101PD SAMPLEChapter 1 — Basic Insurance Concepts and Principles (16 of 150 Q) High-yield review. Full doctrine: Treatise Ch. 1. Practice material — not affiliated with CDI/PSI. §1.1 Definition and structure - Ins C §22: contract; indemnify; loss/damage/liability; contingent or unknown event. - Life = valued contract (face amount), not strict indemnity; DI capped at ~60–70% of earnings to keep indemnity discipline. - Insurance = risk transfer + pooling. Substance over label: anything meeting §22 IS insurance. §1.2 Risk, peril, hazard - Risk uncertainty of loss · peril cause · hazard increases likelihood/severity. - Pure risk (loss/no-loss) insurable; speculative (loss or gain) never. - Hazards: physical (condition), moral (dishonesty), morale (carelessness); legal hazard = claim-enlarging environment. §1.3 Law of large numbers; adverse selection - Predictability rises with pool size; requires large + homogeneous exposure units. - Mortality tables (life) / morbidity tables (health). - Adverse selection = high-risk buy more; countered by underwriting, waiting periods, exclusions — and in ACA medical by enrollment windows, not health underwriting. §1.4 Ideally insurable risk (6 tests) Due to chance · definite & measurable · statistically predictable · not catastrophic · large homogeneous pool · economically feasible premium. War/nuclear fail catastrophe; certainties (wear, routine care) fail chance/feasibility. §1.5 Risk management (STARR) Sharing · Transfer (insurance; hold-harmless) · Avoidance · Retention (deductibles, SIR, self-insurance) · Reduction (loss control). High-severity/low-frequency → insure; low/low or high-frequency/low-severity → retain-budget. §1.6 Insurable interest (life/health) - §10110: self (unlimited) · dependence for support/education · legal obligation (creditor capped by debt) · vested economic interest. - Timing: life = inception only (§10110.1(d)); property = at loss. Owner needs it, not the beneficiary. - Another adult insured → written consent. No interest/consent → void wager; STOLI void — time never cures it. Legit later sale = life settlement (regulated). §1.7 Insurance vs wagering Wager creates risk; insurance transfers existing pure risk. Insurable interest is the legal divider. §1.8 Reinsurance Ceding insurer → reinsurer; treaty (automatic, class-wide) vs facultative (per-risk). Purposes: capacity, stabilization, catastrophe, surplus relief. Policyholder is not a party; ceding insurer stays fully liable. §1.9 Health lens Mortality vs morbidity; three health exposures: medical costs, lost income (more likely than pre-65 death), LTC. Accidental results standard (modern) vs accidental means (obsolete). Indemnity (DI) vs reimbursement (medical) vs service (HMO). Exam triggers §22 · unlimited self-interest · creditor cap · inception timing · consent · STOLI void · treaty/facultative · morale≠moral · 6 tests · STARR. Trap pairs — answer-splitting distinctions If the question says… The answer turns on ------ "Bet on a stranger's life" Wager — void; no insurable interest "Divorced, still owns policy" Inception timing — collects "Beneficiary lacks interest" Irrelevant — owner needed it "Coverage for casino losses" Speculative risk — uninsurable "Forgot to lock up because insured" Morale (not moral) hazard "Lied on the application" Moral hazard → concealment doctrine "Small pool of mixed risks" Homogeneity/large-numbers failure "Sick people flock to buy" Adverse selection "Insurer's insurer fails" Ceding insurer still owes insured "Employer pays own claims" Retention/self-insurance (+stop-loss) Worked