KY Claims Adjuster study materials
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KY Claims Adjuster: Casualty Insurance Coverages and Policy Provisions

KY Claims Adjuster · Work through your exam, one topic at a time.

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Casualty Insurance Coverages and Policy Provisions

Liability fundamentals

Casualty coverage responds to the insured's legal liability to others. The commercial general liability (CGL) policy is usually occurrence-triggered: the injury or damage must occur during the policy period, even if the claim comes later. A claims-made policy (common for professional liability) responds only if the claim is made and reported during the policy period or an extended reporting period, subject to a retroactive date.

CGL Coverage A covers bodily injury and property damage; Coverage B covers personal and advertising injury; Coverage C provides medical payments. Limits include each occurrence, general aggregate, products-completed operations aggregate, personal and advertising injury, damage to premises rented, and medical expense. Additional insured endorsements extend coverage to others; an additional named insured has broader status. Umbrella policies sit above primary coverage, may drop down, and can broaden coverage; excess policies typically follow form.

Auto and other lines

The personal auto policy includes liability, medical payments or PIP, uninsured/underinsured motorist, and physical damage to your auto, plus duties and general provisions. Business auto policies use numbered symbols to designate covered autos. Homeowners Coverage E/F provides personal liability and medical payments.

Kentucky's Motor Vehicle Reparations Act creates no-fault PIP benefits (basic reparations) with a tort threshold and a choice to retain tort rights; distinguish PIP from medical payments coverage. Workers compensation provides exclusive remedy benefits for work injuries.

Worked example

A CGL has a $1,000,000 each-occurrence limit and $2,000,000 general aggregate. Two separate occurrences each produce $800,000 in covered damages: both are paid in full ($1.6 million), leaving $400,000 aggregate. A third occurrence is capped at the remaining $400,000.

Traps: applying occurrence wording to a claims-made policy; confusing PIP with med pay; overlooking the aggregate; assuming an additional insured has the same rights as a named insured.