Week 6 & 7 (Negligence Law/Non-cooperation/Insurable Interest/Re-po Vehs/Emergency Doctrine -april

1. When our investigation reveals our insured's word against the claimant's word with no proof the accident happened one way over the other and either way would result in 100% in favor of the person giving the statement, how should these claims be settled?

Comparative Negligence 50/50

Contributory Negligence with a denial

Driver vs. Driver with a denial

Not Greater Than

2. If the insured has not reported the loss, but the insured's statement is on the police report, and failure by the insured to provide timely notice has not prejudiced us, we may still process the 3rd party claim.

True

False

3. If you suspect you have a case of insurable interest, you should do all of the following except?

Review the police report for the registered owner information.

Request a DMV search to verify the titled and registered owner.

Call the insured and discuss his/her interest in the vehicle.

Pay the collision claim because insurable interest is hard to prove.

4. NYS follows which type of Negligence Law?

Pure Comparative

Contributory

Less Than

Not Greater Than

5. Pick the answer that best describes the sequence of actions to be taken when the insured has not reported the loss.

Phone calls as often as needed, L34, L44, 15 day letter (aka final non-coop letter), non-cooperation disclaimer

Pend to EFW, phone calls as often as needed, L34, L44, non-cooperation disclaimer.

L34, phone calls as often as needed, 15 day letter, L44, non-cooperation disclaimer

L34, SIU Assist, L44, Attempt a call to the insured, non-cooperation disclaimer

6. Companies that use their own money to take care of their losses without going through insurance companies

Utilize subrogation

Practice re-insurance methods

Are self-insured

Receive a company bonus

7. A person faced with an emergency and who acts without opportunity to consider the alternatives is not negligent if he/she acts as a reasonable prudent person would act in the same emergency even if it later appears that he/she did not make the safest choice or exercise the best judgment. This is known as the {blank} doctrine.

Legal

Abstention

Last clear chance

Emergency

8. When a bank takes possession of the insured vehicle and places a claim for damages, what steps are necessary to process the claim? (check all that apply)

Payment is made immediately to the lienholder upon first notice review.

Verify there is physical damage coverage for the insured vehicle.

Call the insured and find out how the damages occurred.

Request a notice of repossession from the lien holder.

Find out if the vehicle is available for inspection and if so, assign the vehicle.

Settlement check is made payable to lienholder and the insured.

Submit

9. The L14/L14C auto pends for how many days?

10

15

25

10

10. The driver of our insured's vehicle (non-household member) reports a loss under the insured's policy. During a call to the insured it is discovered the insured sold the vehicle several months ago to the driver and agreed to keep the insurance in the insured's name as the driver has a DWI on his record. The insured cannot be paid for comp or collision as they have no insurable interest in the vehicle.

True

False

11. Which letter would you send to the claimant who is making a claim with NYCM and is found to be 100% at fault?

L64A

L74A

L74B

L64B

12. If we have determined the insured has no insurable interest in a vehicle and deny physical damage coverage, we will also deny any liability claims that arise due to a loss.

True

False

13. If the lienholder is listed on the policy, they are entitled to payment under Part D regardless of a statement from our insured.

True

False

14. If we have received a small claims summons as our first notice of the claim, the examiner should contact the insured for their loss statement; however, the L74A/L74 should NOT be sent to the claimant.

True

False

15. Match the definition with the correct Negligence Law

An insured can collect from an adverse only if their negligence is not greater than the other party. 50/50 rule

An insured can collect any % from the adverse when the other party holds liability.

An insured can collect from the adverse only if their negligence is less than the claimant's negligence. 49/51 rule

If an insured hold any % of liability, they cannot collect anything from the adverse.

Submit