Claims P1
An employee driving a forklift inside a warehouse runs into a visiting vendor, causing severe injuries. The vendor sues the company. The forklift is not licensed for road use and isn’t on the auto schedule. What coverage is triggered?
General Liability for vendor's injuries.
A customer is injured on a store’s property by falling merchandise. They sue the store for $1M. The store’s GL limit is $1M per occurrence but $2M aggregate, and the store already has $1.5M in prior paid claims this policy term. How much coverage is left, and what options apply?
$500k remaining on the GL. Umbrella policy may be triggered if available. If not available, the store will have to pay out of pocket expenses.
During a yoga class, a visitor slips on a wet floor and breaks their wrist. The gym has a GL policy with a $25k SIR. The visitor suffers $18k in injuries. What policy pays and how?
GL - The client will pay the full $18k because the claim is within the policy retention.
UW
Underwriter
What Acord form number is a COI issued on?
Acord 25
In-N-Out has a GL policy with no deductible and an Auto policy with $1,000 Physical Damage deductible. A customer parks their car in their parking lot and In-N-Out’s tree falls onto the customer’s vehicle causing $15,000 in damage to the customer vehicle. What policy pays out and how much?
GL - $15k
An employee on a sales trip is injured slipping in a hotel lobby. They require surgery and time off work. The hotel is also sued for unsafe conditions. What coverage responds?
Workers' Compensation for employee medical/wages.
Hotel's General Liability for subrogation if negligence is proven.
Crunch Fitness has a GL policy with a $25k SIR and a Workers' Comp policy with a $100k deductible. A gym instructor is demonstrating a rowing machine to a member when the cable snaps and hits the member in the face. The employee falls back and breaks their arm. Employee injuries are $25,000. Member injuries are $50,000. What policy responds and how is the claim paid?
WC - Covers the employee injuries. The carrier will pay the $25,000 and bill back the amount to the client as the claim is within the deductible.
GL - Covers the member injuries. The client will pay the first $25k and the carrier will pay the next $25k.
HNOA
Hired and Non-owned Auto
Changes to a policy
Endorsement
3 claims during the policy period occur on a client’s GL policy with a $1M per occurrence and $2M aggregate limit. Claim 1 total cost is $1.3M. Claim 2 total cost is $750k. Claim 3 total cost is $500k. How much is each claim paid out?
Claim 1 - $1M, Claim 2 - $750k, Claim 3 - $250k
A pizza delivery driver assaults another motorist after a fender bender during a delivery. Both pizza delivery driver and motorist are injured in the fight. The injured motorist sues both the driver and the pizza shop for negligent hiring/supervision. What coverage(s) are triggered?
Auto to cover the original fender bender accident. GL could possibly be triggered, but intentional acts are often excluded. Workers Comp to cover the driver's injuries during the fight.
A company has a symbol 1 Auto Liability policy with symbol 7 and 8 for physical damage. An employee is driving their personal car to make a last minute delivery for the company. While en route, they collide with a parked car, causing $18,000 in damage. The employee’s personal car also sustains $7,000 in damage. What policies respond and how do they pay out?
The company's auto policy would pay out the $18,000 in damages to the third-party parked car. The physical damage to the employee's personal car is not covered under the company policy. Their personal auto policy would need to pay out their physical damages.
BI
Bodily Injury (will accept business income/business interruption but that is Property related)
What kind of carrier do we need to include surplus lines taxes for our policy invoices?
Non-admitted
A delivery truck owned by ABC company crashes into a customer’s building leading to $75,000 in property damage to the building. The driver incurs $25,000 in medical expenses, and there are $10,000 in repairs needed for the truck. What policies respond and how much do they pay?
Auto Liability - $75k, Auto PD - $10k, WC - $25k
A company is transporting heavy demo equipment to a trade show in a company van. While unloading, the driver accidentally lets a dolly roll into a trade show attendee, causing $30,000 in medical bills. Immediately after, the driver gets back in the van and accidentally hits a parked car, causing $12,000 in vehicle damage to the parked car. GL SIR is $25,000. Auto PD deductibles are $2,500. Which policies respond and how do they pay out?
GL - covers bodily injury to the trade show attendee from the unloading accident. Client pays $25,000 first. Carrier will pay the remaining $5,000.
Auto - will cover the $12k in damages to parked car. Carrier pays in full.
An employee working in Ohio slips on a wet floor in their warehouse injuring their back. They suffer $15,000 in medical bills and $5,000 in lost wages. What policy would respond (be specific) and how much is paid?
Ohio is a monopolistic state, so the WC policy that the client places through the state fund would cover the employee injuries and lost wages for the full $20k amount.
AINS
Associate in Insurance
What is an Exposure Basis?
The basis used to calculate insurance premiums by applying rates.
A severe storm damages a company vehicle causing $30,000 in repairs and $10,000 in injuries to the driver. The auto policy has a $1,000 collision deductible and a $2,000 comprehensive deductible. The GL policy has no deductible. What policy responds and how much do they pay?
Auto PD - $28,000, WC - $10,000
A company truck hits two third party vehicles causing $25,000 and $35,000 in damages. Company’s auto Comp/Collision deductible is $5,000 per accident. The GL has a $25,000 SIR. How much is paid by the carrier and insured?
Auto Liability would pay the full $60k for the third-party vehicles.
Auto PD deductible would apply to the company vehicle if damaged. GL does not respond.
An employee files a claim against their employer alleging they were misclassified in the 401k plan and as a result, didn't receive proper contribution. The employee claims $75,000 in lost benefits. What policy responds?
GL under the Employee Benefits Liability limits.
BOR
Broker of Record
What does total incurred mean on loss runs?
The sum of total paid amounts plus reserves.