Chartered Insurance Institute (CII) Qualifications General Insurance Products and Claims Syllabus

General Insurance Products and Claims syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for General Insurance Products and Claims in Chartered Insurance Institute (CII) Qualifications, not a summary of it.

1. 1

   Personal Lines Insurance

   4 topics

   • Motor insurance
     • Road Traffic Act minimum requirements
     • Third party, third party fire and theft, comprehensive
     • No-claims discount and total loss settlement
   • Household insurance
     • Buildings and contents cover
     • All risks and specified perils
     • Sums insured and bedroom-rated policies
   • Travel and personal accident
     • Medical expenses and repatriation
     • Cancellation and curtailment
   • Healthcare and protection products
     • Private medical insurance
     • Income protection basics
2. 2

   Commercial and Specialty Insurance

   4 topics

   • Property and business interruption
     • Material damage and declaration-linked sums
     • Indemnity periods and gross profit calculation
   • Liability insurance
     • Employers' liability (compulsory cover)
     • Public and products liability
     • Professional indemnity and D&O
   • Marine, aviation and transit
     • Cargo, hull and freight
     • Goods in transit
   • Specialty and packaged products
     • Cyber insurance
     • Engineering and construction
     • Commercial combined and SME packages
3. 3

   Claims Handling

   4 topics

   • The claims process
     • Notification, validation and reserving
     • Fraud detection and management
     • Settlement options and payment
   • Claims documentation and proof
     • Burden and standard of proof
     • Role of loss adjusters and assessors
   • Policy interpretation in claims
     • Applying conditions, warranties and exclusions
     • Contribution and recovery actions
   • Customer outcomes in claims
     • Fair claims handling under ICOBS
     • Vulnerable customer considerations

General Insurance Products and Claims flashcards for Chartered Insurance Institute (CII) Qualifications

23 of 50 cards from the General Insurance Products and Claims deck — real questions with worked answers.

1. In UK motor insurance, what are the three legally recognised levels of cover, and which is the legal minimum?

   Third party only (TPO), third party fire and theft (TPFT), and comprehensive. Third party only is the legal minimum required under the Road Traffic Act 1988.

2. Under the Road Traffic Act 1988, what minimum third party liability must a UK motor policy provide?

   Unlimited cover for death or bodily injury to third parties, and property damage cover of at least GBP 1,200,000 (commonly provided as unlimited by insurers).

3. What is the difference between an 'agreed value' and a 'market value' basis of settlement in motor insurance?

   Market value pays what the vehicle was worth immediately before the loss (its current second-hand value); agreed value fixes a sum at inception (used for classics/specialist vehicles) that is paid as a total loss without depreciation argument.

4. In motor insurance, what is a No Claims Discount (NCD) and how is it affected by a fault claim?

   NCD is a premium reduction earned for consecutive claim-free years. A fault (or non-recoverable) claim reduces or removes the NCD at renewal unless NCD protection has been purchased.

5. What does NCD 'protection' actually protect — the discount or the premium?

   It protects the discount (number of years/percentage), not the premium itself. Insurers may still raise the underlying base premium, but the protected discount remains intact despite a limited number of claims.

6. In household insurance, what is the key distinction between Buildings cover and Contents cover?

   Buildings covers the permanent structure (walls, roof, fixtures, fitted kitchens/bathrooms); Contents covers movable possessions and personal belongings within the home.

7. What is 'underinsurance' in household buildings cover, and what is the correct sum insured basis?

   Underinsurance occurs when the sum insured is below the full rebuilding cost. Buildings should be insured on a rebuilding (reinstatement) cost basis, not market value, because rebuild cost can differ markedly from sale price.

8. State the average (condition of average) formula used to reduce a household claim payment when a property is underinsured.

   $$\text{Claim paid} = \text{Loss} \times \frac{\text{Sum insured}}{\text{Full value at risk}}$$

9. A contents item worth GBP 6,000 is damaged; the sum insured is GBP 40,000 but the full value at risk is GBP 50,000. Applying average, how much is paid?

   $$6000 \times \frac{40000}{50000} = 6000 \times 0.8 = \pounds 4{,}800$$

10. What is the difference between 'new for old' and 'indemnity' settlement on household contents?

    New for old replaces items with equivalent new ones without deduction for wear and tear; indemnity pays the depreciated (second-hand) value, deducting for age and use (typically applied to clothing and linen).

11. In travel insurance, what are the main sections of cover typically provided?

    Cancellation/curtailment, emergency medical expenses and repatriation, personal accident, baggage and personal effects, personal liability, missed departure/travel delay, and loss of passport/money.

12. Why is the medical expenses section usually regarded as the most important part of a travel policy?

    Because overseas medical treatment and emergency repatriation can cost very large, potentially unlimited sums, far exceeding the value of baggage or cancellation claims; it protects against catastrophic financial loss.

13. Define personal accident (PA) insurance and the four classic benefits it pays.

    PA pays fixed benefits for bodily injury caused by accidental, violent, external and visible means. The classic benefits are: death, loss of limb(s), loss of eye(s)/sight, and permanent total disablement.

14. What is the difference between Permanent Total Disablement (PTD) and Temporary Total Disablement (TTD) under a PA policy?

    PTD is a lump-sum benefit for permanent inability to work in any/usual occupation; TTD is a weekly benefit paid for a limited period while the insured is temporarily unable to work.

15. In healthcare and protection, distinguish Private Medical Insurance (PMI) from a Health Cash Plan.

    PMI funds private acute treatment for curable conditions (consultations, surgery, hospital stays); a cash plan pays fixed cash sums towards everyday costs (dental, optical, physiotherapy) regardless of actual cost, usually up to annual limits.

16. What is the difference between term assurance and whole-of-life assurance?

    Term assurance pays out only if death occurs within a fixed term and has no surrender value; whole-of-life provides cover for the insured's entire life and pays out whenever death occurs.

17. Distinguish Critical Illness cover from Income Protection (PHI).

    Critical illness pays a tax-free lump sum on diagnosis of a defined serious condition; income protection pays a regular replacement income if the insured is unable to work through illness/injury, until recovery, death, or end of the policy term.

18. What is a 'deferred period' in income protection insurance?

    The waiting period between the start of incapacity and the date benefit payments begin (e.g., 4, 13, 26 or 52 weeks). A longer deferred period reduces the premium.

19. In commercial property insurance, what does Business Interruption (BI) insurance cover?

    It covers loss of gross profit/revenue and increased cost of working following an insured material damage event (e.g., fire, flood) that interrupts the business; it is generally conditional on the material damage being covered.

20. Define the 'indemnity period' (maximum indemnity period) in business interruption insurance.

    The maximum length of time, chosen at inception (e.g., 12, 24 or 36 months), for which the insurer will pay BI losses from the date of damage — not the policy period. It should reflect the realistic time to full recovery.

21. In business interruption, define the gross profit on the 'difference' (insurable) basis.

    Gross profit = Turnover + closing stock and work in progress − (opening stock and work in progress + uninsured/specified working expenses). It is the amount that must be insured to cover lost profit plus standing charges.

22. What is the 'material damage proviso' in a business interruption policy?

    A condition that BI cover only operates if the property damage causing the interruption is itself insured (and a claim is, or would be, payable) under a material damage policy that is in force.

23. What is the fundamental difference between liability insurance and property/first-party insurance?

    Liability insurance is third-party cover: it indemnifies the insured against legal liability (damages and costs) owed to others. Property insurance is first-party: it indemnifies the insured's own loss.

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