Contents
         1111
         Preface xiii
         Chapter 1 FUNDAMENTALS AND TERMINOLOGY
         Chapter Objectives
         Introduction
         Insurance Defined Financial Definition Legal Definition Loss, Chance of
         Loss, Peril, Hazard, and Proximate Cause Loss ChanceofLoss Peril and
         Hazard Proximate Cause Risk Risk Management The Mathematical
         Basis for Insurance A Mathematical Example of an Insurance System's
         Operations Building Blocks of an Insurance Premium Four Basic
         Components Cash Flow Underwriting The Benefits and Costs to Society
         of Insurance Systems Costs Benefits Arson: Who Really Pays for
         Insnred Losses Summary Review Terms Review Discussion
         Questions Research Assignment Suggestions for Further Study 18
         Chapter2 INSURABLE LOSS EXPOSURES
         Chapter Objectives
         Introduction
         Gambling and Speculative Risks Ideally Insurable Loss Exposures
         A Large Group of Similar Units Exposed to the Same PeriKs) Losses Must be
         Accidental and Beyond the Insured's Control Losses Must be Definite,
         Measurable, and of Sufficient Severity to Cause Economic Hardship
         Catastrophic Losses When Only the People Most Exposed to Loss Want
         Coverage, Insurance Becomes Unfeasible Risk Classification
         Subsidization Adverse Selection Principles ofRisk Classification
         Important Social Issues AIDS (Acquired Immune Deficiency Syndrome)
         Automobile Insurance Pension Benefits Conclusion Branches of
         Insurance Summary Review Terms Review Discussion
         Questions Research Assignment Suggestionsfor Further Study
         Chapter 3 RISK MANAGEMENT 1: ESSENTIALS
         Chapter Objectives
         Introduction
         The Risk Management Function Risk Management Staff Statement of
         Objectives and Principles The Risk Management Process Step One:
         Identification and Measurement of Exposures Direct Property Losses
         Loss oflncome Liability Losses Loss ofKey Personnel Estimation of
         Maximum Loss Emergency Planning-Disastor Recovery Step Two: Loss
         Control and Risk Financing Loss Control Risk Financing Step
         Three: Regular Review of the Risk Management Program Chicago Tunnel
         Collapse: A Risk Management Problem Summary Review Terms
         Review Research Assignment: Case Study Suggestions for Further
         Study Appendix: Personal Risk Management
         Chapter 4 RISK MANAGEMENT 2: ADVANCED TOPICS
         Chapter Objectives
         Introduction
         Risk Management Information Systems (RMIS) Loss Data Other
         Information Deductibles and Policy Limits Financial and Other
         Considerations British Petroleum: A Case Study Intemational Risk
         Management Identification and Measurement of Exposures Development
         and Implementation ofPlans Regular Review and Evaluation Foreign
         Insurance Financial Risk Management Summary Review
         Terms Review Discussion Questions Research Assignment
         Suggestions for Further Study Case Study: Blue Star Airlines
         Introduction The Story The Risk Management Process Facts and
         Assumptions Assignment
         Chapter 5 PRIVATE INSURANCE COMPANIES
         Chapter Objectives
         Introduction
         Two Different Types of Insurance Companies Mutual Insurance
         Companies Stock Insurance Companies Stock Versus Mutual: A
         Consumer's Viewpoint Demutualization Lloyd's of London
         Lloyd's ofLondon Is an Insurance Market Lloyd's History Typical
         Transaction Lloyd's and the Risk Management Function American
         Lloyds Other Legal Forms of Insurance Companies The Reciprocal
         Exchange Fratemal Insurers Savings Bank Life Insurance Blue
         Cross and Blue Shield Health Maintenance Organizations (HMOs) and
         Preferred Provider Organizations (PPOs) Industrial Organization
         Insurance Industry Summary Review Terms Review
         Discussion Questions Research Assignment Suggestions for
         Further Study Appendix: Insurance and Private Enterprise: The Potential
         for Eastern Europe Introduction Why Insurance? Why Private
         Insurance? Competition and Efficiency Essential Requirements of a Free
         Enterprise (Capitalist) System The Requirements ofa Private Insurance
         System Difficulties Starting a Private Insurance System in Eastern Europe
         The Future
         Chapter 6 INSURANCEOCCUPATIONS
         Chapter Objectives
         Introduction
         Insurance Agents and Brokers Agency Law Insurance Brokers
         Licensing Requirements Property and Liability Insurance Agents and
         Brokers Life Insurance Agents and Brokers An Insurance Agent's
         Duties Loss Adjuster Employees, Independent Adjustment
         Bureaus, and Public Adjusters Adjusters Are Agents Underwriter
         Property Insurance Underwriting Life Insurance Underwritmg
         Underwriting and Privacy Actuary Attomey Finance
         Other Occupations Summary Review Terms Review
         Discussion Questions Research Assignment Suggestions for
         Further Study Appendix: Legal Issues Involving Insurance Agents and
         Brokers Case 1 Case 2 Appendix: The Ethical Choice
         Introduction Vocabulary Ethical Norms Three Practice Cases
         Suggestions for Further Study
         Chapter 7 THE INSURANCE MARKET: THE ECONOMIC PROBLEM
         Chapter Objectives
         Introduction
         Economic Theory Supply and Demand Historical Problems The
         Insurance Consumer The Consumer's Choice: Company, Agent or Broker,
         Policy, Amount, and Price Consumer Protection: The Role of the Courts,
         the Law, and the Insurance Commissioner The Courts The Law
         The Insurance Commissioner Summary Review Terms
         Review Discussion Questions Research Assignment
         Suggestions for Further Study Appendix: Further Consideration of
         Supply and Demand Elasticity of Supply and Demandfor Insurance
         Shifting Supply and Demand Curves 170
         Chapter 8 INSURANCE REGULATION
         Chapter Objectives
         Introduction
         Insurance Regulation The Reasons for Insurance Regulation
         Solvency Unequal Knowledge and Bargaimng Power Prices
         Promotion ofSocial Goals The History of Insurance Regulation Paul
         v. Virginia Armstrong and Merritt Investigations South-Eastern
         Underwriters Association (SEUA) The McCarran Act State or Federal
         Regulation? State Insurance Regulation The National Association of
         Insurance Commissioners (NAIC) Repeal of P.L.-15 Both Sides ofthe
         Argument Regulated Activities Legal Reserves and Surplus
         Regular Audits and Solvency Testing Guaranty Funds Rate
         Regulations Investment Activities Policy Form Approval and Expense
         Limitations Qualifications or Licensesfor Companies, Agents, Brokers, Loss
         Adjusters, and Company Officers Consumer Complaints Taxation
         Summary Review Terms Review Discussion Questions
         Research Assignment Suggestions for Further Study Appendix:
         The McCarran Act (P.L.-15)
         Chapter 9 INSURANCE CONTRACTS
         Chapter Objectives
         Introduction
         Contract Terminology Binder Conditional Receipt Elements of
         a Valid Contract Offer and Acceptance Consideration
         Capacity Legal Purpose Distinguishing Characteristics of Insurance
         Contracts Principle ofIndemnity Insurable Interest ActualCash
         Value Subrogation Contract ofAdhesion The Personal Feature
         Utmost Good Faith (Latin: Uberrimae Fidei) The Entire Contract and
         Incontestability Clauses The Aleatory Feature Discharge of Insurance
         Contracts Summary Review Terms Review Research
         Assignment Suggestions for Further Study Appendix: Cases for
         Dscussion Material Misrepresentation Contract of Adhesion: The
         Metpath Case Breach ofWarranty: General Chicken Case
         Chapter 10 BASIC PROPERTY AND LIABILITY INSURANCE CONTRACTS
         Chapter Objectives
         Iritroduction
         Standard Policies Basic Parts of an Insurance Policy
         Declarations Insuring Agreement Deductibles Definitions
         Exclusions Endorsements Conditions Fraud Suspension of
         Coverage Cancellation Other Insurance Duties After a Loss
         Appraisal Salvage Claims Payment Conclusion
         Summary Review Terms: Review Case for Discussion:
         Vacancy Clause Research Assignment Suggestions for Further
         Study 235
         Chapter 11 HOMEOWNERS INSURANCE
         Chapter Objectives
         Introduction
         A General Description of the HO Insurance Policies Policy Layout
         Declarations Definitions Section 1-Property Coverages
         Additional Coverage Section 1--Perils Insured Against in the Broad
         Form,HO-2 Specified Perils HO-2: Section 1-Exclusions
         Ordinance-or-Law Exclusion Other Exclusions Section 1--
         Conditions Loss Settlement Replacement Cost and Coinsurance
         Reasonsfor the Coinsurance Requirement Mortgage Clause Section
         2--Liability Coverages Section 2--Exclusions Claims Not Couered
         Arisingfrom Bqdily Injury or Property Damage , Sections 1 and 2--
         Conditions Endorsements Reduction of Insurance Resulting from
         Previous Losses Summary Review Terms Review
         Practice Questions Research Assignment Suggestions for Further
         Study Appendix: Buying Homeowners Insurance 264
         Chapter 12 THE PERSONAL AUTO POLICY
         Chapter Objectives
         Introduction
         The Tort Liability System and Automobile Insurance: A Review Case The
         Personal Auto Policy Layout Definitions Part A--Liability Limit
         ofLiability Insureds Exclusions Part B--Medical Payments
         Part C--Uninsured Motorist Coverage Coverage under the PAP
         Contact or No-Contact Rules The State's Response to Uninsured Motorists
         Underinsured Motorists Part D--Damage to Your Auto Loss
         Settlement Part E--Duties After an Accident or Loss Part F--General
         Provisions Summary Review Terms Review Practice
         Questions Research Assignment Suggestions for Further Study
         Chapter 13 COMMERCIAL PROPERTY INSURANCE
         Chapter Objectives
         Introduction
         Commercial Insurance Commercial and Personal Property Ihsurahce
         Property and Marine (Transportation) Insurance Commercial Package Policy
         The Insurance Services Office (ISO) Building and Personal Property
         Form Property Covered Property Excludedfrom Coverage Perils
         Covered Fire Insurance History Definition ofFire Reporting Formts
         Business Income Coverage Additional Forms Property Insurance
         Rating Transportation Insurance Ocean Marine Insurance Inldnd
         Marine Insurance Aviation Insurance Automobile Property Insurance
         Business Automobile Insurance Summary Review Terms
         Review Discussion Questions Research Assignments
         Suggestions for Further Study
         Chapter 14 GENERAL LIABILITY INSURANCE
         Chapter Objectives
         Introduction
         Legal Background CategoriesofTorts (Civil Wrongs) Negligerice
         Lawsuits Establishing Negligence and Damages Defenses in a Negligence
         Suit The Relationship Between Negligence and Legal Liability Insurance
         Questions ofFact Legal Judgements Ethics and Liability Insurance
         Social Host Liquor Liability: An Example The Facts Categories
         of Liability Insurance Business General Luability Insurance Business
         Liability Umbrella Policies Automobile Liability Insurance Summary
         Review Terms Review Discussion Questions Case for
         Discussion Research Assignment Suggestions for Further Study 328
         Chapter 15 SPECIAL LIABILITY INSURANCE
         Chapter Objectives
         Introduction
         Claims-Made and Occurrehce Policies Claims-Made Policies Occurrence-
         Basis Policies Environmental Impairment Liability Insurance History
         Risk Management Strategy Insurance Principles and EIL Coverage
         Products Liability Insurance Risk Management Strategy The Continuing
         Controversy Professional Liability Insurance Wfut Is a Professional?
         Coverage Clause Claims Settlement Types of Professional Liability
         Coverage Employment Practices Liability Americans with Disabilities Act
         (ADA) Nuclear Liability Insurance Summary Review Terms
         Review Discussion Questions Research Assignments
         Suggestions for Further Study Appendix Case Study: Sexual
         Harassment Case Study: Americans with Disabilities Act (ADA) 353
         Chapter 16 BONDING, CRIME INSURANCE, AND REINSURANCE
         Chapter Objectives
         Introduction
         Surety Bonding Introductory Terminology The Reasons for Surety
         Bonding The Uifference Between Suretyship and Insurance Underwriting
         Bonds Types of Bonds Crime Insurance Reinsurance
         Introductory Terminology Reinsurance Arrangements Reinsurance
         Coverage Reasons for Reinsurance Reinsurance and Risk Management
         Providers of Reinsurance Concluding Comments Summary
         Review Terms Review Discussion Questions Research
         Assignment Suggestions for Further Study 368
         Chapter 17 LIFE INSURANCE POLICIES
         Chapter Objectives
         Introduction
         Three Ways Life Insurance Is Distributed Group Life Insurance
         Industrial Life Insurance Individual Life Insurance Term Insurance
         Types of Term Life Insurance Uses of Term Life Insurance Whole Life
         Insurance Cash Values Types of Whole Life Policies The Uses of
         Whole Life Insurance Reasonsfor Saving with Life Insurance A Whole Life
         Ledger Sheet Buy Term and Invest the Difference: The Consumer's
         Viewpoint Universal Life Insurance Universal Life Insurance Policies
         Universal Life Insurance Death Benefits Uses of Universal Life Insurance
         Ledger Sheetfor Universal Life Insurance Variable Life Insur'ance
         Summary Review Terms Review Discussion Questions
         Research Assignment Suggestions for Further Study Appendix
         Endowment Life Insurance 391
         Chapterl8 ANNUITIES
         Chapter Objectives
         Introduction 394
         Definitions Classification of Annuities Method ofPremium
         Payment Beginning of Benefits Promises Purchased Number of
         Annuitants Determination of Annuity Benefits Uses of
         Annuities Types of Benefits Taxation of Annuities Withdrawal
         before Liquidation Withdrawals in Liquidation Summary Review
         Terms Review Discussion Questions Research
         Assignment Suggestions for Further Study 406
         Chapter 19 LIFE INSURANCE PLANNING
         Chapter Objectives
         Introduction
         The Economic Value of the Human Life The Needs-Based Purchase of
         Life Insurance Life Insurance Planning Planning Process The
         Early Adult Years Life Insurance Planning: A Case Study Insurance for
         Wiues, Children, and College Students Life Insurance Planning: The Middle
         Years Life Insurance Plahning: The Later Years Wills Federal
         Estate Tax Business Uses of Life Irisurance Funding Business
         Continuation Agreements with Life Insurance The Taxation of Life
         Insurance Death Proceeds Living Benefits: Dividends, Savings, and
         Accelerated Death Benefits Summary Review Terms
         Review Discussion Questions Research Assignment Facts and
         Data Suggestions for Further Study
         The
         Chapter 20 STANDARD LIFE INSURANCE CONTRACT PROVISIONS
         ANDOPTIONS
         Chapter Objectives
         Introduction
         Insured, Owner, and Beneficiary Beneficiary Designation General
         Life Insurance Policy Provisions Grace Period The Reinstatement
         Provision The Incontestable Clause he Entire-Contract Proviswn
         Misstatement-of-Age Provision Annual Apportionment of Divisible Surplus
         The Suicide Clause and Other Restrictive Clauses Four Options Providing the
         Insured with Choices Dividend Options Nonfbrfeifure Options
         Policyholder Loans Settlement Options Available Riders and Options
         The Guaranteed-Insurability Option The Waiver-of-Premium Option The
         Double-Indemnity Option Summary Review Terms Review
         Discussion Questions Research Assignment Suggestions for Further
         Study 445
         Chapter 21 SIMPLIFIED LIFE INSURANCE MATHEMATICS
         Chapter Objectives
         Introduction
         Mortality Tables The 1980CSO Other Mortality Tables Interpretation
         ofMortality Tables Some Simplifying Assumptions Single-Prenuum,
         One-Year Term Insurance Smgle-Premium, Five-Year Term Insurance
         Single-Premium, Whole Life Insurance Leveling the Whole Life Premium
         The Cost of Life Insurance and Sales Illustrations A Complex Issue
         Traditional Calculation Interest-Adjnsted Method The Sales Illustration
         Controversy Summary Review Terms Review Research
         Assignment Suggestions for Further Study
         Chapter 22 MEDICAL EXPENSE AND DISABILITY INSURANCE
         Chapter Objectives
         Intrpduction
         Background Information Increasing Health Care Costs Medical
         Inflation Cost Containment Conunon Contract Provisions Entire
         Contract Grace Period Reinstatement Incontestable Clause
         Claims Physical Exam and Autopsy Legal Action Change of
         Beneficiary Optional Contract Provisions Definitions and Exclusions
         Five Kinds of Health Insurance Coverage Basic Medical Expense
         Insurance Major Medical Insurance Disability Income Inswance
         Medicare Supplement Insurance Long-Term Care Insurance
         Demographics The Financial Problem Long-Term Care Policy
         Development The Continuing Debate Health Insurance Providers
         Summary Review Terms Review Discussion Questions
         Research Assignment Suggestions for Further Study
         Chapter 23 EMPLOYEE BENEFITS
         Chapter Objectives
         Introduction
         The Goals of the Govemment, Employer, and Employee The Gauemment
         The Employer The Employee Insured Employee Benefits
         Qualification Rules General Features Group Life Insurance Group
         Disability Income Insurance Long-Term Disability Group Health
         Insurance Social Problems Health Insurance Providers Health
         Insurance Contracts General Provisions ofGroup Health Inswance Contracts
         Two Federal Regulations Insured Pension Plans Introduction
         Requirements for QuaUfied Plans Federal Regulation ofPension Plans The
         Role of Insurance in Pension Plans Profit-Sharmg, 401(k), 4030(b), Keogh, and
         Cafeteria Plans Profit.-Sharing Plans 401(k) Plans 403(b) Plans or
         Tax-Deferred Annuities (TDAs) Keogh Plans Cafeteria Plans
         Individual Retirement Account (IRA) EHgibility for Deductible Contributions
         Investment Alternative Rollovers Taxation Summary
         Review Terms Review Discussion Questions Research
         Assignment Suggestions for Further Study Appendix: Tax Deferral
         The Advantages of Tax Deferral
         Chapter24 SOCIAL SECURITY
         Chapter Objectives
         Introduction
         Social Insurance Background The History and Philosophy of the American Social
         Security System Social Security Js Not a Public Assistance Program Social
         Security and Private Insurance Are Different Social Security Is an Insurance System
         The Operation of the Social Security Program The Program Is
         Compulsory for Almost Every Worker A Tax on Wages Is the Main Source ofFunds
         Benefits Are Not Fully Funded Insured Statns and Eligibility for Benefits
         Qnarters ofCoverage Calculationof Benefits Categories of Benefits
         Retirement Benefits Survivor Benefits Disability Benefits Medicare
         (Health Insurancefor the Aged and Disabled) some Current Issues Facing the
         Social Security System Will Social Security "Be There"for Young and Middle-
         Aged Americans? The Social Security Surplus and the Federal Deficit Other
         Criticism Summary ReviewTerms Review Discussion
         Questions Research Assignment Suggestions for Further Study
         Chapter 25 UNEMPLOYMENT AND WORKERS' COMPENSATION INSURANCE
         Chapter Objectives
         Introduction
         Unemployment Insurance Some Background Information Operations
         ofthe Unemployment Insurance Program 1s Unemployment Insurance Really
         Insurance? General Provisions ofState Programs Summary-
         Unemployment Insurance Workers' Compensation The Problem
         The Solution The Purposes of Workers' Compensation Laws Operations of
         Workers' Compensation Systems Current Concerns About Workers'
         Compensation Summary-Worker's Compensation, Review Terms
         Review Discussion Questions Research Assignment
         Suggestions for Further Study
         Glossary
         Appendix A: Homeowner's Insurance Policy
         Appendix B: Personal Auto Policy
         Appendix C: Sample Whole Life Insurance Policy and Application
         Index
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