Michigan Insurance Exam Content Outlines. Effective June 18, 2007

Transcription

1 Michigan Insurance Exam Content Outlines Effective June 18, 2007 The following outlines describe the content of each of the Michigan examinations. The outlines are the basis of the examinations. Each exam has questions on the subjects contained in the outline. The percentages indicate the relative weight assigned to each section of the examination. For example, 10 percent means that 6 questions will be drawn from the section on a 60-question exam, 10 will be drawn on a 100- question exam and 15 will be drawn on a 150-question exam. All references are to the Michigan Insurance Code, MCLA et seq., MCLA et seq. When preceded by R, refer to Michigan Regulations. RL refers to Michigan Related Laws. All references to MCLA 418 et seq. are to the Worker s Disability Compensation Act. Note that Sections 1.0 and 2.0 (Insurance Regulation and General Insurance) are common to many of the exams. Details of these two sections are presented only once, immediately below. Similarly, combination exams contain all of the content of the single-line exams they combine and you are referred to the single-line outlines for details. Note, however, that the section weights differ. You should refer to the outline of the exam you plan to take for the individual section weights. Customized outlines are available through our Web site at Section 1.0: Insurance Regulation and Section 2.0: General Insurance One or both of the following sections are common to outlines for Series through16-69, 16-73, 16-75, 16-76, 16-78, and Individual section percentages are located with the particular series outline. Be sure to study material that covers Sections 1.0 and 2.0 in addition to particular line(s) you are studying. 1.0 Insurance Regulation 1.1 Licensing Process ( ,.1201a,.1204,.1205,.1206,.1206b,.1240) Types of licensees ( ) Producer ( , ,.1201a,.1204,.1205,.1206,.1206b,.1240) Adjuster ( , ) Counselor ( ,.1234,.1236) Managing general agent ( (b),.1405) Limited (R ) Business entity ( ,.1205) Financial institutions ( ,.1243) Resident versus nonresident ( , a, b, ; R ) Temporary ( b) Maintenance and duration Continuation (24.291; ,.134,.1153) Change of address ( (5),.1238) Reporting of actions ( b,.1239,.1244,.1246,.1247) Assumed names ( a) Continuing education requirements ( , 1204c, 1204d,.1204e,.1206; ) Bond ( ,.1407,.1504) Disciplinary actions Cease and desist order ( ,.2038) Suspension, revocation, refusal to issue or renew ( ,.1209,.1239,.1379,.2029,.2043) Penalties and fines ( ,.1244,.1379,.2038,.2040,.2064,.2069) 1.2 State regulation Commissioner's general duties and powers ( ,.200,.202,.210) Company regulation Certificate of authority ( ,.402) Solvency ( ,.410,.436a) Rates ( ,.1615,.1904,.2106,.2403, 2411,.2603) Forms ( ) Unfair claims settlement practices ( ,.2026) Producer appointment ( a,.1208b,.1209,.1411) Termination of appointment ( b,.1209) Producer regulation Acting without a license ( ,.1201a,.1202,.1203) Prohibited conduct ( ,.1216,.2003,.2059,.2062) Commissions ( ,.2011)

2 Fiduciary capacity ( ) Unfair trade practices ( ,.1244,.2003, , ,.2026,.2029) Misrepresentation ( ,.2005a,.2055,.2057,.2064,.2218) False information and advertising ( ,.2002,.2005,.2005a,.2007,.2055,.2057,.2064) Twisting ( (f),.2064(2), ) False financial statements ( ,.2014,.2018,.2055,.2062,.2474,.2666) Defamation ( ,.2009; ; ; R ,.1377(14)) Boycott, coercion and intimidation ( ,.2012) Unfair discrimination ( ,.2020,.2027,.2082) Rebating ( ,.2024,.2069,.2070) Illegal inducement ( a,.2024,.2069,.2070; ) Examination of books and records ( ,.222) Insurance fraud regulation ( , , , , , , ; , ) Consumer privacy regulation ( ,.505,.507,.515,.535,.2005a,.4501, ) 1.3 Federal regulation Fair Credit Reporting Act (15 USC d) Fraud and false statements (18 USC 1033, 1034) Patriot Act Violent Control Act 2.0 General Insurance 2.1 Concepts Risk management key terms Risk Exposure Hazard Peril Loss Methods of handling risk Avoidance Retention Sharing Reduction Transfer Elements of insurable risks Adverse selection Law of large numbers Re 2.2 Insurers Types of insurers Stock companies Mutual companies Fraternal benefit societies Lloyd's associations Risk retention groups Private versus government insurers Authorized versus unauthorized insurers Domestic, foreign and alien insurers Financial status (independent rating services) Marketing (distribution) systems 2.3 Producers and general rules of agency Insurer as principal Producer/insurer relationship Authority and powers of producers Express Implied Apparent Responsibilities to the applicant/insured 2.4 Contracts Elements of a legal contract Offer and acceptance Consideration Competent parties Legal purpose Distinct characteristics of an contract Contract of adhesion Aleatory contract Personal contract Unilateral contract Conditional contract Legal interpretations affecting contracts Ambiguities in a contract of adhesion Reasonable expectations Indemnity Utmost good faith Representations/ misrepresentations Warranties Concealment Fraud Waiver and estoppel Series Life Producer 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 5% - 5 items (See Page 2) 3.0 Life Insurance Basics 17% - 17 items 3.1 Michigan life laws ( ,.2211) Insurable interest ( ,.2211) Viatical settlements ( ) Regulation of variable products (SEC, NASD and Michigan) (R , ) Solicitation and sales presentations ( ) Advertising (R ) Life and Health Insurance Guaranty Association ( ) Illustrations (R ) Policy summary (R ) Buyer's guides for life and annuities Life policy cost comparison methods Replacement (R ) Use and disclosure of information Selection criteria and unfair discrimination ( ) 3.2 Personal uses of life Survivor protection Estate creation Cash accumulation Security Liquidity Estate conservation 3.3 Determining amount of personal life Human life value approach Needs approach Types of information gathered Determining lump-sum needs Planning for income needs 3.4 Business uses of life Buy-sell funding Key person Executive bonuses Corporate-owned life 3.5 Classes of life policies Group versus individual Permanent versus term Participating versus nonparticipating Fixed versus variable life and annuities 3.6 Premiums 2

3 Factors in premium determination Mortality Interest Expense Premium concepts Net single premium Gross annual premium Premium payment mode 3.7 Producer responsibilities Field underwriting Notice of information practices Application procedures including conditional receipts Delivery Policy review Effective date of coverage Premium collection Statement of good health 3.8 Individual underwriting by the insurer Information sources and regulation Application Producer report Attending physician statement Investigative consumer (inspection) report Medical Information Bureau (MIB) Medical examinations and lab tests including HIV Classification of risks Preferred Standard Substandard 4.0 Life Insurance Policies 16% - 16 items 4.1 Term life Level term Annual renewable term Level premium term Decreasing term 4.2 Whole life Continuous premium (straight life) Limited payment Single premium Graded premium Modified life Interest sensitive Equity index 4.3 Flexible premium policies Adjustable life 4.4 Specialized policies Joint life (first-to-die) Survivorship life (second-to-die) Juvenile life 4.5 Group life Characteristics of group plans Types of plan sponsors Group underwriting requirements 4.6 Life policy law Credit life (individual versus group) ( ; R ) Group life conversion to individual policy ( ) Universal life ( ,.4037,.4038) 5.0 Life Insurance Policy Provisions, Options and Riders 18% - 18 items 5.1 Standard provisions Ownership Assignment Entire contract ( ) Modifications Right to examine (free look) ( ,.4073) Payment of premiums ( ) Grace period ( ) Reinstatement ( ) Incontestability ( ) Misstatement of age or gender ( ) and restrictions ( ) Interest on proceeds ( ) 5.2 Beneficiaries Designation options Individuals Classes Estates Minors Trusts Succession Facility of payment clause Revocable versus irrevocable Common disaster clause Spendthrift clause 5.3 Settlement options Cash payment Interest only Fixed-period installments Fixed-amount installments Life income Single life Joint and survivor 5.4 Nonforfeiture options Cash surrender value Extended term Reduced paid-up 5.5 Policy loan and withdrawal options Cash loans Automatic premium loans Withdrawals or partial surrenders 5.6 Dividend options Cash payment Reduction of premium payments Accumulation at interest One-year term option Paid-up additions 5.7 Disability riders Waiver of premium/waiver of stipulated premium (universal life) Waiver of cost of Disability income benefit Payor benefit life/disability (juvenile ) 5.8 Living benefit provisions/ riders ( ,.3949) Accelerated for payment Effect on death benefit Long-term care for payment Effect on death benefit 5.9 Riders covering additional insureds Spouse/other-insured term rider Children's term rider Family term rider 5.10 Riders affecting the death benefit amount Accidental death Guaranteed insurability Cost of living Return of premium 6.0 Annuities 10% - 10 items 6.1 Annuity principles and concepts Accumulation period versus annuity period Owner, annuitant and beneficiary Insurance aspects of annuities 6.2 Immediate versus deferred annuities Single premium immediate annuities (SPIAs) Deferred annuities Premium payment options Nonforfeiture Surrender and withdrawal charges Death benefits 6.3 Annuity (benefit) payment options Life contingency options Pure life versus life with guaranteed minimum Single life versus multiple life Annuities certain (types) 6.4 Annuity products Fixed annuities General account assets Interest rate guarantees (minimum versus current) Level benefit payment amount Equity indexed annuities Market value adjusted annuities (modified guaranteed annuities) 6.5 Uses of annuities Lump-sum settlements Qualified retirement plans Group versus individual annuities 3

4 Personal uses Individual retirement annuities (IRAs) Tax-deferred growth Retirement income Education funds 7.0 Federal Tax Considerations for Life Insurance and Annuities 6% - 6 items 7.1 Taxation of personal life Amounts available to policyowner Cash value increases Dividends Policy loans Surrenders Amounts received by beneficiary General rule and exceptions Settlement options Values included in insured's estate 7.2 Modified endowment contracts (MECs) Modified endowment versus life Seven-pay test Distributions 7.3 Taxation of non-qualified annuities Individually-owned Accumulation phase (tax issues related to withdrawals) Annuity phase and the exclusion ratio Distributions at death Corporate-owned 7.4 Taxation of individual retirement annuities (IRAs) Traditional IRAs Contributions and deductible amounts Premature distributions (including taxation issues) Annuity phase benefit payments Values included in the annuitant's estate Amounts received by beneficiary Roth IRAs Contributions and s Distributions 7.5 Rollovers and transfers (IRAs and qualified plans) 7.6 Section 1035 exchanges 8.0 Qualified Plans 3% - 3 items 8.1 General requirements 8.2 Federal tax considerations Tax advantages for employers and employees Taxation of distributions (age-related) 8.3 Plan types, characteristics and purchasers Simplified employee pensions (SEPs) Self-employed plans (HR 10 or Keogh plans) Money purchase plans Profit-sharing and 401(k) plans SIMPLE plans 403(b) tax-sheltered annuities (TSAs) Series Accident and Health Producer 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 7% - 7 items (See Page 2) 3.0 Health Insurance Basics 10% - 10 items 3.1 of perils Accidental injury Sickness 3.2 Principal types of losses and benefits Loss of income from disability Hospital/medical expense Dental expense Long-term care expense/home health care 3.3 Classes of health policies Individual versus group Private versus government Limited versus comprehensive 3.4 Limited policies Limited benefits Required notice to insured Types of ed policies Accident-only Critical illness Hospital indemnity (income) Credit disability Blanket ( ,.3640,.3650) Prescription drugs Dental Vision care Medicare supplements 3.5 Common exclusions from coverage 3.6 Producer responsibilities in individual health Marketing requirements Advertising (R , ) Life and Health Insurance Guaranty Association ( ) Sales presentations Outline of coverage (R ,.661) Field underwriting Nature and purpose Disclosure of information about individuals Application procedures Requirements at delivery of policy Common situations for errors/omissions 3.7 Individual underwriting by the insurer Underwriting criteria Sources of underwriting information Application Producer report Attending physician statement Investigative consumer (inspection) report Medical Information Bureau (MIB) Medical examinations and lab tests (including HIV consent) Use of genetic information ( b) Unfair discrimination ( ,.2027,.2082) Classification of risks Preferred Standard Substandard 3.8 Considerations in replacing health Pre-existing conditions ( f,.3607; R ) Credit for previously satisfied pre-existing condition exclusion (R ) Benefits, ations and exclusions Underwriting requirements Producer liability for errors and omissions 4.0 Individual Health Insurance Policy General Provisions 6% - 6 items 4.1 Required provisions Entire contract; changes ( ) Time on certain defenses ( ) Grace period ( ) Reinstatement ( ) Claim procedures ( , ) Physical examinations and autopsy ( ) Legal actions ( , 3422) Change of beneficiary ( ) Right to examine (free look) ( ) 4

5 4.2 Optional provisions Change of occupation ( ) Misstatement of age ( ,.3434) Other in this insurer ( ) Insurance with other insurers Expense-incurred basis ( ) Other benefits ( ,.3440) Unpaid premium ( ) Conformity with state statutes ( ) Illegal occupation ( ) 4.3 Other general provisions Insuring clause Consideration clause Renewability clause ( b; R ) Noncancelable Guaranteed renewable Conditionally renewable Renewable at option of insurer Nonrenewable (cancelable, term) 5.0 Disability Income and Related Insurance 7% - 7 items 5.1 Qualifying for disability benefits Inability to perform duties Own occupation Any occupation Pure loss of income (income replacement contracts) Presumptive disability Requirement to be under physician care 5.2 Individual disability income Basic total disability plan Income benefits (monthly indemnity) Elimination and benefit periods Waiver of premium feature Coordination with social and workers compensation benefits Additional monthly benefit (AMB) Social supplement (SIS) Occupational versus nonoccupational coverage At-work benefits Partial disability benefit Residual disability benefit Other provisions affecting income benefits Cost of living adjustment (COLA) rider Future increase option rider Relation of earnings to ( ) Other cash benefits Accidental death and dismemberment Rehabilitation benefit Medical reimbursement benefit (nondisabling injury) Refund provisions Return of premium 5.3 Unique aspects of individual disability underwriting Occupational considerations Benefit s Policy issuance alternatives 5.4 Group disability income Group versus individual plans Short-term disability (STD) Long-term disability (LTD) 5.5 Business disability Key person disability income Disability buy-sell policy 5.6 Social Security disability Qualification for disability benefits Definition of disability Waiting period Disability income benefits 5.7 Workers compensation Eligibility Benefits 6.0 Medical Plans 15% - 15 items 6.1 Medical plan concepts Fee-for-service basis versus prepaid basis Specified coverages versus comprehensive care Benefit schedule versus usual/reasonable/customary charges Any provider versus ed choice of providers Insureds versus subscribers/participants 6.2 Types of plans Major medical (indemnity plans) Characteristics Common ations from coverage Provisions affecting cost to insured Health Maintenance Organizations (HMOs) General characteristics Preventive care services Primary care physician versus referral (specialty) physician Emergency care Hospital services Other basic services Preferred provider arrangements and point-of-service (POS) plans General characteristics In-network and out-ofnetwork provider access PCP referral Indemnity plan features 6.3 Cost containment in health care delivery Cost-saving services Preventive care Hospital outpatient benefits Alternatives to hospital services Utilization review Prospective review Concurrent review 6.4 Michigan eligibility requirements (individual and/or group) Dependent child age ( ,.3402,.3406h) Child enrollment; non-custodial parents ( ,.3406g,.3406h) Newborn child coverage ( ) Adopted children 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements Eligibility Guaranteed issue Pre-existing conditions Creditable coverage Renewability 7.0 Group Health Insurance 15% - 15 items 7.1 Characteristics of group Group contract Certificate of coverage ( ,.3606,.3608) Experience rating versus community rating 7.2 Types of eligible groups Employment-related groups Individual employer groups Associations (alumni, professional, other) Customer groups (depositors, creditor-debtor, other) 7.3 Marketing considerations Advertising ( ,.2007,.2055,.2091; R ) Regulatory jurisdiction/place of delivery 7.4 Employer group health Insurer underwriting criteria Characteristics of group Plan design factors Persistency factors Administrative capability Eligibility for coverage Annual open enrollment Employee eligibility Dependent eligibility 5

6 Coordination of benefits provision ( a; ) Change of companies or loss of coverage Co and deductible carryover No-loss no-gain Events that terminate coverage Extension of benefits ( ) Continuation of coverage under COBRA and Michigan specific rules Conversion privilege ( ; ) 7.5 Small employer medical plans Definition of small employer ( ) Eligibility of employees ( ,.3707) Renewability ( ,.3711) 8.0 Dental Insurance 3% - 3 items 8.1 Types of dental treatment Diagnostic and preventive Restorative Oral surgery Endodontics Periodontics Prosthodontics Orthodontics 8.2 Indemnity plans Choice of providers Scheduled versus nonscheduled plans Benefit categories Diagnostic/preventive services Basic services Major services and co Combination plans Limitations Predetermination of benefits 8.3 Employer group dental expense Integrated deductibles versus stand-alone plans Minimizing adverse selection 9.0 Insurance for Senior Citizens and Special Needs Individuals 8% - 8 items 9.1 Medicare Nature, financing and administration Part A Hospital Insurance Individual eligibility requirements Enrollment Coverages and cost-sharing amounts Part B Medical Insurance Individual eligibility requirements Enrollment Coverages and cost-sharing amounts Claims terminology and other key terms Part C Medicare Advantage Part D Prescription Drug Insurance 9.2 Medicare supplements ( ) Purpose Open enrollment Standardized Medicare supplement plans ( ) Core benefits Additional benefits Michigan regulations and required provisions Advertising ( ,.3847) Standards for marketing ( ) Permitted compensation Appropriateness of recommended purchase and excessive ( ) Required disclosure provisions ( ) Reporting of multiple policies ( ) Buyer's guide ( ) Right to return ( ) Replacement ( ) Benefit standards ( ) Pre-existing conditions ( ) Outline of coverage ( ) Guaranteed issue for eligible persons ( ) Medicare Select ( ) 9.3 Other options for individuals with Medicare Employer group health plans Disabled employees Employees with kidney failure Individuals age 65 or older Medicaid Eligibility Benefits 9.4 Long-term care (LTC) ( f) LTC, Medicare and Medicaid compared Eligibility for benefits Levels of care Skilled care Intermediate care Custodial care Home health care ( ) Adult day care Respite care Benefit periods Benefit amounts Optional benefits Guarantee of insurability Return of premium Qualified LTC plans (state and federal) Underwriting considerations Michigan regulations and required provisions ( ) Standards for marketing ( ) Shopper's guide ( ) Outline of coverage ( ) Required disclosure provisions ( ) Replacement ( ) Right to return ( ) Inflation protection ( ) 10.0 Federal Tax Considerations for Health Insurance 4% - 4 items 10.1 Personally-owned health Disability income Medical expense Dental Long-term care 10.2 Employer group health Disability income (STD, LTD) Benefits subject to FICA Medical and dental expense Long-term care Accidental death and dismemberment 10.3 Medical expense coverage for sole proprietors, partners and ed liability corporations 10.4 Business disability Key person disability income Buy-sell policy Series Property Producer/Solicitor 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 8% - 8 items (See Page 2) 3.0 Property Insurance Basics 27% - 27 items 6

7 3.1 Principles and concepts Insurable interest Underwriting Function Loss ratio Rates Types Loss costs Components Hazards Physical Moral Morale Causes of loss (perils) Named perils versus special (open) perils Direct loss Consequential or indirect loss Blanket versus specific Basic types of construction Loss valuation Actual cash value Replacement cost Functional replacement cost Market value / repair cost Agreed value Stated amount Valued policy 3.2 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 3.3 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Property s Restoration/nonreduction of s Co Vacancy or unoccupancy Named insured provisions Duties after loss Assignment Abandonment Insurer provisions Liberalization Subrogation Salvage Claim settlement options Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 3.4 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) Standard fire policy ( ) ( ) Appraisal ( ) Concealment, misrepresentation or fraud ( ) Terrorism Risk Insurance Act of 2002 and Extension Act of 2005 (15 U.S.C. 6701; Public Law ) Essential Insurance Act ( ) Termination of authority to represent insurer ( ) 4.0 Dwelling ('02) Policy 5% - 5 items 4.1 Characteristics and purpose 4.2 Coverage forms Perils insured against Basic Broad Special 4.3 Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Fair rental value Coverage E Additional living expense Other coverages 4.4 General exclusions Special provisions Michigan (DP 01 21) Automatic increase in (DP 04 11) Broad theft coverage (DP 04 72) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners ('00) Policy 15% - 15 items 5.1 Coverage forms HO-2 through HO Section I Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Loss of use 5.4 Perils insured against Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria coverage (HO 04 26, HO 04 27) Permitted incidental occupancies (HO 04 42) Earthquake (HO 04 54) Scheduled personal property (HO 04 61) Personal property replacement cost (HO 04 90) Home day care (HO 04 97) 6.0 Commercial Package Policy (CPP) 10% - 10 items 6.1 Components of a commercial policy Common policy declarations Common policy conditions Interline endorsements One or more coverage parts 6.2 Commercial property ('02) Commercial property conditions form Coverage forms Building and personal property Condominium association Condominium commercial unit-owners Builders risk Business income Legal liability Extra expense Causes of loss forms Basic Broad Special Ordinance or law (CP 04 05) Spoilage (CP 04 40) Peak season of (CP 12 30) Value reporting form (CP 13 10) 6.3 Commercial inland marine Nationwide marine definition Commercial inland marine conditions form Inland marine coverage forms Accounts receivable Bailee's customer Commercial articles Contractors equipment floater Electronic data processing Equipment dealers Installation floater Jewelers block Signs Valuable papers and records Transportation coverages Common carrier cargo liability Motor truck cargo forms Transit coverage forms 6.4 Boiler and machinery ('01) Equipment breakdown protection coverage form (BM 00 20) 7

8 Business income Report of values (BM 15 31) Actual cash value (BM 99 59) 6.5 Farm coverage Farm property coverage form ('03) Coverage A Dwellings Coverage B Other private structures Coverage C Household personal property Coverage D Loss of use Coverage E Scheduled farm personal property Coverage F Unscheduled farm personal property Coverage G Other farm structures Mobile agriculture machinery and equipment coverage form Livestock coverage form Causes of loss (basic, broad and special) Limits 7.0 Businessowners ('06) Policy 8% - 8 items 7.1 Characteristics and purpose 7.2 Businessowners Section I Property Coverage Limits of Loss conditions General conditions Optional coverages 7.3 Businessowners Section III Common Policy 7.4 Protective safeguards (BP 04 30) Utility services direct damage (BP 04 56) Utility services time element (BP 04 57) 8.0 Other Coverages and Options 2% - 2 items 8.1 National Flood Insurance Program "Write your own" versus government Eligibility Coverage Limits 8.2 Other policies Boatowners 8.3 Residual markets Joint underwriting or joint re pool ( ) Series Casualty Producer/Solicitor 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 6% - 6 items (See Page 2) 3.0 Casualty Insurance Basics 20% - 20 items 3.1 Principles and concepts Insurable interest Underwriting Function Loss ratio Rates Types Loss costs Components Hazards Physical Moral Morale Negligence Elements of a negligent act Defenses against negligence Damages Compensatory special versus general Punitive Absolute liability Strict liability Vicarious liability 3.2 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 3.3 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Contribution by equal shares Limits of liability Per occurrence (accident) Per person Aggregate general versus products completed operations Split Combined single Named insured provisions Duties after loss Assignment Insurer provisions Liberalization Subrogation Duty to defend 3.4 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) ( ) Concealment, misrepresentation or fraud ( ) Terrorism Risk Insurance Act of 2002 and Extension Act of 2005 (15 U.S.C. 6701; Public Law ) Essential Insurance Act ( ) Termination of authority to represent insurer ( ) 4.0 Homeowners ('00) Policy 10% - 10 items 4.1 Coverage forms HO-2 through HO Section II Liability coverages Coverage E Personal liability Coverage F Medical payments to others Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria coverage (HO 04 26, HO 04 27) Permitted incidental occupancies (HO 04 42) Home day care (HO 04 97) Business pursuits (HO 24 71) Watercraft (HO 24 75) Personal injury (HO 24 82) 5.0 Auto Insurance 14% - 14 items 5.1 Laws Michigan Motor Vehicle Financial Responsibility Law Required s of liability (RL ) Required proof of (RL ) Michigan Automobile Insurance Placement Facility ( ) No-fault coverage ( ) 8

9 Personal injury protection ( ) Property protection ( ) Residual liability ( ) Uninsured/underinsured motorist ( ) Bodily injury UM/UIM rejection Required s Cancellation/nonrenewal Grounds ( ) Notice ( ,.3224) Notice of eligibility in Automobile Insurance Placement Facility ( ,.3365) Rental vehicle coverage Medical payments Aftermarket crash parts regulation (RL ) 5.2 Personal ('05) auto policy Liability coverage Bodily injury and property damage Supplementary payments Medical payments coverage Uninsured motorists coverage Coverage for damage to your auto Collision Other than collision Transportation expense Duties after an accident or loss General provisions Amendment of policy provisions Michigan (PP 01 80) Towing and labor costs (PP 03 03) Miscellaneous type vehicle (PP 03 23) Extended non-owned coverage vehicles furnished or available for regular use Michigan (PP 03 53) Personal injury protection coverage Michigan (PP 05 90) 5.3 Commercial auto ('06) Commercial auto coverage forms Business auto Garage Business auto physical damage Truckers Motor carrier Coverage form sections Covered autos Liability coverage Garagekeepers coverage Physical damage coverage Lessor additional insured and loss payee (CA 20 01) Mobile equipment (CA 20 15) Michigan personal injury protection (CA 22 21) Auto medical payments coverage (CA 99 03) Drive other car coverage (CA 99 10) Individual named insured (CA 99 17) Commercial carrier regulations The Motor Carrier Act of 1980 Endorsement of motor carrier policies of for public liability (MCS-90) 6.0 Commercial Package Policy (CPP) 5% - 5 items 6.1 Components of a commercial policy Common policy declarations Common policy conditions Interline endorsements One or more coverage parts 6.2 Commercial general liability ('04) Commercial general liability coverage forms Bodily injury and property damage liability Personal and advertising injury liability Medical payments Supplementary payments Who is an insured Limits of Occurrence versus claims-made Claims-made features Trigger Retroactive date Extended reporting periods basic versus supplemental Claim information Premises and operations Products and completed operations Insured contract 6.3 Commercial crime ('06) General definitions Burglary Theft Robbery Crime coverage forms Commercial crime coverage forms (discovery/loss sustained) Government crime coverage forms (discovery/loss sustained) Coverages Employee theft Forgery or alteration Inside the premises theft of money and securities Inside the premises robbery or safe burglary of other property Outside the premises Computer fraud Funds transfer fraud Money orders and counterfeit money Other crime coverages Extortion commercial entities (CR 04 03) Lessees of safe deposit boxes (CR 04 09) Securities deposited with others (CR 04 10) Guests' property (CR 04 11) Safe depository (CR 04 12) 6.4 Farm Coverage Farm liability coverage form ('06) Coverage H Bodily injury and property damage liability Coverage I Personal and advertising injury liability Coverage J Medical payments Limits 7.0 Businessowners ('06) Policy 5% - 5 items 7.1 Characteristics and purpose 7.2 Businessowners Section II Liability Coverages Who is an insured Limits of General conditions 7.3 Businessowners Section III Common Policy 7.4 Selected endorsement Hired auto and non-owned auto liability (BP 04 04) 8.0 Workers Compensation Insurance 12% - 12 items 8.1 Workers compensation laws Types of laws Monopolistic versus competitive 9

10 Compulsory versus elective Michigan Worker's Disability Compensation Act (Ch. 418) Exclusive remedy ( ) Employer covered (required) ( ) Covered injuries ( ) Occupational disease ( ,.405,.411,.415,.425,.431,.435,.441) Benefits provided ( ,.315,.321,.345,.351) Second injury fund ( ) Federal workers compensation laws Federal Employer Liability Act (FELA) (45 USC 51 60) U.S. Longshore and Harbor Workers Compensation Act (33 USC 904) The Jones Act (46 USC 688) 8.2 Workers compensation and employers liability policy General section Part One Workers compensation Part Two Employers liability Part Three Other states Part Four Your duties if injury occurs Part Five Premium Part Six Selected endorsement Voluntary compensation 8.3 Premium computation Job classification payroll and rates Experience modification factor Premium discounts 8.4 Other sources of coverages Self-insured employers and employer groups ( m; ) 9.0 Other Coverages and Options 3% - 3 items 9.1 Umbrella/excess liability policies Personal (DL 98 01) Commercial (CU 00 01) 9.2 Specialty liability Errors and omissions Professional liability Directors and officers liability Fiduciary liability Liquor liability Employment practices liability 9.3 Surplus lines and markets Licensing requirements 9.4 Surety bonds Principal, obligee, surety Contract bonds License and permit bonds Judicial bonds 9.5 Other policies Boatowners 9.6 Residual markets Joint underwriting or joint re pool ( ) Series Personal Lines 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 7% - 7 items (See Page 2) 3.0 Property and Casualty Insurance Basics 20% - 20 items 3.1 Principles and concepts Insurable interest Underwriting Function Loss ratio Rates Types Loss costs Components Hazards Physical Moral Morale Negligence Elements of a negligent act Defenses against negligence Damages Compensatory special versus general Punitive Absolute liability Strict liability Vicarious liability Causes of loss (perils) Named perils versus special (open) perils Direct loss Consequential or indirect loss Blanket versus specific Basic types of construction Loss valuation Actual cash value Replacement cost Functional replacement cost Market value / repair cost Agreed value Stated amount Valued policy 3.2 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 3.3 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Limits of liability Per occurrence (accident) Per person Split Combined single Property s Restoration/nonreduction of s Co Vacancy or unoccupancy Named insured provisions Duties after loss Assignment Abandonment Insurer provisions Liberalization Subrogation Salvage Claim settlement options Duty to defend Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 3.4 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) Standard fire policy ( ) ( ,.3020) Appraisal ( ) Concealment, misrepresentation or fraud ( ) Essential Insurance Act ( ) Termination of authority to represent insurer ( ) 4.0 Dwelling ('02) Policy 6% - 6 items 4.1 Characteristics and purpose 4.2 Coverage forms Perils insured against Basic Broad Special 10

11 4.3 Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Fair rental value Coverage E Additional living expense Other coverages 4.4 General exclusions Special provisions Michigan (DP 01 21) Automatic increase in (DP 04 11) Broad theft coverage (DP 04 72) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners ('00) Policy 17% - 17 items 5.1 Coverage forms HO-2 through HO Section I Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Loss of use 5.4 Section II Liability coverages Coverage E Personal liability Coverage F Medical payments to others 5.5 Perils insured against Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria coverage (HO 04 26, HO 04 27) Permitted incidental occupancies (HO 04 42) Earthquake (HO 04 54) Scheduled personal property (HO 04 61) Personal property replacement cost (HO 04 90) Home day care (HO 04 97) Business pursuits (HO 24 71) Watercraft (HO 24 75) Personal injury (HO 24 82) 6.0 Auto Insurance 22% - 22 items 6.1 Laws Michigan Motor Vehicle Financial Responsibility Law Required s of liability (RL ) Required proof of (RL ) Michigan Automobile Insurance Placement Facility ( ) No-fault coverage ( ) Personal injury protection ( ) Property protection ( ) Residual liability ( ) Uninsured/underinsured motorist ( ) Bodily injury UM/UIM rejection Required s Cancellation/nonrenewal Grounds ( ) Notice ( ,.3224) Notice of eligibility in Automobile Insurance Placement Facility ( ,.3365) Rental vehicle coverage Medical payments Aftermarket crash parts regulation (RL ) 6.2 Personal ('05) auto policy Liability coverage Bodily injury and property damage Supplementary payments Medical payments coverage Uninsured motorists coverage Coverage for damage to your auto Collision Other than collision Transportation expense Duties after an accident or loss General provisions Amendment of policy provisions Michigan (PP 01 80) Towing and labor costs (PP 03 03) Miscellaneous type vehicle (PP 03 23) Extended non-owned coverage vehicles furnished or available for regular use Michigan (PP 03 53) Personal injury protection coverage Michigan (PP 05 90) Property protection coverage Michigan (PP 05 91) 7.0 Other Coverages and Options 3% - 3 items 7.1 Umbrella/excess liability policies Personal (DL 98 01) 7.2 National Flood Insurance Program "Write your own" versus government Eligibility Coverage Limits 7.3 Other policies Boatowners Series Public Adjuster 100 questions Two-hour time 1.0 Insurance Regulation 20% - 20 items 1.1 Licensing requirements Qualifications ( ,.1224) Fees ( ) 1.2 Maintenance and duration Renewal ( ) Contract requirements ( ,.1228) Change of address ( (5),.1238) 1.3 Disciplinary actions Cease and desist orders ( ,.1244,.2038) Suspension and revocation ( ,.1239,.1242) Penalties and fines ( ,.1244,.2038,.2040, 2064,.2069) 1.4 Claim settlement laws and regulations ( ) Unfair claim practices ( ) Prohibited practices ( ) 1.5 Unfair Insurance trade practices ( ,.1244,.2003, , ,.2017,.2026,.2029) Misrepresentation ( ,.2005a,.2055,.2057,.2064,.2218) False information and advertising ( ,.2002,.2005,.2005a,.2007,.2055,.2057) Twisting ( (f)) False financial statements ( ,.2018,.2055,.2062,.2666) Defamation ( ,.2009; ; ) Boycott, coercion and intimidation ( ,.2012) Rebating ( ) Illegal inducement ( a) 1.6 Federal regulation 11

12 Fraud and false statements (18 USC 1033, 1034) 2.0 Insurance Basics 22% - 22 items 2.1 Contracts Elements of a legal contract Offer and acceptance Consideration Competent parties Legal purpose Legal interpretations affecting contracts Ambiguities in a contract of adhesion Reasonable expectations Indemnity Utmost good faith Representations/ misrepresentations Warranties Concealment Fraud 2.2 Insurance principles and concepts Insurable interest Hazards Physical Moral Morale Causes of loss (perils) Named perils versus special (open) perils Direct loss Consequential or indirect loss Blanket versus specific Basic types of construction Loss valuation Actual cash value Replacement cost Functional replacement cost Market value / repair cost Agreed value Stated amount 2.3 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 2.4 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Policy s Restoration/nonreduction of s Co Vacancy or unoccupancy Assignment Liberalization Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 2.5 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) Standard fire policy ( ) Private residential ( ) Commercial ( ) Basic property ( ) Binders ( ) Terrorism Risk Insurance Act of 2002 and Extension Act of 2005 (15 USC 6701; Public Law ) Termination of authority to represent insurer ( ) 3.0 Adjusting Losses 25% - 25 items 3.1 Role of the adjuster Duties and responsibilities Staff and independent adjuster versus public adjuster Relationship to the legal profession 3.2 Property losses Duties of insured after a loss Notice to insurer Minimizing the loss Proof of loss Special requirements Production of books and records Abandonment Determining value and loss Burden of proof of value and loss Estimates Depreciation Salvage Claim settlement options Payment and discharge 3.3 Coverage problems Waiver and estoppel Dealing with coverage disputes Reservation of rights letter Nonwaiver agreement Declaratory judgment action 3.4 Claims adjustment procedures Settlement procedures Advance payments Draft authority Execution of releases Subrogation procedures Alternative dispute resolution Appraisal Arbitration Competitive estimates Mediation Negotiation 4.0 Dwelling ('02) Policy 4% - 4 items 4.1 Characteristics and purpose 4.2 Coverage forms Perils insured against Basic Broad Special 4.3 Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Fair rental value Coverage E Additional living expense Other coverages 4.4 General exclusions Special provisions Michigan (DP 01 21) Automatic increase in (DP 04 11) Broad theft coverage (DP 04 72) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners ('00) Policy Section I 6% - 6 items 5.1 Coverage forms HO-2 through HO Section I Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Loss of use 5.4 Perils insured against Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria (HO 04 26, HO 04 27) Scheduled personal property (HO 04 61) Personal property replacement cost Michigan (HO 04 90) Home day care (HO 04 97) 6.0 Commercial Package Policy (CPP) 9% - 9 items 6.1 Components of a commercial policy Common policy declarations Common policy conditions Interline endorsements One or more coverage parts 12

13 6.2 Commercial property ('02) Commercial property conditions form Coverage forms Building and personal property Condominium commercial unit-owners Builders risk Business income Legal liability Causes of loss Basic Broad Special Ordinance or law (CP 04 05) Spoilage (CP 04 40) Peak season of (CP 12 30) Value reporting form (CP 13 10) 6.3 Commercial inland marine Commercial inland marine conditions form Inland marine coverage forms Accounts receivable Bailee's customer Commercial articles Electronic data processing Signs Valuable papers and records Transportation coverages Common carrier cargo liability 6.4 Farm coverage Farm property coverage form ('03) Coverage A Dwellings Coverage B Other private structures Coverage C Household personal property Coverage D Loss of use Coverage E Scheduled farm personal property Coverage F Unscheduled farm personal property Coverage G Other farm structures Causes of loss (basic, broad and special) Limits 7.0 Businessowners ('06) Policy Property 8% - 8 items 7.1 Characteristics and purpose 7.2 Businessowners Section I Property Coverage Limits of Loss conditions General conditions Optional coverages 7.3 Businessowners Section III Common Policy 7.4 Protective safeguards (BP 04 30) Utility services direct damage (BP 04 56) Utility services time element (BP 04 57) 8.0 Other Coverages and Options 6% - 6 items 8.1 National Flood Insurance Program "Write your own" versus government Eligibility Coverage Limits 8.2 Ocean marine Major coverages Cargo Freight Implied warranties Perils General and particular average 8.3 Other policies Aircraft hull Boatowners Federal Crop Insurance (RMA) Series Independent Adjuster without Worker's Compensation Authority 100 questions Two-hour time 1.0 Insurance Regulation 20% - 20 items 1.1 Licensing requirements Qualifications ( ,.1224) Process ( ,.1201a,.1204,.1206,.1206b) Licensing exemptions ( ,.1203) 1.2 Maintenance and duration Continuation (24.291, ) Records ( ) Duty to notify of changes ( (5),.1238) 1.3 Disciplinary actions Cease and desist order ( ,.1244,.2038) Suspension or revocation ( ,.1239,.1242) Penalties and fines ( ,.1244,.2038,.2040,.2064,.2069) 1.4 Claim settlement laws and regulations Unfair claim practices ( ) Prohibited practices ( ) 1.5 Unfair trade practices ( ,.1244,.2003, , ,.2017,.2026,.2029) Misrepresentation ( ,.2005a,.2055,.2057,.2064,.2218) False information and advertising ( ,.2002,.2005,.2005a,.2007,.2055,.2057) Twisting ( (f)) False financial statement ( ,.2018,.2055,.2062,.2666) Defamation ( ,.2009; ; ) Boycott, coercion and intimidation ( ,.2012) Rebating ( ) Illegal inducement ( a) 1.6 Federal regulation Fraud and false statements (18 USC 1033, 1034) 2.0 Insurance Basics 20% - 20 items 2.1 Contract basics Elements of a legal contract Offer and acceptance Consideration Competent parties Legal purpose Legal interpretations affecting contracts Ambiguities in a contract of adhesion Reasonable expectations Indemnity Utmost good faith Representations/ misrepresentations Warranties Concealment Fraud Waiver and estoppel 2.2 Insurance principles and concepts Insurable interest Hazards Physical Moral Morale Negligence Elements of a negligent act Defenses against negligence Damages Compensatory special versus general Punitive Absolute liability Strict liability Vicarious liability Causes of loss (perils) Named perils versus special (open) perils Direct loss 13

14 Consequential or indirect loss Blanket versus specific Basic types of construction Loss valuation Actual cash value Replacement cost Functional replacement cost Market value / repair cost Agreed value Stated amount Valued policy 2.3 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 2.4 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Contribution by equal shares Limits of liability Per occurrence (accident) Per person Aggregate general versus products completed operations Split Combined single Restoration/nonreduction of s Co Vacancy or unoccupancy Assignment Insurer provisions Liberalization Duty to defend Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 2.5 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) Standard fire policy ( ) ( ,.3020) Appraisal ( ) Concealment, misrepresentation or fraud ( ) Terrorism Risk Insurance Act of 2002 and Extension Act of 2005 (15 U.S.C. 6701; Public Law ) Termination of authority to represent insurer ( ) 3.0 Adjusting Losses 23% - 23 items 3.1 Role of the adjuster Duties and responsibilities Staff and independent adjuster versus public adjuster Relationship to the legal profession 3.2 Claim reporting Claim investigation Claim file documentation of events Types of reports Initial or first field Interim or status Full formal 3.3 Property losses Duties of insured after a loss Notice to insurer Minimizing the loss Proof of loss Special requirements Production of books and records Abandonment Determining value and loss Burden of proof of value and loss Estimates Depreciation Salvage Claim settlement options Payment and discharge 3.4 Liability losses Investigation procedures Verify coverage Determine liability Gathering evidence Physical evidence Witness statements Determining value of intangible damages 3.5 Coverage problems Dealing with coverage disputes Reservation of rights letter Nonwaiver agreement Declaratory judgment action 3.6 Claims adjustment procedures Settlement procedures Advance payments Draft authority Execution of releases Subrogation procedures Alternative dispute resolution Appraisal Arbitration Competitive estimates Mediation Negotiation 4.0 Dwelling ('02) Policy 3% - 3 items 4.1 Characteristics and purpose 4.2 Coverage forms Perils insured against Basic Broad Special 4.3 Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Fair rental value Coverage E Additional living expense Other coverages 4.4 General exclusions Special provisions Michigan (DP 01 21) Automatic increase in (DP 04 11) Broad theft coverage (DP 04 72) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners ('00) Policy 5% - 5 items 5.1 Coverage forms HO-2 through HO Section I Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Loss of use 5.4 Section II Liability coverages Coverage E Personal liability Coverage F Medical payments to others 5.5 Perils insured against Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria coverage (HO 04 26, HO 04 27) Scheduled personal property (HO 04 61) Personal property replacement cost (HO 04 90) Home day care (HO 04 97) Business pursuits (HO 24 71) Personal injury (HO 24 82) 6.0 Auto Insurance 14% - 14 items 6.1 Laws Michigan Motor Vehicle Financial Responsibility Law 14

15 Required s of liability (RL ) Required proof of (RL ) Michigan Automobile Insurance Placement Facility ( ) No-fault coverage ( ) Personal injury protection ( ) Property protection ( ) Residual liability ( ) Uninsured/underinsured motorist ( ) Bodily injury UM/UIM rejection Required s Rental vehicle coverage Medical payments Aftermarket crash parts regulation (RL ) 6.2 Personal ('05) auto policy Liability coverage Bodily injury and property damage Supplementary payments Medical payments coverage Uninsured motorists coverage Coverage for damage to your auto Collision Other than collision Transportation expense Duties after an accident or loss General provisions Amendment of policy provisions Michigan (PP 01 80) Towing and labor costs (PP 03 03) Miscellaneous type vehicle (PP 03 23) Extended non-owned coverage vehicles furnished or available for regular use Michigan (PP 03 53) Personal injury protection coverage Michigan (PP 05 90) Property Protection coverage Michigan (PP 05 91) 6.3 Commercial auto ('06) Commercial auto coverage forms Business auto Garage Business auto physical damage Truckers Motor carrier Coverage form sections Covered autos Liability coverage Garagekeepers coverage Physical damage coverage Lessor additional insured and loss payee (CA 20 01) Mobile equipment (CA 20 15) Michigan personal injury protection (CA 22 21) Michigan property protection coverage (CA 22 24) Drive other car coverage (CA 99 10) Individual named insured (CA 99 17) 7.0 Commercial Package Policy (CPP) 6% - 6 items 7.1 Components of a commercial policy Common policy declarations Common policy conditions Interline endorsements One or more coverage parts 7.2 Commercial general liability ('04) Commercial general liability coverage forms Bodily injury and property damage liability Personal and advertising injury liability Medical payments Supplementary payments Who is an insured Limits of Premises and operations Products and completed operations Insured contract 7.3 Commercial property ('02) Commercial property conditions form Coverage forms Building and personal property Condominium association Condominium commercial unit-owners Builders risk Business income Legal liability Extra expense Causes of loss forms Basic Broad Special 7.4 Commercial crime ('06) General definitions Burglary Theft Robbery Coverages Employee theft Forgery or alteration Inside the premises theft of money and securities Inside the premises robbery or safe burglary of other property Outside the premises Computer fraud 7.5 Commercial inland marine Commercial inland marine conditions form Inland marine coverage forms Accounts receivable Bailee's customer Commercial articles Electronic data processing Signs Valuable papers and records Transportation coverages Common carrier cargo liability 7.6 Farm Coverage Farm property coverage form ('03) Coverage A Dwellings Coverage B Other private structures Coverage C Household personal property Coverage D Loss of use Coverage E Scheduled farm personal property Coverage F Unscheduled farm personal property Coverage G Other farm structures Farm liability coverage form ('06) Coverage H Bodily injury and property damage liability Coverage I Personal and advertising injury liability Coverage J Medical payments Causes of loss (basic, broad and special) Limits 8.0 Businessowners ('06) Policy 7% - 7 items 8.1 Characteristics and purpose 8.2 Businessowners Section I Property Coverage Limits Loss conditions 15

16 General conditions Optional coverages 8.3 Businessowners Section II Liability Coverages Who is an insured Limits of General conditions 8.4 Businessowners Section III Common Policy 8.5 Hired auto and non-owned auto liability (BP 04 04) Protective safeguards (BP 04 30) Utility services direct damage (BP 04 56) Utility services time element (BP 04 57) 9.0 Other Coverages and Options 2% - 2 items 9.1 Umbrella/excess liability policies Personal (DL 98 01) Commercial (CU 00 01) 9.2 Ocean marine Major coverages Cargo Freight Protection and indemnity Series Independent Adjuster with Worker's Compensation Authority 100 questions Two-hour time 1.0 Insurance Regulation 20% - 20 items 1.1 Licensing requirements Qualifications ( ,.1224) Process ( ,.1201a,.1204,.1206,.1206b) Licensing exemptions ( ,.1203) 1.2 Maintenance and duration Continuation (24.291, ) Records ( ) Duty to notify of changes ( (5),.1238) 1.3 Disciplinary actions Cease and desist order ( ,.1244,.2038) Suspension or revocation ( ,.1239,.1242) Penalties and fines ( ,.1244,.2038,.2040,.2064,.2069) 1.4 Claim settlement laws and regulations Unfair claim practices ( ) Prohibited practices ( ) 1.5 Unfair trade practices ( ,.1244,.2003, , ,.2026,.2029) Misrepresentation ( ,.2005a,.2055,.2057,.2064,.2218) False information and advertising ( ,.2002,.2005,.2005a,.2007,.2055,.2057) Twisting ( (f)) False financial statements ( ,.2018,.2055,.2062,.2666) Defamation ( ,.2009; ; ) Boycott, coercion and intimidation ( ,.2012) Rebating ( ) Illegal inducement ( a) 1.6 Federal regulation Fraud and false statements (18 USC 1033, 1034) 2.0 Insurance Basics 13% - 13 items 2.1 Contract basics Elements of a legal contract Offer and acceptance Consideration Competent parties Legal purpose Legal interpretations affecting contracts Ambiguities in a contract of adhesion Reasonable expectations Indemnity Utmost good faith Representations/ misrepresentations Warranties Concealment Fraud Waiver and estoppel 2.2 Insurance principles and concepts Insurable interest Hazards Physical Moral Morale Negligence Elements of a negligent act Defenses against negligence Damages Compensatory special versus general Punitive Absolute liability Strict liability Vicarious liability Causes of loss (perils) Named perils versus special (open) perils Direct loss Consequential or indirect loss Blanket versus specific Basic types of construction Loss valuation Actual cash value Replacement cost Functional replacement cost Market value / repair cost Agreed value Stated amount Valued policy 2.3 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Endorsements 2.4 Common policy provisions Insureds named, first named, additional Policy period Policy territory Other Nonconcurrency Primary and excess Pro rata Contribution by equal shares Limits of liability Per occurrence (accident) Per person Aggregate general versus products completed operations Split Combined single Restoration/nonreduction of s Co Vacancy or unoccupancy Assignment Insurer provisions Liberalization Duty to defend Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 2.5 Michigan laws, regulations and required provisions Michigan Property and Casualty Guaranty Association ( ) Standard fire policy ( ) ( ,.3020) Appraisal ( ) Concealment, misrepresentation or fraud ( ) Terrorism Risk Insurance Act of 2002 and Extension Act of 2005 (15 U.S.C. 6701; Public Law ) 16

17 Termination of authority to represent insurer ( ) 3.0 Adjusting Losses 13% - 13 items 3.1 Role of the adjuster Duties and responsibilities Staff and independent adjuster versus public adjuster Relationship to the legal profession 3.2 Claim reporting Claim investigation Claim file documentation of events Types of reports Initial or first field Interim or status Full formal 3.3 Property losses Duties of insured after a loss Notice to insurer Minimizing the loss Proof of loss Special requirements Production of books and records Abandonment Determining value and loss Burden of proof of value and loss Estimates Depreciation Salvage Claim settlement options Payment and discharge 3.4 Liability losses Investigation procedures Verify coverage Determine liability Gathering evidence Physical evidence Witness statements Determining value of intangible damages 3.5 Coverage problems Dealing with coverage disputes Reservation of rights letter Nonwaiver agreement Declaratory judgment action 3.6 Claims adjustment procedures Settlement procedures Advance payments Draft authority Execution of releases Subrogation procedures Alternative dispute resolution Appraisal Arbitration Competitive estimates Mediation Negotiation 4.0 Dwelling ('02) Policy 3% - 3 items 4.1 Characteristics and purpose 4.2 Coverage forms Perils insured against Basic Broad Special 4.3 Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Fair rental value Coverage E Additional living expense Other coverages 4.4 General exclusions Special provisions Michigan (DP 01 21) Automatic increase in (DP 04 11) Broad theft coverage (DP 04 72) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners ('00) Policy 3% - 3 items 5.1 Coverage forms HO-2 through HO Section I Property coverages Coverage A Dwelling Coverage B Other structures Coverage C Personal property Coverage D Loss of use 5.4 Section II Liability coverages Coverage E Personal liability Coverage F Medical payments to others 5.5 Perils insured against Special provisions Michigan (HO 01 21) Limited fungi, wet or dry rot, or bacteria coverage (HO 04 26, HO 04 27) Scheduled personal property (HO 04 61) Personal property replacement cost (HO 04 90) Home day care (HO 04 97) Business pursuits (HO 24 71) Personal injury (HO 24 82) 6.0 Auto Insurance 10% - 10 items 6.1 Laws Michigan Motor Vehicle Financial Responsibility Law Required s of liability (RL ) Required proof of (RL ) Michigan Automobile Insurance Placement Facility ( ) No-fault coverage ( ) Personal injury protection ( ) Property protection ( ) Residual liability ( ) Uninsured/underinsured motorist ( ) Bodily injury UM/UIM rejection Required s Rental vehicle coverage Medical payments Aftermarket crash parts regulation (RL ) 6.2 Personal ('05) auto policy Liability coverage Bodily injury and property damage Supplementary payments Medical payments coverage Uninsured motorists coverage Coverage for damage to your auto Collision Other than collision Transportation expense Duties after an accident or loss General provisions Amendment of policy provisions Michigan (PP 01 80) Towing and labor costs (PP 03 03) Miscellaneous type vehicle (PP 03 23) Extended non-owned coverage vehicles furnished or available for regular use Michigan (PP 03 53) Personal injury protection coverage Michigan (PP 05 90) Property protection coverage Michigan (PP 05 91) 6.3 Commercial auto ('06) Commercial auto coverage forms Business auto Garage Business auto physical damage Truckers Motor carrier 17

18 Coverage form sections Covered autos Liability coverage Garagekeepers coverage Physical damage coverage Lessor additional insured and loss payee (CA 20 01) Mobile equipment (CA 20 15) Michigan personal injury protection (CA 22 21) Michigan property protection coverage (CA 22 24) Drive other car coverage (CA 99 10) Individual named insured (CA 99 17) 7.0 Commercial Package Policy (CPP) 3% - 3 items 7.1 Components of a commercial policy Common policy declarations Common policy conditions Interline endorsements One or more coverage parts 7.2 Commercial general liability ('04) Commercial general liability coverage forms Bodily injury and property damage liability Personal and advertising injury liability Medical payments Supplementary payments Who is an insured Limits of Premises and operations Products and completed operations Insured contract 7.3 Commercial property ('02) Commercial property conditions form Coverage forms Building and personal property Condominium association Condominium commercial unit-owners Builders risk Business income Legal liability Extra expense Causes of loss forms Basic Broad Special 7.4 Commercial crime ('06) General definitions Burglary Theft Robbery Crime coverage forms Commercial crime coverage forms (discovery/loss sustained) Government crime coverage forms (discovery/loss sustained) Coverages Employee theft Forgery or alteration Inside the premises theft of money and securities Inside the premises robbery or safe burglary of other property Outside the premises Computer fraud Funds transfer fraud Money orders and counterfeit money Other crime coverages Extortion commercial entities (CR 04 03) Lessees of safe deposit boxes (CR 04 09) Securities deposited with others (CR 04 10) Guests' property (CR 04 11) Safe depository (CR 04 12) 7.5 Commercial inland marine Commercial inland marine conditions form Inland marine coverage forms Accounts receivable Bailee's customer Commercial articles Electronic data processing Signs Valuable papers and records Transportation coverages Common carrier cargo liability Motor truck cargo forms Transit coverage forms 7.6 Farm Coverage Farm property coverage form ('03) Coverage A Dwellings Coverage B Other private structures Coverage C Household personal property Coverage D Loss of use Coverage E Scheduled farm personal property Coverage F Unscheduled farm personal property Coverage G Other farm structures Farm liability coverage form ('06) Coverage H Bodily injury and property damage liability Coverage I Personal and advertising injury liability Coverage J Medical payments Causes of loss (basic, broad and special) Limits 8.0 Businessowners ('06) Policy 3% - 3 items 8.1 Characteristics and purpose 8.2 Businessowners Section I Property Coverage Limits Loss conditions General conditions Optional coverages 8.3 Businessowners Section II Liability Coverages Who is an insured Limits of General conditions 8.4 Businessowners Section III Common Policy 8.5 Hired auto and non-owned auto liability (BP 04 04) Protective safeguards (BP 04 30) Utility services direct damage (BP 04 56) Utility services time element (BP 04 57) 9.0 Workers Compensation Insurance 30% - 30 items 9.1 Workers compensation laws Types of laws Monopolistic versus competitive Compulsory versus elective Michigan Worker's Disability Compensation Act (Ch. 418) Exclusive remedy ( ) Employment covered (required) ( ) Covered injuries ( ) Occupational disease ( ) Benefits provided ( ,.315,.321,.345,.351) Second injury fund ( ) Federal workers compensation laws 18

19 Federal Employer Liability Act (FELA) (45 USC 51 60) U.S. Longshore and Harbor Workers Compensation Act (33 USC 904) The Jones Act (46 USC 688) 9.2 Workers compensation and employers liability policy General section Part One Workers compensation Part Two Employers liability Part Three Other states Part Four Your duties if injury occurs Part Five Premium Part Six Selected endorsement Voluntary compensation 9.3 Premium computation Job classification payroll and rates Experience modification factor Premium discounts 9.4 Other sources of coverages Self-insured employers and employer groups ( m) 10.0 Other Coverages and Options 2% - 2 items 10.1 Umbrella/excess liability policies Personal (DL 98 01) Commercial (CU 00 01) Series Life Counselor 100 questions Two-hour time 1.0 Insurance Regulation 25% - 25 items (See Page 1) 2.0 General Insurance 5% - 5 items (See Page 2) 3.0 Life Insurance Basics 16% - 16 items 3.1 Michigan life laws Insurable interest ( ,.2211) Viatical settlements ( ) Regulation of variable products (SEC, NASD and Michigan) (R , ) Solicitation and sales presentations ( ) Advertising (R ) Life and Health Insurance Guaranty Association ( ) Illustrations (R ) Policy summary (R ) Buyer's guides for life and annuities Life policy cost comparison methods Replacement (R ) Use and disclosure of information Selection criteria and unfair discrimination ( ) 3.2 Personal uses of life Survivor protection Estate creation Cash accumulation Security Liquidity Estate conservation 3.3 Determining amount of personal life Human life value approach Needs approach Types of information gathered Determining lump-sum needs Planning for income needs 3.4 Business uses of life Buy-sell funding Key person Executive bonuses Deferred compensation funding Split dollar plans Corporate-owned life Change of insured rider Minimum deposit 3.5 Classes of life policies Group versus individual Permanent versus term Participating versus nonparticipating Fixed versus variable life and annuities 3.6 Premiums Factors in premium determination Mortality Interest Expense Premium concepts Net single premium Gross annual premium Premium payment mode 3.7 Producer responsibilities Field underwriting Notice of information practices Application procedures including conditional receipts Delivery Policy review Effective date of coverage Premium collection Statement of good health 3.8 Individual underwriting by the insurer Information sources and regulation Application Producer report Attending physician statement Investigative consumer (inspection) report Medical Information Bureau (MIB) Medical examinations and lab tests including HIV Classification of risks Preferred Standard Substandard 4.0 Life Insurance Policies 16% - 16 items 4.1 Term life Level term Annual renewable term Level premium term Life expectancy contract Term to 65 (or older) contract Decreasing term 4.2 Whole life Continuous premium (straight life) Limited payment Single premium Graded premium Modified life Interest sensitive Equity index 4.3 Flexible premium policies Adjustable life 4.4 Specialized policies Joint life (first-to-die) Survivorship life (second-to-die) Juvenile life 4.5 Group life Characteristics of group plans Types of plan sponsors Group underwriting requirements 4.6 Life policy law ( ; R ) Credit life (individual versus group) ( ; R ) Universal life ( ,.4037,.4038) 19

20 Group life conversion to individual policy ( ) 5.0 Life Insurance Policy Provisions, Options and Riders 18% - 18 items 5.1 Standard provisions Ownership Assignment Entire contract ( ) Modifications Right to examine (free look) ( ,.4073) Payment of premiums ( ) Grace period ( ) Reinstatement ( ) Incontestability ( ) Misstatement of age or gender ( ) and restrictions ( ) Interest on proceeds ( ) 5.2 Beneficiaries Designation options Individuals Classes Estates Minors Trusts Succession Facility of payment clause Revocable versus irrevocable Common disaster clause Spendthrift clause 5.3 Settlement options Cash payment Interest only Fixed-period installments Fixed-amount installments Life income Single life Joint and survivor 5.4 Nonforfeiture options Cash surrender value Extended term Reduced paid-up 5.5 Policy loan and withdrawal options Cash loans Automatic premium loans Withdrawals or partial surrenders 5.6 Dividend options Cash payment Reduction of premium payments Accumulation at interest One-year term option Paid-up additions 5.7 Disability riders Waiver of premium/waiver of stipulated premium (universal life) Waiver of cost of Disability income benefit Payor benefit life/disability (juvenile ) 5.8 Living benefit provisions/ riders ( ,.3949) Accelerated for payment Effect on death benefit Long-term care for payment Effect on death benefit 5.9 Riders covering additional insureds Spouse/other-insured term rider Children's term rider Family term rider 5.10 Riders affecting the death benefit amount Accidental death Guaranteed insurability Cost of living Return of premium 6.0 Annuities 10% - 10 items 6.1 Annuity principles and concepts Accumulation period versus annuity period Owner, annuitant and beneficiary Insurance aspects of annuities 6.2 Immediate versus deferred annuities Single premium immediate annuities (SPIAs) Deferred annuities Premium payment options Nonforfeiture Surrender and withdrawal charges Death benefits 6.3 Annuity (benefit) payment options Life contingency options Pure life versus life with guaranteed minimum Single life versus multiple life Annuities certain (types) 6.4 Annuity products Fixed annuities General account assets Interest rate guarantees (minimum versus current) Level benefit payment amount Equity indexed annuities Market value adjusted annuities (modified guaranteed annuities) 6.5 Uses of annuities Lump-sum settlements Qualified retirement plans Group versus individual annuities Personal uses Individual retirement annuities (IRAs) Tax-deferred growth Retirement income Education funds 7.0 Federal Tax Considerations for Life Insurance and Annuities 6% - 6 items 7.1 Taxation of personal life Amounts available to policyowner Cash value increases Dividends Policy loans Surrenders Amounts received by beneficiary General rule and exceptions Settlement options Values included in insured's estate 7.2 Modified endowment contracts (MECs) Modified endowment versus life Seven-pay test Distributions 7.3 Taxation of non-qualified annuities Individually-owned Accumulation phase (tax issues related to withdrawals) Annuity phase and the exclusion ratio Distributions at death Corporate-owned 7.4 Taxation of individual retirement annuities (IRAs) Traditional IRAs Contributions and deductible amounts Premature distributions (including taxation issues) Annuity phase benefit payments Values included in the annuitant's estate Amounts received by beneficiary Roth IRAs Contributions and s Distributions 7.5 Rollovers and transfers (IRAs and qualified plans) 7.6 Section 1035 exchanges 8.0 Qualified Plans 4% - 4 items 8.1 General requirements 8.2 Federal tax considerations Tax advantages for employers and employees Taxation of distributions (age-related) 8.3 Plan types, characteristics and purchasers Simplified employee pensions (SEPs) Self-employed plans (HR 10 or Keogh plans) 20