certificate of authority from the state and plays by that state's rules. A non-admitted (unauthorized) insurer hasn't been granted one, which is where surplus lines come in for hard-to-place risks. Also worth knowing: domestic equals home state, foreign equals another state, alien equals another country.

A captive (or exclusive) agent represents a single insurer, and that insurer owns the book of business. An independent agent represents multiple companies and owns their own expirations (the renewal rights). The ownership-of-expirations detail is the classic distinguisher.

Premiums an agent collects belong to the insurer, not the agent, so the agent holds them in a fiduciary capacity, a position of financial trust. Mixing that money with personal funds (commingling) is a big no-no and a fast way to lose a license.

A contract of adhesion is written by one party (the insurer) and accepted as-is by the other, with no line-by-line negotiating. The practical kicker: because the insured didn't get to write it, any ambiguity is interpreted in the insured's favor. That's a courtroom rule worth knowing.

Concealment is staying silent about a material fact you know the insurer would want, and if it's intentional, it can void the policy. It's the sin-of-omission version of misrepresentation (which is an active false statement). Both turn on the fact being 'material,' meaning it would have affected the insurer's decision.

Market value reflects what the property would sell for, including the land and location-driven demand, while replacement cost is purely the cost to rebuild the structure. The two can differ widely. Hook: market value includes the land and the neighborhood; replacement cost is just bricks and labor.

A named perils policy covers only the perils it specifically lists, such as fire, lightning, windstorm, or theft. If the cause isn't named, there's no coverage. Hook: named perils covers only what's on the list.

An indirect, or consequential, loss is the financial fallout that follows a direct loss, like the income a business loses while closed for repairs. Business income (interruption) coverage addresses it. Hook: indirect loss is the ripple effect, the income lost after the physical damage.

Negligence is the failure to act with the care a reasonable, prudent person would under the same circumstances. It's the foundation of most liability claims and is unintentional, unlike an intentional tort. Hook: negligence is falling short of the reasonable-person standard of care.

The four elements of negligence are a duty owed, a breach of that duty, the breach being the proximate cause, and actual damages. Intent is not required; in fact, negligence is unintentional, which separates it from an intentional tort. Hook: duty, breach, causation, damages, but never intent for negligence.

Comparative negligence reduces the claimant's award by their percentage of fault, so someone 30% responsible recovers 70% of their damages. It's more forgiving than the older contributory negligence rule, which could bar recovery entirely for any fault at all. Hook: comparative negligence trims your recovery by your share of the blame.

After paying the insured for a loss caused by someone else, the insurer steps into the insured's shoes (subrogation) and pursues the at-fault party to recover what it paid. It prevents the insured from collecting twice. Hook: subrogation lets the insurer go after whoever caused the loss to get its money back.

A pro rata provision splits a loss among insurers in proportion to each policy's limit, so a policy carrying half the total coverage pays half the loss. It keeps the insured from collecting more than the actual loss. Hook: pro rata splits the loss by each policy's share of the total limits.

An excess provision makes that policy pay only after other primary coverage has been used up; it sits on top as a second layer. Hook: excess coverage waits its turn, paying only after the primary is exhausted.

A physical hazard is a tangible condition of property or environment that increases risk, like icy steps, faulty wiring, or stored chemicals. It exists in the physical world, unlike moral or morale hazards. Hook: a physical hazard is a real-world condition you could point to.

Part D, Coverage for Damage to Your Auto, is the physical damage section that pays for damage to the insured's own car under collision and other-than-collision coverage. Part A handles liability to others, not your own vehicle. Hook: Part D is the D in damage to your own auto.

Liability coverage responds when the insured is legally responsible for injuring someone else or damaging their property, and it also pays the cost of defending the insured. It does not pay for the insured's own car. Hook: liability pays the other guy, both his injuries and his property.

UM coverage steps in when an at-fault driver has no liability insurance (or cannot be identified, as in a hit-and-run), paying the insured for injuries the other driver should have covered. Hook: uninsured motorist covers you when the at-fault driver has zero insurance.

UM bodily injury pays for the insured's injuries caused by an at-fault driver who is uninsured or who flees the scene. Whether UM also covers property damage varies by state. Hook: UM-BI is for your injuries when the other driver is uninsured or a hit-and-run.

Other-than-collision, often called comprehensive, covers the non-crash perils: theft, fire, hail, falling objects, vandalism, glass breakage, and animal strikes. Crashing or overturning is collision, not comprehensive. Hook: comprehensive is everything but the crash, fire, theft, hail, and Bambi.

Hitting an animal is treated as an other-than-collision (comprehensive) loss, not a collision, even though there is an impact. This usually means the comprehensive deductible applies. Hook: hitting an animal is comprehensive, not collision.

When repair cost exceeds the vehicle's actual cash value, the insurer totals the car and pays the ACV rather than the higher repair bill, less the deductible. Here that is 8,000 minus 500, or 7,500. Hook: if repairs cost more than the car is worth, you get ACV minus deductible, not the repair bill.

The newly acquired auto rule automatically extends the policy to a car the insured buys during the term, for a limited window (commonly up to 14 days), so the insured is not driving uninsured before reporting it. Hook: buy a new car and you get an automatic grace period to add it.

Towing and labor coverage, sometimes called roadside assistance, pays for towing and on-site labor costs after a disablement. It is a low-cost optional endorsement. Hook: towing and labor is the tow-truck and roadside endorsement.

Rental reimbursement (transportation expense) coverage pays a daily amount for a rental car while the insured's vehicle is being repaired or replaced after a covered loss, usually subject to a daily and total cap. Hook: rental reimbursement keeps you on the road while your car is in the shop.

A monoline policy covers a single line of business, such as property alone. Add a second coverage part and it becomes a package. Hook: one line is monoline; two or more is a package.

Packaging usually lowers the premium (a package credit) and reduces the chance of gaps or overlaps between separately written policies. It does not erase deductibles, conditions, or exclusions. Hook: packages save money and close the gaps between separate policies.

The first named insured may cancel by mailing or delivering notice, and the insurer may cancel by sending advance written notice (the number of days is set by the condition and state law). The first named insured acts on behalf of all insureds. Hook: the first named insured cancels by notice; the insurer cancels with advance written notice.

Building coverage takes in the structure, completed additions, permanently installed fixtures and machinery, and equipment used to maintain or service the building (like heating and air conditioning). Movable contents and stock are business personal property instead. Hook: building is the structure plus what is bolted in to run it.

Commercial property attaches one of three causes-of-loss forms, Basic, Broad, or Special, to decide which perils are covered. They run narrowest to broadest. Hook: commercial causes of loss are Basic, Broad, Special.

Business income coverage replaces the net income (and continuing expenses like payroll) the business would have earned had a covered loss not suspended operations. It is time-element coverage. Hook: business income replaces the profit you lose while you are shut down.

CGL Coverage A is the core: bodily injury and property damage liability arising out of the insured's premises, operations, products, and completed operations. Hook: CGL Coverage A is bodily injury and property damage liability.

Coverage C is goodwill medical payments: it pays reasonable medical bills for others injured on the premises or by the insured's operations, no fault required, which can prevent a larger liability claim. Hook: CGL Coverage C pays small injury bills no-fault, just like home med pay.

An occurrence form responds based on when the injury or damage took place. If it happened during the policy period, it is covered even if the claim surfaces years later. Hook: occurrence form looks at when it happened, not when it is reported.

Inland marine covers property that moves or is hard to value at a fixed location: contractors' equipment, fine arts, goods in transit, and similar floating risks. Despite the name, it is largely land-based. Hook: inland marine insures property on the move and hard-to-rate items.

Workers compensation pays benefits to employees who are injured or become ill because of their job. It is employee coverage, not customer or personal coverage. Hook: workers comp is for employees hurt on the job.

Under workers compensation, an injured worker collects benefits without proving the employer was negligent, and benefits are generally owed even if the worker was careless. Fault is set aside. Hook: no-fault means benefits flow without proving blame.

Benefit types and amounts are set by each state's workers compensation statute, which is why the policy promises to pay whatever the law requires rather than a chosen dollar limit. Hook: the state statute, not the employer, sets the benefits.

Workers compensation covers not just sudden accidents but also occupational diseases, illnesses that develop from job conditions over time, such as repetitive stress or exposure to harmful substances. Hook: comp covers both the sudden accident and the slow occupational disease.

Under the going-and-coming rule, an ordinary commute is normally not in the course of employment, so a commuting injury usually is not covered (special exceptions can apply, such as travel that is part of the job). Hook: the normal commute is off the clock for comp purposes.

Vocational rehabilitation helps a worker who cannot return to the old job get back to gainful work, through retraining, job placement, or similar services. Hook: voc rehab is about getting the worker back to work, retrain and replace the income.

Part Two protects the employer against lawsuits for work-related injuries that escape the exclusive-remedy bar, such as a third-party-over action or a consequential injury claim by a family member. It backstops the gaps Part One does not address. Hook: Part Two catches the work-injury suits that slip past exclusive remedy.

The experience mod compares an employer's actual losses with those expected for its class. A mod above 1.0 raises premium, below 1.0 lowers it, rewarding good safety records. Hook: the experience mod credits or debits you for your own loss history.

Second Injury Funds limit an employer's liability when a new work injury combines with a worker's prior impairment to cause a greater disability, removing a disincentive to hire workers with pre-existing conditions. Hook: second injury funds make it safer to hire workers with prior impairments.

The core bargain is certainty for the worker (guaranteed no-fault benefits) traded for giving up the right to sue the employer, which also caps the employer's exposure. Hook: certain benefits for the worker, no lawsuit for the employer, that is the deal.

Hull coverage insures the vessel itself against physical damage, much like physical damage coverage on an auto. Cargo, freight, and protection and indemnity cover other ocean marine exposures. Hook: hull is the boat itself, the ship's physical damage.

Protection and indemnity (P&I) is the liability portion of ocean marine, covering the owner's legal liability for bodily injury and property damage arising from the vessel, including crew injury and damage to other ships. Hull covers the vessel, cargo covers the goods, P&I covers the liability. Hook: P&I is the liability piece of ocean marine.

Large or powerful vessels exceed the homeowners watercraft limits and exclusions, so their liability and physical damage belong on a dedicated boatowners or yacht policy. Hook: the bigger the boat, the more it needs its own watercraft policy.

Because they are driven on the road, motor homes and RVs need auto-style liability and physical damage coverage, often on a specialized RV policy that also addresses their living-quarters contents. Hook: if it drives on the road, it needs auto-type coverage, even a motor home.

A fidelity bond covers an employer for losses caused by dishonest employees, such as theft or embezzlement. It is about employee dishonesty, not third-party liability. Hook: fidelity bonds guard against the crooked employee.

Unlike insurance, a surety expects the principal to ultimately bear the loss, so after paying the obligee the surety can seek reimbursement from the principal. Hook: the surety pays, then comes back to the principal to be repaid.

A performance bond is a surety bond guaranteeing the contractor will complete the project according to the contract; if not, the surety makes the obligee whole. Hook: performance bonds guarantee the job gets finished.

Most insurance covers future accidental losses, but title insurance looks backward, covering title defects that already exist, and it is paid for with a one-time premium at closing. Hook: title insurance is paid once and looks backward at past defects.

Personal umbrellas typically start at $1,000,000 of additional liability and increase from there, giving high-net-worth and ordinary insureds a large cushion above their home and auto limits. Hook: personal umbrellas usually begin at a cool one million.

The residual or shared market is the insurer of last resort, providing coverage (auto through assigned risk plans, property through FAIR Plans) to applicants the voluntary market turns down. Hook: the residual market is the last resort for risks no one else will write.