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Willy Gallant's blog ::Workers’ Compensation Law Transcription Services – Get Accurate Transcripts






Willy Gallant's blog ::Workers’ Compensation Law Transcription Services – Get Accurate Transcripts










This               section               of               sample               problems               and               solutions               is               a               part               of               The               Actuary's               Free               Study               Guide               for               Exam               5,               authored               by               Mr.

Stolyarov.

This               is               Section               62               of               the               Study               Guide.

See               an               index               of               all               sections               by               following               the               link               in               this               paragraph.

This               section               of               the               study               guide               is               intended               to               provide               practice               problems               and               solutions               to               accompany               the               pages               of               Insurance               Operations,               Regulation,               and               Statutory               Accounting,               cited               below.

Students               are               encouraged               to               read               these               pages               before               attempting               the               problems.

This               study               guide               is               entirely               an               independent               effort               by               Mr.

Stolyarov               and               is               not               affiliated               with               any               organization(s)               to               whose               textbooks               it               refers,               nor               does               it               represent               such               organization(s).
               Some               of               the               questions               here               ask               for               short               written               answers               based               on               the               reading.

This               is               meant               to               give               the               student               practice               in               answering               questions               of               the               format               that               will               appear               on               Exam               5.

Students               are               encouraged               to               type               their               own               answers               first               and               then               to               compare               these               answers               with               the               solutions               given               here.

Please               note               that               the               solutions               provided               here               are               not               necessarily               the               only               possible               ones.
               Source:
               Myhr,               A.E.;               and               Markham,               J.J.

Insurance               Operations,               Regulation,               and               Statutory               Accounting               (Second               Edition).

American               Institute               for               Chartered               Property               Casualty               Underwriters.

2004.

Chapter               6,               pp.

6.33-6.41.
               Original               Problems               and               Solutions               from               The               Actuary's               Free               Study               Guide
               Problem               S5-62-1.

The               following               questions               pertain               to               workers'               compensation               insurance               and               employers'               liability               insurance.
               (a)               List               three               types               of               benefits               made               available               under               workers'               compensation               insurance.
               (b)               What               does               employers'               liability               insurance               cover?
               (c)               Does               a               standard               workers'               compensation               /               employers'               liability               insurance               policy               cover               all               perils               not               specifically               excluded               or               only               those               perils               that               are               specifically               listed?
               Solution               S5-62-1.
               (a)               The               following               four               types               of               benefits               made               available               under               workers'               compensation               insurance               are               mentioned               by               Myhr               and               Markham,               p.

6.33:
               1.

Death               benefits;               
               2.

Disability               income;               
               3.

Medical               expense;               
               4.

Rehabilitation               expense.
               Any               three               of               the               above               answers               would               suffice.
               (b)               Employers'               liability               insurance               covers               "employers               for               their               legal               liability               to               an               employee               for               bodily               injury               arising               out               of               and               in               the               course               of               employment               that               is               not               covered               under               the               workers'               compensation               law"               (Myhr               and               Markham,               p.

6.34).
               (c)               A               standard               workers'               compensation               /               employers'               liability               insurance               policy               covers               all               perils               not               specifically               excluded.
               Problem               S5-62-2.
               (a)               Describe               two               types               of               on-premises               hazards               considered               by               underwriters               of               workers'               compensation               insurance.
               (b)               According               to               Myhr               and               Markham,               p.

6.36,               what               are               the               three               elements               of               an               off-premises               hazard?
               Solution               S5-62-2.
               (a)               The               following               two               types               of               on-premises               hazards               are               described               by               Myhr               and               Markham,               p.

6.35:
               1.

Housekeeping:               This               hazard               concerns               "the               physical               layout               of               the               workplace,               its               cleanliness,               and               its               operating               efficiency.

Housekeeping               includes               not               only               tidiness               but               also               machinery               arrangement,               aisle               placement               and               adequacy,               stair               cleanliness,               and               freight-elevator               opening               and               stair               marking"               (Myhr               and               Markham,               p.

6.35).
               2.

Maintenance:               This               hazard               concerns               the               condition               of               the               plant               and               machinery,               and               whether               these               are               kept               in               good               working               order.
               (b)               The               following               three               elements               of               off-premises               hazards               are               discussed               by               Myhr               and               Markham,               p.

6.36:
               1.

The               duration               of               travel;               
               2.

The               mode               of               transportation;               
               3.

The               hazards               at               remote               job               sites.
               Problem               S5-62-3.
               (a)               What               are               professional               employer               organizations               (PEOs)?
               (b)               What               important               question               does               the               existence               of               PEOs               raise               with               regard               to               workers'               compensation               insurance?
               (c)               How               do               most               workers'               compensation               laws               and               standard               workers'               compensation               insurance               policies               address               the               treatment               of               uninsured               subcontractors               of               a               contractor?
               Solution               S5-62-3.

These               questions               are               based               on               the               discussion               in               Myhr               and               Markham,               pp.

6.37-6.38:
               (a)               PEOs               are               vendors               who               lease               employees               to               firms.
               (b)               The               question               the               existence               of               PEOs               raises               is               that               of               "who               employs               these               workers,               the               leasing               company               or               the               firm               that               hires               them"               (Myhr               and               Markham,               p.

6.37).

This               is               an               important               question               to               address               when               payrolls               are               segregated               to               develop               experience               modifications               and               collect               statistical               data.
               (c)               "Most               workers'               compensation               laws               hold               a               contractor               responsible               for               workers'               compensation               benefits               to               employees               of               its               uninsured               subcontractors.

The               standard               workers'               compensation               policy               automatically               insures               this               loss               exposure"               (Myhr               and               Markham,               p.

6.38).
               Problem               S5-62-4.

The               following               questions               pertain               to               the               Occupational               Safety               and               Health               Act               of               1970:
               (a)               What               entity               enforces               this               act?
               (b)               Under               this               act,               when               may               safety               inspectors               enter               working               premises               to               inspect               the               premises,               equipment,               and               environment?
               (c)               Once               an               employer               receives               written               notice               of               a               violation               of               the               act,               how               long               does               the               employer               have               to               notify               the               Department               of               Labor               that               the               action               taken               under               the               act               will               be               contested?
               (d)               How               does               the               act               define               a               recordable               case?
               (e)               What               information               could               OSHA               safety               logs               and               inspections               provide               to               workers'               compensation               insurance               underwriters?
               Solution               S5-62-4.

These               questions               are               based               on               the               discussion               in               Myhr               and               Markham,               p.

6.39.
               (a)               The               Department               of               Labor               enforces               the               Occupational               Safety               and               Health               Act               of               1970.
               (b)               Under               the               act,               safety               inspectors               may               enter               working               premises               to               perform               inspections               "at               any               reasonable               time"               (Myhr               and               Markham,               p.

6.39).
               (c)               Once               an               employer               receives               written               notice               of               a               violation               of               the               act,               the               employer               has               15               days               to               notify               the               Department               of               Labor               that               the               action               taken               under               the               act               will               be               contested.
               (d)               The               act               defines               a               recordable               case               as               "one               involving               an               occupational               death;               occupational               illness;               or               occupational               injury               involving               loss               of               consciousness,               restriction               of               work               or               motion,               transfer               to               another               job,               or               medical               treatment               (other               than               first               aid)"               (Myhr               and               Markham,               p.

6.39).
               (e)               OSHA               safety               logs               and               inspections               can               provide               workers'               compensation               insurance               underwriters               with               information               regarding               "types               of               losses,               loss               frequency,               and               loss               duration               in               terms               of               lost               workdays."               It               "can               also               be               used               to               verify               other               loss               information               submitted               with               the               insurance               application"               (Myhr               and               Markham,               p.

6.39).
               Problem               S5-62-5.
               (a)               Define               maritime               loss               exposures               in               the               context               of               workers'               compensation               insurance.
               (b)               Name               the               two               principal               U.

S.

federal               laws               that               address               on-the-job               injuries               for               maritime               occupations.
               (c)               What               potential               "gray               areas"               of               coverage               can               arise               because               benefits               pertaining               to               many               marine               occupations               are               addressed               by               federal               laws,               whereas               most               workers'               compensation               benefits               are               addressed               by               state               laws?
               (d)               Give               three               examples               of               ways               in               which               a               workers'               compensation               residual               market               can               be               structured.
               Solution               S5-62-5.
               (a)               Maritime               loss               exposures               are               loss               exposures               "related               to               occupations               involving               work               on               vessels               while               at               sea               or               in               close               proximity               to               bodies               of               water,               such               as               on               docks,               on               piers,               or               in               terminals"               (Myhr               and               Markham,               p.

6.39).
               (b)               The               two               principal               U.

S.

federal               laws               that               address               on-the-job               injuries               for               maritime               occupations               are               the               United               States               Longshore               and               Harbor               Workers'               (USL&HW)               Compensation               Act               and               the               Merchant               Marine               Act               (Jones               Act)               (Myhr               and               Markham,               p.

6.40).
               (c)               If               an               individual               who               does               not               regularly               work               on               a               vessel               on               water               boards               such               a               vessel               and               is               injured               in               the               course               of               doing               work               there,               it               is               sometimes               not               clear               whether               federal               laws               or               state               laws               apply.

The               injured               party               will               often               seek               benefits               under               federal               laws,               because               these               benefits               are               typically               greater.
               (d)               The               following               examples               of               ways               in               which               a               workers'               compensation               residual               market               can               be               structured               are               provided               by               Myhr               and               Markham,               p.

6.41:
               1.

Monopolistic               state               funds;               
               2.

Competitive               state               funds;               
               3.

Joint               underwriting               associations               (JUAs);               
               4.

Assigned               risk               plans;               
               5.

Reinsurance               pools.
               Any               three               of               the               above               answers               suffice.

Other               valid               answers               may               be               possible.
               See               other               sections               of               The               Actuary's               Free               Study               Guide               for               Exam               5.




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