324 questions

Policy Structure & Provisions

The entire contract provision in a property and casualty policy means that:

  • a.The agent's spoken promises modify the contract
  • b.The insurer's underwriting file is part of the deal
  • c.The company's advertising becomes a warranty
  • d.The policy and application are the whole contract✓

The provision confines the agreement to the written policy plus whatever is attached to it, so nothing outside the four corners of the document adds to or subtracts from coverage. That is why an agent's oral assurance cannot rewrite the form and why the underwriting file and the company's brochures are not part of the bargain. Any change must be made by a written endorsement made part of the contract.

Policy Structure & Provisions

An applicant says nothing about a fire that destroyed an earlier building at the same location, and the insurer does not ask about it. This is best described as:

  • a.Concealment of a material fact✓
  • b.A warranty the insured breached
  • c.A misrepresentation of a fact
  • d.An immaterial omission of history

Concealment is silence about a material fact the applicant knew and had a duty to disclose; a misrepresentation, by contrast, is an untrue statement actually made. Loss history at the very same location is plainly material, since it would change how an underwriter rates or accepts the risk, so calling it immaterial fails. A warranty is a promise written into the contract, not information withheld before it issues.

Policy Structure & Provisions

Immediately after a covered fire, which action is a duty the policy places on the insured?

  • a.Discard the damaged property to clear the site
  • b.Protect the property from further damage✓
  • c.Begin permanent repairs before an inspection
  • d.Settle directly with anyone who was injured

Duties after loss include giving prompt notice, protecting the property from additional damage, preparing an inventory, cooperating with the investigation and submitting to examination under oath. Making permanent repairs or throwing out damaged goods first destroys the evidence the adjuster needs to value the claim, and settling voluntarily with a claimant is barred because it prejudices the insurer's defense.

Policy Structure & Provisions

In the claim process, a proof of loss is best described as:

  • a.The insurer's formal offer to settle a claim
  • b.A receipt showing the insured paid the premium
  • c.The adjuster's written estimate of repair cost
  • d.A sworn statement of the loss and its amount✓

The proof of loss is the insured's own signed and sworn statement of the time, cause and amount of the loss and of the insured's interest in the property, and the policy requires it before the insurer must pay. It is not the adjuster's estimate, which is the insurer's own valuation of the same damage, and it is not a settlement offer, which comes later once the claim has been reviewed.

Policy Structure & Provisions

The insured and the insurer agree the fire loss is covered but cannot agree on what it is worth. Under the appraisal condition:

  • a.The insurer's adjuster sets the binding amount
  • b.Each picks an appraiser and they pick an umpire✓
  • c.The claim is denied until the parties agree
  • d.A court decides the amount before any payment

Appraisal is a valuation mechanism, not a coverage mechanism: each side names a competent independent appraiser, the two of them select an umpire, and agreement between any two of the three sets the amount of loss. It is available only where coverage itself is not in dispute. Nothing in it lets the adjuster fix the figure alone or forces the insured into court, and the claim is not denied merely for want of agreement.

Policy Structure & Provisions

The suit against us condition in a property policy provides that the insured may sue the insurer only if:

  • a.The insured hires counsel approved by the insurer
  • b.The loss exceeds the deductible by a wide margin
  • c.The insurer has refused arbitration in writing
  • d.The insured has complied with the policy terms✓

The condition bars an action unless there has been full compliance with the terms of the policy, including notice, proof of loss and cooperation, and unless suit is brought within the time the policy allows, a period that varies by jurisdiction. Its purpose is to make the insured exhaust the claim process first. The insurer does not select the insured's lawyer, and the size of the loss is not a condition of suing.

Policy Structure & Provisions

After a covered glass loss, the insurer notifies the insured that it will replace the glass rather than pay cash. This is permitted because:

  • a.The deductible was not yet collected
  • b.The insured waived cash by filing a claim
  • c.Repair is required whenever it costs less
  • d.The policy gives the insurer that option✓

Loss settlement conditions reserve to the insurer the choice of paying the loss in money or of repairing or replacing the damaged property with material of like kind and quality, after telling the insured what it intends to do. It is the insurer's election, not a rule that the cheaper route must be taken, and not something the insured surrenders by filing. The deductible is subtracted from the settlement either way.

Policy Structure & Provisions

A warehouse is covered by two policies on the same property, one for $100,000 and one for $300,000, each with a pro rata other-insurance clause. A $40,000 covered loss occurs. The $100,000 policy pays:

  • a.$10,000✓
  • b.$20,000
  • c.$40,000
  • d.$30,000

Pro rata sharing gives each policy the share its limit bears to the total insurance in force: $100,000 out of $400,000 is one quarter, so that policy pays one quarter of the $40,000 loss, or $10,000, while the larger policy pays $30,000. Splitting the loss evenly at $20,000 apiece ignores the limits, and no single policy pays the whole loss where a pro rata clause governs.

Policy Structure & Provisions

A policy contains an excess other-insurance clause. When another policy also covers the same loss, the excess policy:

  • a.Shares in proportion to the two policy limits
  • b.Pays half the loss alongside the other insurer
  • c.Is void because of the duplicate coverage
  • d.Pays only after the other insurance is used up✓

An excess clause puts that policy behind any other collectible insurance, so it pays nothing until the primary limit is exhausted and then only what remains. That differs from pro rata sharing, where each policy contributes according to its limit. When two policies are written on different terms, the resulting non-concurrency can leave the clauses in conflict and the insured with less than expected.

Policy Structure & Provisions

After a driver damages the insured's fence, the insured signs a paper releasing that driver from all claims and then files with his own insurer. The effect is that:

  • a.The release transfers to the insurer on payment
  • b.The insurer's recovery right has been impaired✓
  • c.The insurer must still pay and pursue the driver
  • d.The driver's insurer now owes the whole loss

The subrogation condition requires the insured to do nothing after a loss that would prejudice the insurer's right to step into his shoes and recover from the party at fault. Signing a release destroys that right, and the insurer may reduce or deny the claim to the extent it was harmed. A waiver given before any loss can sometimes stand, but a release signed afterward cannot be handed on to the insurer.

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Policy Structure & Provisions

A homeowner intentionally sets fire to his own insured house. Under the standard mortgage clause, the mortgagee:

  • a.Receives only the unearned premium back
  • b.Is paid to the extent of its interest✓
  • c.Loses its claim along with the owner's
  • d.Must first sue the owner for the balance

The standard mortgage clause creates a separate contract between the insurer and the mortgagee, so the mortgagee's interest survives acts of the owner that would defeat the owner's own claim, arson and misrepresentation included. Having paid, the insurer takes an assignment of the mortgage or subrogates against the owner. The mortgagee need not sue first, and it is owed its interest rather than a premium refund.

Policy Structure & Provisions

An insured sells his building and tries to hand the property policy to the buyer. That assignment is effective only if:

  • a.The policy has run half of its term
  • b.The buyer assumes the unpaid premium
  • c.The insurer consents to it in writing✓
  • d.The deed and policy are recorded together

A property policy is a personal contract between the insurer and the particular insured whose character, loss history and use of the property were underwritten, so it cannot be handed to a stranger without the insurer's written consent. Paying the outstanding premium or recording documents at the courthouse does nothing to bind an insurer to someone it did not evaluate, and the age of the policy is irrelevant.

Policy Structure & Provisions

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

  • a.Returns the entire premium to the insured
  • b.Terminates the contract before it expires✓
  • c.Declines to continue it past expiration
  • d.Requires the insured's written agreement

Cancellation cuts the contract short while the term is still running, and either party may do it on the terms the policy and the law of the jurisdiction allow. Non-renewal is a decision made at the end of a term not to offer another one, so the contract simply runs out on schedule. Neither one needs the other party's agreement, and cancellation returns unearned premium only, not the whole premium.

Policy Structure & Provisions

A policy carries a $1,000 deductible for each occurrence. A windstorm damages the roof for $12,000 and, three months later, a separate hailstorm causes $4,000 of damage. The insurer pays in total:

  • a.$14,000✓
  • b.$16,000
  • c.$11,000
  • d.$15,000

A per-occurrence deductible is subtracted from each separate loss, so the insured absorbs $1,000 twice: $11,000 is paid on the wind claim and $3,000 on the hail claim, a total of $14,000. Applying one deductible to the whole year yields $15,000, and ignoring the deductible altogether yields the full $16,000. The deductible reduces the payment; it is not a bill sent to the insured.

Policy Structure & Provisions

A bank that financed the insured's equipment is shown on the declarations as a loss payee. That means the bank:

  • a.Owes the premium if the insured does not
  • b.Can cancel the policy and collect a refund
  • c.Is paid for damage to that equipment✓
  • d.Receives liability coverage as an insured

A loss payee has a financial interest in specific property and is named so that payment for damage to that property runs to it along with the insured; its rights reach no further than that property. An additional insured, by contrast, is brought under the liability coverage. Only the named insured holds the right to change or cancel the policy and the duty to pay the premium.

Policy Structure & Provisions

A customer slips in the insured's store and sues him. What the insured presents to his liability insurer is:

  • a.A third-party claim, defended by the insurer✓
  • b.A subrogation claim against the customer
  • c.An excess claim over the customer's health plan
  • d.A first-party claim for the insured's own loss

A first-party claim is the insured presenting his own loss to his own insurer, such as fire damage to the store itself. When someone outside the contract asserts a claim against the insured, it is a third-party claim, and the liability policy owes both a defense and payment of damages up to the limit. Subrogation runs the other way, against whoever caused the insured's loss.

Montana P&C Law & Regulation

Which official regulates insurance and licenses resident property and casualty producers in Montana?

  • a.The Montana Secretary of State
  • b.The Montana Department of Revenue
  • c.The Montana Commissioner of Securities and Insurance (the State Auditor's office)✓
  • d.The Montana Public Service Commission

In Montana the elected State Auditor serves as the Commissioner of Securities and Insurance (CSI), whose office licenses producers, reviews forms and rates, and enforces the insurance code. A distinctive Montana fact is that the insurance regulator and the State Auditor are the same office.

Montana Auto Coverage Requirements

What are Montana's minimum bodily-injury auto liability limits for a private passenger vehicle?

  • a.$15,000 per person / $30,000 per accident
  • b.$25,000 per person / $50,000 per accident✓
  • c.$50,000 per person / $100,000 per accident
  • d.$100,000 per person / $300,000 per accident

Montana's minimum bodily-injury liability limits are $25,000 per person and $50,000 per accident (25/50), with a separate property-damage minimum also required. These are minimums set by state law and can change; confirm the current bodily-injury and property-damage figures with the Montana Commissioner of Securities and Insurance.

Montana Auto Coverage Requirements

How is Montana's auto insurance system best characterized with respect to the right to sue?

  • a.A no-fault state that restricts auto injury lawsuits
  • b.An add-on PIP state with mandatory first-party benefits
  • c.A tort ('at-fault') state in which the injured party keeps the right to sue the at-fault driver✓
  • d.A state with no financial-responsibility requirement

Montana is a tort, or at-fault, state: it does not mandate no-fault personal injury protection, so an injured person retains the full right to sue the at-fault driver for damages. Compulsory liability coverage still applies under Montana's financial-responsibility law. Confirm current requirements with the Montana Commissioner of Securities and Insurance.

Montana Auto Coverage Requirements

Under Montana's compulsory insurance / financial-responsibility law, a private passenger auto must at minimum carry:

  • a.Bodily-injury and property-damage liability coverage at the state minimum limits✓
  • b.Only comprehensive coverage
  • c.No coverage, because Montana does not require auto insurance
  • d.Collision coverage only

Montana requires every registered motor vehicle to be covered by liability insurance meeting the state minimum bodily-injury and property-damage limits (or an approved alternative proof of financial responsibility). Verify the current minimum limits with the Montana Commissioner of Securities and Insurance.

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Montana P&C Law & Regulation

A Montana producer offers to rebate part of the commission to a client as an inducement to buy a policy. Under Montana's unfair trade practices law this is:

  • a.Permitted if disclosed to the insurer
  • b.Permitted for new clients only
  • c.Prohibited rebating✓
  • d.Required to be reported but otherwise lawful

Giving any part of the premium or commission, or other valuable consideration not stated in the policy, as an inducement to buy is prohibited rebating under Montana's unfair trade practices law and can bring fines and license action by the Montana Commissioner of Securities and Insurance.

Montana P&C Law & Regulation

After a Montana personal auto or homeowners policy is past its initial underwriting period, mid-term cancellation by the insurer is generally permitted only:

  • a.For specific statutory grounds such as nonpayment of premium, fraud, or a substantial increase in the hazard, with required advance written notice✓
  • b.For any reason with no notice
  • c.Only in the first week after issuance
  • d.Never, under any circumstances

Montana limits mid-term cancellation of seasoned personal-lines policies to defined grounds such as nonpayment, fraud, or a material increase in the insured hazard, and requires advance written notice so the insured can replace coverage. The exact notice day-counts are set by statute; verify current figures with the Montana Commissioner of Securities and Insurance.

Montana Licensing & CE

Before a licensed Montana producer may transact business for a specific insurer, what must occur?

  • a.Nothing further once the license is issued
  • b.The insurer must appoint the producer, with the appointment on file with the Commissioner of Securities and Insurance✓
  • c.The producer must post a surety bond with the state treasurer
  • d.The producer must establish residency in the insurer's home state

A license authorizes a person to act as a producer, but to represent a specific insurer that company must appoint the producer, with the appointment recorded with the Montana Commissioner of Securities and Insurance. A producer may hold appointments from several insurers at once.

Montana Licensing & CE

Which statement best describes continuing education for a Montana resident P&C producer?

  • a.CE is never required
  • b.CE is required only for the first renewal
  • c.State-approved continuing education, including an ethics component, is required each renewal cycle✓
  • d.CE can be satisfied only by retaking the licensing exam

Following the NAIC model, Montana requires resident producers to complete approved continuing education each renewal cycle, including an ethics portion. The exact hour totals are set by the Montana Commissioner of Securities and Insurance and should be verified before renewal.

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