FOI — IBABC Fundamentals of Insurance Quick Reference

Compact independent quick reference for IBABC Fundamentals of Insurance (FOI): principles, contracts, property, liability, habitational, auto, claims, and calculations.

This Quick Reference supports candidates preparing for the IBABC Fundamentals of Insurance (FOI) exam offered by the Insurance Brokers Association of British Columbia. Use it as compact, independent review support for core property and casualty insurance concepts, scenario wording, and calculation practice.

Exam-Day Orientation

TaskWhat to do quicklyCommon trap
Identify the insuredNamed insured, spouse/partner, relatives, employees, mortgagee, loss payee, tenant, condo corporationAssuming every household member or business associate is automatically insured
Identify the property or exposureBuilding, contents, liability, auto, business income, money, customer goods, tools, equipmentTreating all property at the premises the same
Identify the cause of lossFire, theft, water escape, wind, collision, negligence, product defectConfusing a peril with the resulting damage
Check the policy basisNamed perils, broad form, comprehensive/all risks, occurrence, claims-madeAssuming “all risks” means all losses are covered
Apply exclusions and conditionsVacancy, intentional acts, wear and tear, business use, illegal activity, notice, proof of lossCalculating a payment before checking whether the loss is covered
Apply valuation and limitsACV, replacement cost, special limits, sublimits, deductibles, coinsuranceForgetting special limits or applying the deductible in the wrong place
Consider recovery rightsSubrogation, salvage, contribution, other insurance, appraisalPaying twice or ignoring another responsible party

Core Insurance Vocabulary

TermCompact meaningExam use
RiskChance of financial loss or uncertainty about lossInsurance deals mainly with pure risk, not speculative risk
Pure riskPossibility of loss or no lossUsually insurable if other conditions are met
Speculative riskPossibility of loss, no loss, or gainNot normally insurable, such as business profit speculation
PerilCause of lossFire, theft, windstorm, collision
HazardCondition that increases chance or severity of lossPoor wiring, icy steps, careless attitude
Physical hazardTangible condition increasing riskWorn roof, flammable storage
Moral hazardDishonesty or intent to cause lossFraudulent claim, deliberate damage
Morale hazardCarelessness because insurance existsLeaving doors unlocked because theft is insured
ExposurePerson, property, activity, or liability subject to lossUsed in underwriting and rating
IndemnityRestoring insured to financial position before loss, not betterKey principle behind ACV, subrogation, contribution
Insurable interestFinancial interest in the subject of insuranceMust exist to prevent wagering; timing depends on policy type
Utmost good faithDuty to disclose material facts and act honestlyMaterial misrepresentation can affect coverage
Material factFact that would influence an insurer’s decision or termsPrior losses, occupancy, business use, renovations
FortuityLoss must be accidental or unexpected from insured’s standpointIntentional loss by insured is not fortuitous
PoolingMany insureds contribute premiums to pay losses of the fewBasis of insurance pricing
Adverse selectionHigher-risk applicants seek coverage more than lower-risk applicantsControlled by underwriting, pricing, exclusions
Spread of riskInsurer needs many similar but independent exposuresAvoids concentration of catastrophic losses
Proximate causeDominant effective cause of lossImportant where multiple perils contribute
Direct lossPhysical damage caused directly by an insured perilFire damages building
Indirect or consequential lossFinancial loss resulting from direct lossAdditional living expense, business interruption
SalvageDamaged property recovered by insurer after claim paymentSupports indemnity
SubrogationInsurer assumes insured’s recovery rights against responsible third partyPrevents insured from collecting twice
ContributionSharing loss among insurers covering same interest and perilApplies when more than one policy responds
DeductibleAmount insured bears before insurer paysReduces small claims and moral/morale hazard

Insurable Risk and Underwriting Logic

Characteristics of an Insurable Risk

CharacteristicPractical meaningIf missing
Large number of similar exposuresLosses can be predicted statisticallyPricing becomes unstable
Accidental and fortuitous lossInsured does not control whether loss occursIntentional or expected losses are excluded
Definite and measurable lossTime, place, cause, and amount can be determinedClaim cannot be adjusted reliably
Financially significant lossLoss is worth insuringSmall predictable costs are better retained
Affordable premiumPremium is reasonable compared with potential lossRisk may be impractical to insure
Not catastrophic to the poolOne event should not ruin the insurerInsurer may use exclusions, limits, reinsurance

Underwriting Inputs

InputWhat underwriter looks forExamples
Applicant detailsIdentity, occupation, experience, loss historyPrior cancellations, claims frequency
Property detailsConstruction, occupancy, protection, exposureBuilding age, wiring, heating, fire protection
Use of propertyPersonal, rental, business, vacant, seasonalHome business, short-term rental, workshop
LocationTheft, fire, weather, flood, earthquake, distance to servicesRemote dwelling, wildfire exposure
Coverage requestedLimits, deductibles, endorsements, valuation basisReplacement cost, sewer backup, scheduled jewelry
Moral/morale indicatorsHonesty, care, maintenance, attitudeLate disclosures, inconsistent facts
Loss controlMeasures to reduce frequency or severityAlarms, sprinklers, safe storage, maintenance

Insurance Contracts and Policy Structure

Contract Concepts

ConceptInsurance meaningExam trap
Offer and acceptanceApplication and insurer acceptance create agreementA quote is not always a binding contract
ConsiderationPremium from insured; promise to pay covered losses by insurerPremium payment rules matter
Legal capacityParties must be legally able to contractMinors or impaired capacity can complicate contracts
Legal purposeContract must not insure illegal activityIllegal use may defeat coverage
Aleatory contractExchange may be unequal; small premium may trigger large claim paymentNot the same as a wager because insurable interest exists
Adhesion contractInsurer drafts wording; ambiguity may be interpreted against insurerDo not rewrite clear exclusions
Conditional contractInsured must meet policy conditionsBreach of condition can affect claim
Unilateral contractInsurer’s promise is enforceable if insured performs required actsInsured is not promising to have a loss
Personal contractPolicy usually follows insured, not automatically the propertySale of property does not automatically transfer policy
Contract of indemnityMost P&C policies pay actual financial loss, subject to wordingSome valued or agreed-value policies modify this

Policy Parts

Policy partPurposeLook for
DeclarationsIdentifies insured, policy period, limits, deductibles, premises, formsNames, addresses, coverage amounts, endorsements
Insuring agreementStates what the insurer agrees to coverCovered property, insured perils, liability promise
DefinitionsGives technical meaning to words“Insured,” “premises,” “business,” “occurrence,” “pollutant”
ExclusionsRemoves coverageIntentional acts, wear and tear, business use, auto liability
ConditionsDuties and rules for coverageNotice, proof of loss, protection of property, cooperation
EndorsementsAdd, remove, or change coverageScheduled property, sewer backup, earthquake, home business
Statutory or mandated conditionsRequired policy conditions where applicableMisrepresentation, notice, proof, appraisal, subrogation concepts

High-Yield Contract Distinctions

DistinctionCorrect exam logic
Warranty vs representationWarranty is a promise or condition that must be complied with; representation is a statement made to induce the contract
Misrepresentation vs non-disclosureMisrepresentation is an inaccurate statement; non-disclosure is failure to reveal a material fact
Void vs voidableVoid means no legal effect; voidable means one party may choose to avoid it if legal grounds exist
Binder vs policyBinder gives temporary evidence of coverage before policy issuance; it must match authority and terms
Certificate vs policyCertificate evidences coverage but usually does not replace the full policy wording
Endorsement vs separate policyEndorsement changes an existing policy; separate policy stands on its own
Loss payee vs mortgageeLoss payee is named for property payment; mortgagee clause may give lender stronger independent protection
Cancellation vs expiryCancellation ends policy before scheduled expiry; expiry occurs at end of term if not renewed

Broker Role, Agency, and Professional Conduct

AreaPractical ruleExam focus
Broker as intermediaryBroker often deals with both client and insurer obligationsIdentify who the broker represents in the specific act
AuthorityExpress, implied, or apparent authority may bind insurerDo not exceed binding authority
Duty to clientObtain information, explain coverage options, place requested coverage if available, document adviceFailure to recommend key coverage can create E&O exposure
Duty to insurerSubmit accurate information, follow binding rules, remit premiums as requiredMaterial facts must not be withheld
DocumentationKeep clear records of instructions, declinations, changes, and advice“If it is not documented, it is harder to prove”
ConfidentialityProtect client information and use it for proper insurance purposesDo not casually disclose client details
Errors and omissionsProfessional liability exposure for negligent advice or placementCommon trigger: client says they requested coverage
Trust handlingPremium funds must be handled according to applicable rules and office proceduresDo not mix personal use with client funds
Renewal reviewCheck changes in risk, limits, forms, deductibles, and marketsRenewal is not just repeating last year’s policy

Property Insurance Reference

Property Concepts

ConceptMeaningExam cue
Real propertyLand and attached structuresDwelling building, garage, fixtures
Personal propertyMovable propertyFurniture, clothing, stock, equipment
Building coveragePhysical structure and attached componentsHome Coverage A or commercial building
Contents coveragePersonal property inside or temporarily awayTenants rely heavily on contents coverage
Detached private structuresSeparate structures on premisesGarage, shed; business or farming use may be restricted
Additional living expenseExtra cost to maintain normal living standard after insured lossNot the same as lost wages
Fair rental valueRental income lost due to insured damageOften relevant to rented premises
Debris removalCost to remove insured damaged property debrisUsually tied to covered loss
Bylaws coverageIncreased cost due to building code or ordinanceNot automatically unlimited
Actual cash valueReplacement cost less depreciationDefault indemnity measure in many contexts
Replacement costCost to replace with new property of like kind and qualityConditions often require actual repair or replacement
Agreed valueValue agreed in advanceReduces valuation dispute if conditions met
Scheduled propertyItems individually listedUsed for high-value jewelry, fine arts, equipment
Blanket coverageOne limit applies over multiple items or locationsWatch for margin clauses or sublimits if present
Pair and set clauseAddresses loss to part of a pair or setInsurer may pay value reduction, not replace entire set
VacancyNo occupants and often no contents or intent of useMore serious than temporary absence
UnoccupancyOccupants temporarily away but contents remainStill may require notice after certain periods if policy says
Change in riskMaterial change in use, occupancy, or hazardMust be disclosed promptly

Named Perils vs Broad vs Comprehensive

Form typeCoverage approachStrengthWeakness
Named perilsCovers only listed causes of lossClear, often lower premiumInsured must fit loss into named peril
Broad formUsually broader building coverage and narrower contents coverage, depending on wordingMiddle groundMust check which property is broad vs named peril
Comprehensive or all risksCovers fortuitous direct physical loss unless excludedBroader starting pointExclusions are critical; not “everything”
Difference in conditions or specialty formFills specific gaps or special exposuresTailored protectionUsually has precise wording and exclusions

Common Property Perils and Exclusions

Wording cueLikely classificationReview point
Fire or lightningCommon insured perilCause and intentional-act exclusions still matter
ExplosionCommon insured perilBoiler/equipment breakdown may require separate coverage
SmokeMay be covered if sudden and accidentalSmoke from repeated industrial operations may be treated differently
Windstorm or hailCommon insured perilExterior water entry exclusions may apply unless opening created by insured peril
TheftCommon insured perilVacancy, mysterious disappearance, employee dishonesty, and special limits matter
Vandalism or malicious actsCommon insured perilVacancy exclusions are common
Water escape from plumbingOften covered with conditionsGradual leakage, seepage, sewer backup, flood may differ
Sewer backupOften needs specific endorsementDo not treat as ordinary plumbing escape without checking wording
Flood or surface waterOften excluded or separately endorsed“Water damage” is not one single peril
EarthquakeOften excluded unless endorsedDeductibles and limits can be special
Wear and tearExclusionInsurance covers resulting insured damage only if wording allows
Inherent viceExclusion for property’s own defect or natureRot, latent defect, spontaneous deterioration
Mechanical breakdownOften excluded under property formEquipment breakdown coverage may respond
Intentional actExclusionFortuity and public policy issue
War, nuclear, contaminationCommon exclusionsDo not look for normal property coverage

Habitational Insurance Matrix

Policy or exposurePrimary insured propertyKey coveragesHigh-yield traps
HomeownerDwelling, detached private structures, personal propertyAdditional living expense, personal liability, voluntary payments, extensionsHome business, vacancy, water exclusions, special limits
TenantPersonal property and tenant improvements if coveredAdditional living expense, personal liability, tenants’ legal liabilityTenant does not insure building structure owned by landlord
Condo unit ownerPersonal property, unit improvements/betterments, assessments if coveredAdditional living expense, personal liability, possible loss assessmentCondo corporation policy and unit owner policy cover different interests
Seasonal or secondary dwellingDwelling and contents with seasonal-use restrictionsNamed or limited perils may applyTheft, water, vacancy, and maintenance conditions are often tighter
Rented dwellingBuilding owned by landlord, rental income exposureFair rental value, premises liabilityTenants’ property is not landlord’s insurable interest
Mobile or manufactured homeUnit and personal propertySimilar personal lines concepts with form-specific rulesTie-down, location, additions, and transport exposures matter
Farm or hobby farm exposureDwelling plus farm property or liability if insuredMay need farm formsDo not assume normal homeowner policy covers farming operations
Home-based businessBusiness property and liability exposureMay need endorsement or commercial policyPersonal liability usually excludes business activities

Personal Property Special Limits and Coverage Gaps

Property typeWhy exam questions use itLikely solution
Jewelry, watches, gemsTheft limits and valuation disputesSchedule or personal articles floater
Money, bullion, securitiesHighly theft-prone and hard to verifySpecial limit; consider specialty coverage
Bicycles, sporting equipmentHigh value and theft exposureCheck limits and off-premises rules
Watercraft and motorsHome policies often restrict size, value, or liabilityWatercraft endorsement or separate policy
Business propertyPersonal policy usually limits or excludesHome business endorsement or commercial policy
Property of roomers or boardersNot automatically insured as family propertySeparate tenant or contents policy
Tools and equipment used for workBusiness-use issueCommercial property or contractor’s equipment
Fine arts, collectiblesValuation and breakage issuesScheduled coverage or agreed-value wording
Property in storageLocation and duration restrictionsCheck off-premises coverage and exclusions
Property while movingTransit and breakage limitationsMoving endorsement or cargo coverage

Liability Insurance Reference

Negligence Framework

ElementMeaningExam question cue
Duty of careLegal obligation to avoid foreseeable harmOccupier, driver, professional, manufacturer
Breach of dutyConduct fell below required standardFailure to shovel ice, unsafe product
CausationBreach caused injury or damage“But for” and proximate cause reasoning
DamagesActual compensable harm occurredBodily injury, property damage, financial loss
DefencesFacts reducing or defeating liabilityContributory negligence, voluntary assumption of risk, waiver, limitation issues

Liability Coverage Types

CoverageWhat it addressesDo not confuse with
Personal liabilityNon-business bodily injury or property damage to othersAuto liability or business liability
Premises liabilityInjury/damage arising from ownership or occupancy of premisesProducts or professional errors
Tenants’ legal liabilityTenant’s legal liability for damage to rented premisesTenant’s own contents coverage
Commercial general liabilityBusiness premises, operations, products, completed operationsProfessional liability or auto liability
Products liabilityInjury/damage caused by products sold or suppliedProduct recall cost unless specifically insured
Completed operationsWork completed away from premises that later causes harmOngoing operations
Professional liability / E&OFinancial loss from negligent professional service or adviceCGL bodily injury/property damage only
Directors and officersManagement liability for wrongful acts as directors/officersEntity property or CGL claims
Employer’s liabilityEmployee injury exposure outside workers compensation responseGeneral public bodily injury
Umbrella or excess liabilityAdditional limit and sometimes broader coveragePrimary policy replacement

Occurrence vs Claims-Made

TriggerCoverage responds whenKey trap
OccurrenceInjury or damage occurs during policy periodClaim may be reported later, subject to wording
Claims-madeClaim is first made during policy periodRetroactive date and reporting requirements are crucial
Claims-made and reportedClaim must be made and reported within required periodLate reporting may defeat coverage
Retroactive dateCuts off acts before a stated dateContinuous coverage matters
Extended reporting periodAllows later reporting of claims from covered actsDoes not cover new acts after expiry

Automobile Insurance Reference

For FOI review, separate mandatory/basic automobile concepts, optional physical damage, and extensions or endorsements. Avoid assuming a coverage is automatic just because many drivers buy it.

Coverage conceptMain purposeExam distinction
Third party liabilityProtects against legal liability to others for bodily injury or property damageLiability to others, not damage to insured’s own vehicle
Accident benefits / injury benefitsBenefits for injured insured persons as defined by the applicable planNot the same as tort liability damages
Uninsured or underinsured motorist protectionResponds when at-fault motorist lacks adequate insurance, if applicableDifferent from collision coverage
CollisionDamage to insured vehicle from collision or upsetApplies even if insured driver is at fault, subject to deductible and exclusions
ComprehensiveNon-collision physical damage, such as theft, fire, vandalism, glass, certain natural eventsDoes not cover collision unless wording says so
Specified perilsOnly listed non-collision perilsNarrower than comprehensive
All perilsCombines collision and comprehensive-type protection, often with theft by certain persons includedStill subject to exclusions
Loss of useCost of substitute transportation after covered lossUsually depends on an insured physical damage claim
Rental vehicle coverageExtends coverage to rented or borrowed vehicles if conditions metCheck territory, vehicle type, use, and limit
Family protection-type coverageProtects insured family where other motorist lacks enough coverage, if includedNot a substitute for mandatory basic coverage
Commercial autoBusiness vehicle use and ownership exposurePersonal auto rating may not fit delivery, livery, or fleet use

Auto Rating and Underwriting Cues

CueWhy it matters
Principal operatorAffects risk classification
Vehicle usePleasure, commute, business, delivery, rideshare, artisan use
TerritoryLocation affects loss frequency and severity
Vehicle type and valuePhysical damage premium and repair cost exposure
Driving recordFrequency and severity predictor
Annual distanceMore use generally increases exposure
ModificationsMay affect value, safety, theft risk, or eligibility
Leased or financed vehicleLessor/lienholder may need to be named
Material changeUse, operator, garaging, or modifications may need disclosure

Commercial Lines Snapshot

ProductCoversChoose when scenario saysNot designed for
Commercial propertyBuildings, stock, equipment, contentsBusiness owns or leases propertyThird-party injury claims
Business interruptionLost income and continuing expenses after insured property loss“Business closed after fire”Loss without insured physical damage unless wording extends it
Extra expenseCosts to continue operations after insured lossTemporary premises, rush repairsLong-term profit decline unrelated to damage
Commercial general liabilityBodily injury/property damage to third partiesCustomer slips, product causes damageProfessional advice errors
CrimeEmployee dishonesty, money, securities, forgeryCash handling, employee theftOrdinary shoplifting unless insured
Equipment breakdownSudden mechanical/electrical pressure breakdownBoiler, HVAC, production equipment failureWear and tear maintenance
Inland marine / floaterMovable property, tools, equipment, transitContractor tools at job sitesFixed building coverage
Cargo / transportationGoods in transitShipment damaged while transportedWarehouse premises liability
Professional liability / E&ONegligent service or adviceBroker, consultant, designer errorGeneral slip-and-fall
CyberData breach, cyber extortion, privacy responseCustomer data compromisedOrdinary property fire loss
Directors and officersManagement wrongful actsBoard decisions, governance allegationsDamage to company-owned equipment
Surety bondGuarantees performance or obligation of principal to obligeeContractor performance bondInsurance indemnity for accidental loss; surety expects reimbursement
Umbrella / excessHigher liability limitsSevere liability exposureFirst-dollar primary coverage

Claims and Loss Settlement

Claims Process

StepInsured or broker actionAdjuster or insurer actionExam trap
Notice of lossReport promptly with basic factsOpen claim and confirm policyLate notice can prejudice insurer
MitigationProtect property from further damageReview reasonableness of expensesInsured cannot let damage worsen
InvestigationProvide documents, statements, accessDetermine cause, coverage, amountInvestigation is not admission of coverage
Proof of lossSubmit formal claim details if requiredReview amount and complianceNotice and proof are different
Coverage analysisCooperate and disclose factsApply insuring agreement, exclusions, conditionsDo not jump straight to payment
ValuationProvide receipts, estimates, inventoryDetermine ACV, replacement cost, depreciationSentimental value is not indemnity value
SettlementAccept payment or repair arrangement if agreedPay covered amount less deductible/limitsPayment cannot exceed policy terms
SalvageTransfer damaged property if insurer pays for itRecover salvage valueInsured should not keep salvage and full payment unless allowed
SubrogationPreserve recovery rightsPursue responsible third partyInsured must not impair insurer’s recovery
AppraisalUse valuation dispute process if applicableResolve amount dispute, not coverage disputeAppraisal does not decide whether policy covers the loss

Recovery Rights and Other Insurance

ConceptApplies whenResult
SubrogationThird party caused insured loss and insurer paidInsurer may recover from responsible party
ContributionMultiple policies insure same interest, subject, and perilInsurers share loss according to policy wording
SalvageInsurer pays for damaged propertyInsurer may take or sell remaining property
AbandonmentInsured attempts to give property to insurer and claim total lossUsually not allowed unless insurer agrees
AppraisalAmount of loss is disputedIndependent valuation mechanism
WaiverInsurer intentionally gives up a known rightMust be clear; investigation alone is not necessarily waiver
EstoppelParty is prevented from denying a position another relied onOften tied to conduct and reliance

Calculation and Formula Sheet

Actual Cash Value

\[ \text{Actual Cash Value} = \text{Replacement Cost New} - \text{Depreciation} \]

Use ACV when the policy settles on depreciated value, when replacement cost conditions are not met, or when the property type is not eligible for replacement cost.

Replacement Cost

Replacement cost generally means the cost to repair or replace with new property of like kind and quality, subject to policy wording. Watch for conditions such as actually repairing or replacing, doing so within required time, and insuring to value.

Deductible Application

\[ \text{Basic Payment} = \min(\text{Covered Loss}, \text{Applicable Limit}) - \text{Deductible} \]

If multiple deductibles, sublimits, or special deductibles apply, follow the policy order given in the question.

Coinsurance

\[ \text{Insurance Required} = \text{Value at Time of Loss} \times \text{Coinsurance Percentage} \]\[ \text{Coinsurance Recovery Before Deductible} = \text{Loss} \times \frac{\text{Insurance Carried}}{\text{Insurance Required}} \]

Then apply the applicable policy limit and deductible according to the question. If insurance carried is equal to or greater than insurance required, there is no coinsurance penalty.

Rate-Based Premium

\[ \text{Premium} = \frac{\text{Amount of Insurance}}{\text{Rate Unit}} \times \text{Rate} \]

Example: if the rate is per 100 of insurance, divide the amount of insurance by 100 before multiplying by the rate.

Pro Rata Cancellation or Refund

\[ \text{Unearned Premium} = \text{Premium} \times \frac{\text{Unexpired Term}}{\text{Total Policy Term}} \]

Pro rata is proportionate. Short-rate cancellation is less favourable to the insured and is usually based on a table or factor supplied in the question.

Calculation Examples

ScenarioCalculation logicResult style
ACVReplacement cost 10,000 minus depreciation 3,000ACV is 7,000
DeductibleCovered loss 8,000, limit 20,000, deductible 1,000Payment is 7,000
Limit caps lossCovered loss 30,000, limit 25,000, deductible 1,000Payment is 24,000
Coinsurance penaltyValue 200,000, coinsurance 80%, required 160,000, carried 120,000, loss 40,000Recovery before deductible is 40,000 × 120,000 / 160,000 = 30,000
No coinsurance penaltyValue 200,000, coinsurance 80%, required 160,000, carried 180,000Loss paid up to limit, less deductible
Pro rata refundPremium 1,200, 90 unexpired days out of 365Unearned premium is 1,200 × 90 / 365

Endorsement Selection Matrix

Client needLikely endorsement or policy changeWhy
Expensive jewelryScheduled personal articlesOvercomes special limits and valuation issues
Sewer backup concernSewer backup endorsementUsually separate from ordinary water escape
Earthquake exposureEarthquake endorsementCommonly excluded from base property coverage
Home businessHome business endorsement or commercial packagePersonal property/liability forms restrict business use
Rental suite or tenant exposureLandlord/rental dwelling coverageOccupancy and liability differ from owner-occupied home
Condo assessment riskLoss assessment coverageCondo corporation may assess unit owners after insured events
Valuable tools off premisesContractor’s equipment floaterProperty moves among job sites
Customer property in insured’s careBailee or legal liability coverageInsured may not own the property
High liability exposureUmbrella or excess liabilityAdds limit above primary liability
Professional adviceE&O/professional liabilityCGL may not cover pure financial loss from advice
Business shutdown after fireBusiness interruptionProperty policy pays damage, not necessarily lost income
Employee theftCrime or fidelity coverageTheft by employees often excluded from property theft coverage

Scenario Decision Rules

Property Loss Scenarios

If the question saysThink firstThen check
“Water seeped over several months”Gradual damage or seepageExclusion for wear, leakage, maintenance
“Pipe suddenly burst”Sudden water escapeFreezing, heat maintenance, vacancy, shut-off conditions
“Sewer backed up”Sewer backupEndorsement or exclusion
“River overflowed”Flood/surface waterSeparate endorsement or exclusion
“Jewelry stolen from home”Theft plus special limitScheduled item? deductible? proof of value?
“Laptop used for business stolen from car”Business property and off-premises limitsAuto exclusion, contents limit, business use
“House vacant for weeks”Vacancy conditionVandalism, water, glass, theft restrictions
“Condo unit damaged by building pipe”Condo corporation vs unit owner interestsUnit improvements, deductible assessment, loss assessment
“Tenant accidentally starts kitchen fire”Tenant contents plus tenants’ legal liabilityLandlord building policy may subrogate
“Wind damages roof and rain enters”Windstorm-created openingInterior water coverage may depend on opening caused by insured peril

Liability Scenarios

If the question saysLikely issueCoverage direction
Guest slips on icy stepsOccupiers’ liability/negligencePersonal or premises liability
Insured punches someoneIntentional actLikely excluded
Dog bites neighbourPersonal liability, subject to exclusionsCheck ownership, breed/use exclusions if stated
Business customer slips in storeCommercial premises liabilityCGL, not homeowner liability
Product sold injures customerProducts liabilityCGL products/completed operations
Consultant gives bad adviceProfessional negligenceE&O, not ordinary CGL
Employee steals cashCrime/employee dishonestyProperty theft may not cover employee theft
Contractor damages customer’s property while workingOperations liabilityCGL; care/custody/control exclusions may matter
Completed repair later causes damageCompleted operationsCGL completed operations
Auto accident injures third partyAuto liabilityNot personal liability under home policy

High-Yield Distinctions

PairDistinction
Peril vs hazardPeril causes the loss; hazard increases likelihood or severity
Hazard vs riskHazard is a condition; risk is uncertainty or chance of loss
Direct vs indirect lossDirect is physical damage; indirect is financial consequence
ACV vs replacement costACV deducts depreciation; replacement cost uses new cost subject to conditions
Named perils vs all risksNamed perils covers listed causes; all risks covers fortuitous loss unless excluded
Vacancy vs unoccupancyVacancy suggests no occupant/contents/use; unoccupancy is temporary absence
Mortgagee vs loss payeeMortgagee may have independent rights; loss payee usually only shares payment
Binder vs quoteBinder creates temporary coverage; quote is pricing indication
Proof of loss vs notice of lossNotice reports occurrence; proof formally documents claim amount and facts
Subrogation vs contributionSubrogation pursues responsible third party; contribution shares among insurers
Salvage vs abandonmentSalvage is insurer’s right after payment; abandonment by insured needs acceptance
Occurrence vs claims-madeOccurrence focuses on when damage happened; claims-made focuses on when claim is made
CGL vs E&OCGL covers BI/PD-type liability; E&O covers professional service errors
Collision vs comprehensiveCollision is upset/impact; comprehensive is non-collision physical damage
Tenants’ legal liability vs tenant contentsLegal liability covers damage to rented premises; contents covers tenant’s property

Common FOI Traps to Drill

  • “All risks” is not all losses. Always check exclusions.
  • A policy limit is not a guaranteed payment. Coverage, valuation, sublimits, coinsurance, and deductibles still apply.
  • Replacement cost is conditional. If the insured does not repair or replace, ACV may apply.
  • Business use changes personal coverage. Home and auto questions often turn on undisclosed business use.
  • Water losses are wording-sensitive. Burst pipe, sewer backup, flood, seepage, and surface water are different.
  • Liability requires legal liability unless coverage is voluntary. Voluntary payments are not the same as negligence damages.
  • The broker should document advice and client decisions. Especially when coverage is declined.
  • Material facts matter before and after binding. Changes in occupancy, use, value, and operators can affect coverage.
  • Do not pay sentimental value. Indemnity is financial value, not emotional value.
  • Do not ignore the insured’s duties after loss. Notice, mitigation, cooperation, and proof of loss are commonly tested.
  • Auto physical damage is not liability. Collision/comprehensive protect the insured vehicle; liability protects against claims by others.
  • Condo insurance has multiple policies. Unit owner, condo corporation, mortgagee, and deductible assessments may all appear in one scenario.

Last-Minute Review Checklist

Can you do this quickly?Drill prompt
Define peril, hazard, risk, indemnity, insurable interestGive one example of each
Classify hazardsPhysical, moral, morale
Read a policy scenarioIdentify insured, property, peril, exclusion, condition, limit
Apply coinsuranceCalculate required insurance and penalty
Apply ACV and replacement costDecide which valuation basis applies
Explain broker authorityExpress, implied, apparent
Distinguish binder, certificate, endorsement, policyState legal effect of each
Choose habitational coverageHomeowner, tenant, condo, seasonal, rental
Identify liability coveragePersonal liability, CGL, E&O, auto
Separate auto coveragesLiability, benefits, collision, comprehensive, specified perils
Work through claim stepsNotice, mitigation, proof, adjustment, settlement
Explain subrogation and contributionIdentify which applies in a scenario
Spot material changesOccupancy, use, operator, value, business activity
Recommend endorsementsJewelry, sewer backup, earthquake, home business, tools

Practical Next Step

Next, complete a timed mixed practice set: calculate coinsurance and ACV questions, then review scenario items by marking the insured, peril, exclusion, condition, valuation basis, and correct coverage form before checking the answer.