How should an amount payable on a covered claim be adjusted when there is recovery from another insurance guaranty association?

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When dealing with claims that involve potential recoveries from another insurance guaranty association, it is essential to adhere to the principle of coordination of benefits. This principle ensures that insured parties do not receive duplicative payments for the same loss, which is why the correct adjustment to the amount payable on a covered claim is to reduce it by the amount recovered from the other association.

This is important because it promotes fairness and proper allocation of resources. Insured individuals should not profit from their losses; therefore, if they have already received a certain amount from another source, the total amount they can claim should reflect that recovery. This helps maintain the financial integrity of insurance systems and prevents overcompensation for losses.

In contrast, increasing the claim amount or keeping it the same would lead to potential profit from insurance coverage, which is not the intended purpose of insurance. Furthermore, stating that the association must not acknowledge other recoveries contradicts the collaborative nature of insurance entities, particularly guaranty associations that work to assist policyholders in times of need.

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