Unit B Personal Law

BB30 Business Law 4.02Summer 2013

Unit BPersonal Law

Essential Standard 4.00 Understand financial, credit, and insurance law


4.02 Understand Types and Aspects of Insurance

A. Insurance Defined

Premiums 1. What are premiums? 2. What type of insurance types have them?

Insurable Interest-Financial Responsibility 1. What determines whether there is an insurable interest?

Risk- What is risk and how does it affect


Insurance Defined-Continued

Exclusions 1. What does exclusion mean? 2. How does exclusion apply to insurance? 3. Why do insurance companies put exclusions in their policies?

Claims 1. What is a claim in regards to insurance? 2. How does a policy holder enter a claim?


Insurance Defined (Continued)

Deductibles 1. What are deductibles? 2. What is the purpose of a deductible for the policy holder?

Insured 1. What or who is the insured 2. Is the insured always the policy holder or not?

Insurer 1. Who is an insurer? 2. Is the insurer a business/corporation or an individual?


Automobile Insurance(http://www.ncdoi.com/_Publications/Consumer%20Guide%20to%20Automobile%20Insurance_CAU1.pdf)

a. Personal Auto Policy (PAP)a. Why have a PAP?b. What does it protect you from?

b. Liability Coverage-a. What are the two types?b. What does it protect you from?

c. Property Damage Coveragea. What does it protect you from?b. What is an example of this type of coverage?

d. Collision Coveragea. What does it protect you from?b. What is an example of this type of coverage?

e. Comprehensive Coverage-Other than Collisiona. What does it protect you from?b. What is an example of this type of coverage?c. How is this different from collision?

http://www.ncdoi.com/_Publications/Consumer%20Guide%20to%20Automobile%20Insurance_CAU1.pdf

http://www.ncdoi.com/_Publications/Consumer%20Guide%20to%20Automobile%20Insurance_CAU1.pdf


Automobile Coverage (Continued)

f. Medical Payment Coverage(Med Pay) 1. What is medical Payment Coverage? 2. Whom does this coverage pay for in the case of a covered accident? g. Uninsured Motorist Coverage 1. What is uninsured motorist coverage? 2. What are two types of losses that this type of coverage will cover?

h. Underinsured Motorist Coverage 1. What is underinsured motorist coverage? 2. Is this coverage mandatory in North Carolina?

i. Miscellaneous Coverage-Towing, Rental Vehicle, Custom Coverage 1. Are these types of coverage mandatory for automobile insurance? 2. What does towing coverage provide? 3. What does rental coverage provide? 4. What does custom insurance provide?


Motorcycle Insurance

Liability, Collision, Uninsured/Underinsured and Towing Coverage is identical to a regular automobile policy. It is important to have a special coverage for a customized motorcycle. Traditional motorcycle coverage will only cover the “stock value” not any customizations are added equipment.


Boat Insurance

Pleasure boat policies or endorsements often state that coverage includes"the boat and all permanently attached equipment". The policy may thenlist items that are not permanently attached, but are covered as either partof the boat's value, or as a separate limit of insurance. Items that may ormay not be considered "permanently attached" under a policy include:• Anchors• Batteries• Bilge pumps• Boat furniture• Boat and motor covers• Cook stoves• Deck chairs• Depth finders• Detachable canopies• Emergency signaling devices• Fire extinguishers• Fittings• Fuel tanks• Horns• Life preservers• Lights


Property Insurance

a. Homeowners Insurance 1. What is homeowners insurance?

2. Why is it necessary? b. Coverage for Property 1. There are (4) basic coverage types within a homeowners policy.

2. Coverage A is for dwelling. What constitutes a dwelling?

3. Coverage B is for other structures. What are other structures?

4. Coverage C is Personal Property. What items might you find listed?

5. Coverage D is for loss of use. What is loss of use and what if anything does this coverage pay for?


Homeowner’s Exclusions

a. Earth Movement

1. What is earth movement?

b. Water Damage

1. What is water damage?

2. Why do most homeowners policies not provide water damage coverage

from flooding?

c. Power Failure

1. What constitutes power failure?

2. Why don’t insurance policies provide coverage for this?

d. Neglect

1. What does neglect mean in regards to being a policy exclusion?

2. Why is it an exclsusion?


e. Renters Insurance

1. What is renters insurance?

2. Whom should purchase renters insurance?

3. Do roommates living in the same house, apartment, condo etc.,

need to each have their own renters insurance?

f. Fire Insurance

1. What hazards does fire insurance provide property coverage for?

.

Additional Types of Property Coverage


Health Insurance

Traditional Health Insurance (Major Medical Coverage)1. What type of coverage does Major Medical Coverage offer?2. What is the main reason for those who elect this type of coverage?3. What is a characteristic of major medical coverage?

Annual Deductible1. What is an annual deductible?2. How does this work?

Major Exclusions for Coverage1. For heath care policies, what do major exclusions include?2. Why do health care insurance providers have these exclusions?

Possible lengthy waiting periods1. What is a “waiting period” in a health insurance policy?

Group Insurance Coverage1. What is group health insurance coverage?2. Why is group health insurance usually better for an employee?


Managed Health Care 1) HMO

1. What does HMO stand for?2. Do HMO’s allow you to pick your primary care physician?3. How is the majority of your health care provided when you have an HMO as your health insurance?

2) PPO1. What is a PPO health insurance company?2. What are the requirements for their policy holders?3. Can you go to any doctor that you desire?

3)HMO-(POS)1. What is HMO (POS) type health care insurance?2. What are the benefits (if any) of this type of policy?

Individual Insurance Coverage

1. What is individual insurance coverage?

2. What is the primary negative to this type of health insurance?

3. Do people that have health insurance primarily have individual or group health insurance?


Supplemental Health Insurance Coverage

a. Cancer Insurance Coverage1. What is cancer insurance?2. What is the purpose of cancer insurance?3. Does cancer insurance cover other illnesses?

b. Dental Insurance Coverage1. Is dental insurance a group or individual policy?2. Does dental insurance have restrictions on most policies?3. Why are there restrictions?4. What type of coverage do dental insurance policies generally provide

c. Long Term Medical Coverage1. What does long term medical coverage provide?2. Why might this be a good insurance policy to purchase if you

are in poor health?


Health Insurance (Continued)

e. Vision Insurance Coverage1. What type of coverage and items does vision insurance normally provide?2. Can you select your own optometrists/ophthalmologist?

Government Insurance CoverageMedicare1. What is Medicare?2. Who provides Medicare?3. Who is eligible for coverage? 4. What is a special consideration for coverage under age?

Medicaid1. What is Medicaid?2. Who provides Medicaid coverage?3. Who is eligible for coverage?4. Do state governments or the Federal government determine eligibility?


Medigap Insurance1. What is Medigap Insurance?2. Who needs this type coverage?3. Does the government (state or Federal) provide this coverage?

Disability Insurance Coverage1. What is disability insurance?2. Who pays for or provides this type insurance to an employee?


Life Insurance-Types (How Much Do You Need?)

Term InsuranceTerm Life Insurance1. What is term insurance?2. What is the primary benefit of term life insurance?

Increasing Term Insurance1. What is increasing term insurance?2. What is the benefit of this type of policy initially but not a benefit as the insured gets older?

Decreasing Term Insurance1. What is decreasing term insurance?2. How does this policy work for the insured?2. Why would a person purchase a decreasing term policy?


Life Insurance (continued)

Level Term Insurance1. What is level term insurance?2. What are the advantages and disadvantages of this type of insurance.

Permanent Life InsuranceWhole Life Insurance1. What is whole life insurance?2. What type of insurance coverage does it provide?3. Is there an advantage to this type of policy?

Universal Life Insurance1. What is universal life insurance?2. How does universal life compare to whole life insurance?3. What is one advantage to universal life insurance.

Variable Life Insurance1. What is variable life insurance?2. What is the primary difference with type of policy?


Life Insurance (Continued)

Life Insurance Optional Rider CoverageDependent Children1. What is a rider?2. What type of coverage does a rider provide for children?

Spouse Rider1. What type of coverage does a rider provide for a spouse?

Guaranteed Insurability1. What is guaranteed insurability?2. What are the advantages of guaranteed insurability?

Accidental Death and Dismemberment 1. What does accidental death mean to you?2. What does accidental dismemberment mean to you?3. How is this coverage different than a traditional life insurance policy?



Beneficiaries1. What is a beneficiary in a life insurance policy?2. What happen if the beneficiary dies before or at the same time as the insured?

Contingent Beneficiary1. What is a contingent beneficiary?2. If there are (3) contingent beneficiaries, how are the proceeds from an insured’s policy distributed if the primary beneficiary is deceased?

Collecting Death Benefits1. How does a beneficiary collect any death benefits?2. What document must a beneficiary have in order to claim any death benefits for any insurance or other death benefits?



Cost factorsNeeds Approach and the Human Life Value Approach

Needs Approach1.What is one thing that must be determined in the needs approach?

Human Life Value 1. What is the one thing that must be determined in the human value

approach?

Statistical Basis for Life InsuranceMortality tables1. How does the mortality table work in order for insurance to calculate

rates?Morbidity tables1. How does the morbidity table work in order for insurance companies

to calculate rates?What are the main differences between the two tables?


Insurance Fraud

1. What is insurance fraud?2. What are some of the most common types of fraud that are reported in North Carolina?

Automobile Repair1. What are some of the common methods that automobile fraud occurs?2. Whom should customers who believe fraud may have been committed against them for an auto repair, report it to?

Billing of Medical Services1. What type billing incidents may be fraud?2. Whom should a person who believes fraud may have been committed for services they did not receive, report the incident to?

Automobile Accidents1. What types of incidents or suspects accidents may constitute fraud?2. What should you do if you suspect you are a victim of this type of fraud?


Insurance Fraud (continued)

Property Claims Adjusting1. What is this type of fraud?2. Why has this type of fraud been so common in North Carolina in the past several years?

Adjusting 1. What is “adjusting” in the insurance property insurance industry?2. How does adjusting work, when the adjuster is doing a professional job and not trying to defraud a consumer?3. What are some of the most common methods that fraudulent

adjusters may utilize to defraud a consumer4. Whom would you contact if you believed you were a victim of

adjusting fraud.

Documents

Unit B Personal Law