IIC Advanced Skills for the Insurance Broker and Agent C131 Question # 18 Topic 2 Discussion
C131 Exam Topic 2 Question 18 Discussion:
Question #: 18
Topic #: 2
Angie is frustrated with her insurer as she recently had a mysterious disappearance claim that was denied under her commercial property policy. Why was Angie likely denied her claim?
A.
She had chosen named perils coverage
B.
She had a similar claim in a previous policy term
C.
Her appraisal was only received in the last three months
D.
Her policy had not earned sufficient premium at the time of the loss
The correct answer is A. She had chosen named perils coverage . Named perils coverage only responds when the loss is caused by a peril specifically listed in the policy. If the cause of loss cannot be shown to fall within one of those named perils, the claim will usually fail. Mysterious disappearance is difficult because the insured may know property is missing but cannot prove theft, burglary, fire, or another insured peril. Under a broad or all-risks form, unexplained disappearance may still be limited or excluded depending on wording, but under named perils coverage the problem is even more direct: the insured must prove the loss was caused by an insured peril. A previous similar claim may affect underwriting attitude, but it does not automatically deny a current valid claim. An appraisal timing issue is not the reason for denial unless policy conditions specifically make it relevant. Unearned premium is not a normal basis to deny a claim when the policy is in force. The broker should explain that cheaper named perils coverage provides narrower protection and requires stronger proof of cause. Course topic reference: Property Coverages; Named Perils; Mysterious Disappearance; Proof of Loss; Coverage Limitations .
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