Virginia Property & Casualty Insurance License Exam — All Questions

The part of an insurance policy that identifies the insured, the property or risk, the policy period, and the coverage limits is the:

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

The declarations page (the 'dec page') states the specific facts of the policy: the named insured, description of the covered property or risk, policy period, limits of insurance, premium, and any 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.

Subrogation is best defined as the insurer's right to:

• a.Deny coverage after it has already paid the claim
• b.Raise the insured's premium after paying a claim
• c.Recover a paid claim from the negligent third party✓
• d.Cancel the policy at any time for any reason at all

Subrogation is the insurer's right, after paying a covered claim, to step into the insured's shoes and pursue recovery from the third party who caused the loss. It prevents the insured from collecting twice and helps hold the responsible party accountable, which supports the principle of indemnity. The insured must not do anything after a loss that impairs the insurer's subrogation rights.

A binder in property and casualty insurance is:

• a.Temporary evidence of coverage until the policy issues✓
• b.A permanent replacement for the written policy form
• c.A list of the exclusions that apply to the policy
• d.A document that cancels the insured's coverage early

A binder is a temporary agreement, oral or written, that provides immediate evidence of insurance 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 A binder is not permanent; it is superseded once the actual policy is delivered or the coverage is formally declined.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 do in return for the premium is the:

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

The insuring agreement is the heart of the contract: it names the perils or the scope of liability covered and commits the insurer to pay. The declarations personalise the contract with the insured's name, the limits and the policy period, while the conditions set out the duties each party owes. Definitions only fix the meaning of terms used elsewhere in the form.

A homeowners form places the phrase residence premises in quotation marks every time it appears. That signals the phrase:

• a.Is defined in the policy and controls coverage✓
• b.Is a term the insured chose on the application
• c.Is used in its ordinary dictionary meaning
• d.Applies only to the declarations page entries

Quotation marks or boldface flag a term carried in the definitions section, and the defined meaning governs everywhere the term appears, often narrowing coverage well below what the everyday meaning suggests. Reading such a term in its dictionary sense is the classic mistake that leaves an insured expecting coverage the form does not grant. The insured does not draft definitions, and they operate throughout the policy.

Insurers write exclusions into a property policy chiefly in order to:

• a.Remove uninsurable or catastrophic exposures✓
• b.Reduce the number of claims that get reported
• c.Satisfy a federal standard on policy forms
• d.Keep the insured from filing a lawsuit later

Exclusions keep the policy insurable and affordable by removing losses that are catastrophic or not accidental, exposures better handled by a different policy, and hazards only some insureds face and only they should pay for. Blocking lawsuits is not the purpose, and there is no federal standard dictating what a property form must exclude, since insurance is regulated primarily at state level.

An endorsement is attached to a policy and its wording conflicts with the printed form. The result is that:

• a.The endorsement controls over the printed form✓
• b.The printed form controls, being the main contract
• c.The insured chooses which wording will apply
• d.The conflict voids the policy from inception

An endorsement is a written amendment that becomes part of the contract, and as the later and more specific expression of the parties' intent it takes precedence over conflicting language in the base form. A conflict voids nothing; it is settled by that rule of construction, with any ambiguity that survives read against the drafter. The insured does not get to pick the wording after a loss.

An agent holding binding authority tells an applicant by phone that coverage is in force, and the building burns before any paperwork is issued. The likely outcome is that:

• a.The agent is personally liable for the loss
• b.No coverage exists until a policy is issued
• c.The loss is covered under the oral binder✓
• d.Coverage begins only when premium is paid

A binder is temporary evidence that coverage is in effect pending underwriting and issuance, and an agent with binding authority can create one orally as well as in writing. Waiting for the policy or for the premium check would leave applicants unprotected during exactly the gap a binder exists to close. Because the agent acted inside the authority the insurer granted, the loss belongs to the insurer, not to him.

Mid-term, an insurer broadens the coverage of its standard form without charging more for it. Under the liberalization clause the change:

• a.Applies to policies already in force✓
• b.Applies only to policies written afterward
• c.Applies if the insured requests it in writing
• d.Applies only at the next renewal date

The liberalization clause hands existing policyholders any broadening the insurer adopts for that form at no additional premium, automatically and without an endorsement. Requiring a written request or waiting for renewal would defeat the purpose, which is to avoid amending thousands of policies one at a time. It works in one direction only: narrowing coverage takes a proper endorsement or a new form.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.