Minnesota Personal Lines Insurance License Exam — All Questions

The portion of an insurance policy that lists the named insured, the covered property, the policy period, and the limits of coverage is the:

• a.Conditions
• b.Declarations✓
• c.Exclusions
• d.Insuring agreement

The declarations page states the specific facts of the policy: the named insured, a description of the covered property, the policy period, the limits of insurance, the premium, and the forms attached. The insuring agreement states what the insurer promises to cover, the exclusions state what is not covered, and the conditions set the rules and duties both parties must follow.

A binder issued by a producer serves to:

• a.Cancel the insured's coverage back to its start date
• b.Give temporary evidence of coverage until the policy issues✓
• c.Permanently replace the policy the insurer will issue
• d.List the exclusions that will apply to the new policy

A binder is a temporary agreement, oral or written, that provides immediate evidence of coverage until the insurer issues the formal policy or declines the risk. It contains the essential terms so the insured is protected in the interim. A binder is not permanent and is replaced once the actual policy is delivered or the coverage is formally declined.

The part of a policy in which the insurer states what it promises to pay for is the:

• a.Exclusions section
• b.Insuring agreement✓
• c.Definitions section
• d.Conditions section

The insuring agreement is the insurer's promise, the broad statement of what perils, property or liability the policy covers in exchange for the premium. Exclusions then carve losses back out of that promise, conditions set the duties of both parties, and definitions fix the meaning of the terms the policy places in quotation marks. Reading the promise first and the exclusions second is how a coverage question is answered.

The insured's duties after a loss, the appraisal clause and the cancellation clause are all found among the policy's:

• a.Definitions
• b.Exclusions
• c.Conditions✓
• d.Endorsements

Conditions are the rules of the bargain: what the insured must do to collect, what the insurer may do, and how disputes, cancellation and other insurance are handled. Failing a condition can cost an otherwise valid claim. Definitions only assign meanings to quoted terms, exclusions remove causes of loss from coverage, and endorsements are attachments that amend the form rather than the place these clauses live.

The main reason a homeowners form excludes flood is that a flood loss:

• a.Is caused by the owner's neglect
• b.Is paid by the personal auto policy
• c.Hits a whole region at one time✓
• d.Happens slowly instead of suddenly

Insurers exclude perils that are catastrophic, because a single event soaks thousands of insureds at once and defeats the spread of risk that pooling depends on. Other exclusions exist for different reasons: wear and tear is excluded as a certainty rather than an accident, and auto liability is excluded because a personal auto policy is the right place for it. Flood is excluded for the catastrophe reason.

A producer with binding authority binds coverage by phone at 9 a.m.; the house burns at noon, before the insurer ever sees the application. The loss is:

• a.Covered, but only for half of the amount
• b.Denied, because no premium was collected
• c.Denied, since no policy had been issued
• d.Covered, because the binder took effect✓

A binder is temporary coverage, oral or written, given by a producer acting within binding authority, and it protects the applicant from the moment it is given until the insurer issues the policy or declines the risk. Because the binder was in force at noon, the fire is covered on the terms the binder contemplated. Neither the absence of a printed policy nor an uncollected premium undoes coverage the producer has already bound.

Under the liberalization clause, when an insurer broadens its form without charging more, an existing insured:

• a.Must ask the insurer for an endorsement
• b.Pays a pro rata additional premium
• c.Receives the broader coverage automatically✓
• d.Gets the broader form only at renewal

The liberalization clause gives the insured the benefit of a broadening the insurer adopts at no additional premium, without any endorsement, request or new policy. It keeps insureds from being penalized for buying before an improvement was filed and saves the insurer from reissuing every policy in force. Waiting for renewal or paying extra describes what the clause exists to avoid.

The entire contract provision means the agreement between insurer and insured consists of:

• a.The declarations page and nothing else
• b.The policy and the underwriting file
• c.Whatever the producer told the applicant
• d.The policy, application and endorsements✓

The entire contract is the printed policy together with the application and any endorsements attached to it, and nothing outside those documents changes the deal. That is why a producer's spoken assurance about coverage does not bind the insurer once the policy is delivered, and why an insured should read the attached forms. The underwriting file is the insurer's internal work, not part of the contract.

An applicant deliberately hides a history of arson losses. Under the concealment, misrepresentation and fraud condition, the insurer may:

• a.Deny only the losses caused by arson
• b.Cut the payment by the hidden amount
• c.Raise the premium at the next renewal
• d.Void the coverage for that insured✓

The condition lets the insurer treat coverage as void where an insured intentionally conceals or misrepresents a material fact, engages in fraudulent conduct or makes false statements, whether that happens in the application or after a loss. Materiality is the test: a fact that would have changed the underwriting decision. Repricing at renewal is an underwriting response, not the remedy this condition provides.

Immediately after a kitchen fire, the duties after loss condition requires the insured to:

• a.Sue the responsible party without delay
• b.Begin permanent repairs before giving notice
• c.Protect the property from further damage✓
• d.Discard the damaged items to avoid mold

Duties after loss include giving prompt notice, protecting the property from further damage and keeping a record of the reasonable emergency repairs, preparing an inventory of damaged property, cooperating with the investigation and submitting a proof of loss when the insurer asks. Throwing damaged items out destroys the proof the adjuster needs, and permanent repairs are made after the loss has been inspected.

A proof of loss filed with the insurer is best described as:

• a.The adjuster's own estimate of repair costs
• b.A receipt showing that the premium was paid
• c.A sworn statement of the amount claimed✓
• d.The insurer's written offer of settlement

A proof of loss is the insured's signed and sworn statement setting out the time and cause of the loss, the interests of the insured and of others in the property, and the amount being claimed, with supporting records. It comes from the insured, not the insurer, which is why the settlement offer and the adjuster's estimate describe other documents. The time allowed to file one is set by law where the policy is issued.

The insured and the insurer agree the fire loss is covered but cannot agree on its dollar amount. Under the appraisal condition:

• a.A court names one appraiser for both parties
• b.The insurer's adjuster sets the final figure
• c.The insured must accept the estimate or sue at once
• d.Each picks an appraiser and the two pick an umpire✓

Either party may demand appraisal. Each side chooses and pays its own competent appraiser, the two appraisers select an umpire, and an amount agreed to by any two of the three sets the amount of the loss, with the umpire's cost shared. Appraisal settles value only; whether the loss is covered at all stays a coverage question the process cannot decide, so it is not a substitute for a coverage dispute.

The suit against us condition provides that an insured may sue the insurer only after:

• a.Complying fully with the policy terms✓
• b.Filing a written complaint with a regulator
• c.The insurer has denied the claim in writing
• d.Both sides finish an appraisal of the loss

The condition bars an action against the insurer unless the insured has complied with the policy's provisions, and it also requires suit to be brought within the period the policy states, a period fixed by the law where the policy is issued. Complaining to a regulator is a separate consumer remedy that the policy does not make a precondition, and appraisal is demanded only when the dispute is about amount.

After a covered loss, the policy's option to repair or replace allows the insurer to:

• a.Refuse the claim when repairs cost too much
• b.Name the contractor the insured has to hire
• c.Restore the property instead of paying cash✓
• d.Pay the insured the full policy limit at once

The insurer reserves the right to pay the value of the lost property, to pay the cost of repairing it, or to repair or replace it with property of like kind and quality, which caps what an insured can insist on in cash. The option is a settlement choice, not a way out of the claim, so refusing a costly claim is not what it permits, and it does not force the insured to hire anyone.

A dry cleaner ruins a customer's coat. Under the no benefit to bailee condition, the cleaner:

• a.Cannot use the customer's insurance✓
• b.May file the claim as a loss payee
• c.Becomes an insured under that policy
• d.Shares the loss with the insurer evenly

The condition states that the insurance gives no benefit to any person or organization holding, storing or moving the property for a fee. So the insurer may pay its own insured for the coat and then subrogate against the cleaner, whose own liability coverage is meant to answer for the damage. Treating a bailee as an insured or a loss payee would let the responsible party hide behind the customer's policy.

Under the loss payment condition, the insurer adjusts a covered loss with, and pays:

• a.The mortgagee alone on any property loss
• b.The named insured, unless another is named✓
• c.The contractor who repaired the property
• d.Any resident of the household who claims

The insurer adjusts losses with the named insured and pays the named insured unless some other person is named in the policy, such as a mortgagee or loss payee, or is legally entitled to receive payment. A repair contractor has no claim against the policy and must look to the insured, and a household resident is not automatically the payee even where that person is an insured for coverage purposes.

Two policies cover the same $30,000 loss, one with a $200,000 limit and one with a $100,000 limit. Under the other insurance condition, the larger policy pays:

• a.$15,000
• b.$20,000✓
• c.$10,000
• d.$30,000

The other insurance condition makes each policy pay the proportion of the loss that its limit bears to the total of all applicable limits, so the larger policy pays 200,000 divided by 300,000, or two thirds of $30,000, which is $20,000, and the smaller one pays $10,000. The insured collects $30,000 in total and no more, because indemnity does not allow a profit from carrying two policies.

A contractor's negligence floods the insured's kitchen, and the insured signs a paper releasing the contractor. The insurer may then:

• a.Pay in full and then sue the insured
• b.Refuse to pay what it cannot recover✓
• c.Cancel the policy back to its start date
• d.Pay the claim and still sue the contractor

The subrogation condition transfers the insured's rights of recovery to the insurer once it pays, and it forbids the insured from doing anything after a loss that impairs those rights. An insured who releases the negligent party destroys the insurer's recovery and can lose the claim to that extent. A release given before any loss is a different matter and is generally permitted in writing.

A dwelling fire is traced to arson by the owner. Under the mortgage clause, the mortgagee shown on the declarations:

• a.Is paid its interest in the property✓
• b.Collects only the unearned premium
• c.Loses its claim along with the insured
• d.Must sue the owner to collect the debt

The mortgage clause gives the mortgagee rights of its own, so denial of the owner's claim for an act such as arson does not defeat the lender's interest, provided the mortgagee meets its own duties, which include paying the premium on demand and filing a proof of loss if the insured will not. Having paid the mortgagee alone, the insurer takes over that much of the debt and may pursue the owner.

The assignment condition provides that an insured who sells the home may hand the policy to the buyer:

• a.At any time before the policy expires
• b.Once the buyer's premium check clears
• c.By recording the deed at the courthouse
• d.Only with the insurer's written consent✓

Insurance is a personal contract written on a particular insured, so the policy cannot be assigned to someone else without the insurer's written consent; the buyer is a different risk the underwriter has never seen. Recording a deed transfers the property, not the contract of insurance, and paying a premium does not make a stranger the insured. In practice the buyer arranges a policy of their own.

When a named insured dies during the policy period, coverage on the covered property continues for:

• a.The deceased's legal representative✓
• b.The buyer of the property at probate
• c.No one, since the policy ends at death
• d.Any heir who is named in the will

The death of the named insured condition keeps the property covered by naming the legal representative of the deceased as an insured for that property, and by covering any person who has proper temporary custody of the property until a representative is appointed. Coverage does not simply stop at the moment of death, and an heir named in a will is not automatically the person the condition protects.

The conceptual difference between cancellation and non-renewal is that a non-renewal:

• a.Requires the insured's written agreement
• b.Refunds the premium on a short-rate basis
• c.Ends the policy at its expiration date✓
• d.Ends the policy in the middle of a term

Cancellation ends a policy before the end of the term it was written for and produces a return of the unearned premium, while non-renewal simply lets the policy run to its expiration date and does not continue it into a new term. Neither requires the insured to agree, and each carries its own notice requirements set by the law where the policy is issued rather than by the form itself.