QUESTION 3 Understanding that the coverage provided under a crime insurance policy for other business was provided under a financial institution bond for banks and other financial institutions, the underwriter thank the group and yielded her remaining time to the claims individual to her left. Joe was Transitions' newest claims supervisor having transferred to the company just last month from a competitor in the neighboring state. He asked the group to explain to him why his team was handling a collision claim for a driver insured under the state's high-risk driver pool. He shared that in his former position, all such claims were handled directly by a special claims unit of state government. Knowing that this state used a JUA, a more experienced claims examiner responded how? This state's JUA expects all insurance companies to handle each high-risk driver's claims as they arise. This state's JUA should be handling the claim so you should forward it to them. You should settle the claim and then bill the JUA for a refund. Although this state uses a JUA to provide insurance to high-risk drivers, it has outsourced all claims handling to a limited number of insurers and Transitions is one of those companies. That's why you were assigned the claim to adjudicate. QUESTION 4 The new claims adjuster couldn't believe he had issued the check to the principal rather than the obligee! Sometimes the answer is staring you right in the face. He thanks his peers and passes the floor to the broker sitting to his left. The broker says he hopes his dilemma doesn't stump the group. He explains that he's relatively new to crime insurance and fidelity institution bonds and needs assistance creating the right coverage for a sophisticated client with complex needs. He shares that in order to determine the correct coverage for his business, the client has asked the broker to share how a Transitions Insurance Company crime insurance policy would cover some hypothetical claim situations. The broker asks the group to help him form the answers, assuming the policy in question is an ISO commercial crime coverage form (loss sustained form) with the following insuring agreements: Employee Theft Inside the Premises - Theft of money and Securities Inside the Premises - Robbery or Safe Burglary of Other Property Outside the Premises Here is a hypothetical claim situation: The client also operates securities brokerage houses across the company. A burglar forced open a locked safe and securities inside the safe were taken. Also, the interior of the store was badly damaged in the burglary. Since the securities were inside a safe, there is no coverage. The safe coverage applicable is for "other property' which excludes money and securities. The loss of securities and damage to the safe are covered under the inside the premises-theft of money and securities insuring agreement. Damage to the interior of the premises is also covered if the insured owns the premises or is liable for damage to it. Before coverage can be determined, Transitions would need to know to whom the securities belonged - the company or clients of the company. The loss of securities and damage to the safe are covered under the inside the premises-theft of money and securities insuring agreement. The damage to the interior of the premises, however, is not covered
