什么是 Moral Hazard（道德危险因素）？

Moral Hazard（道德危险） 是指：

由于一个人的品德、态度、诚实程度或行为倾向，使保险损失发生的可能性或损失金额增加。

简单理解：

不是环境或物品本身有问题，而是“人的行为或心态”增加了风险。

典型例子

1. 故意夸大损失（Exaggerating a Claim）

例如：

• 实际损失 $5,000；
• 被保险人向保险公司声称损失 $8,000。

这种不诚实行为属于 Moral Hazard。

2. 故意纵火骗保（Arson for Insurance Money）

例如：

• 生意经营不善；
• 屋主故意放火烧毁房屋；
• 希望获得保险赔偿。

这是严重的 Moral Hazard。

3. 有盗窃历史或欺诈记录

一个曾多次提交虚假索赔的人，更有可能再次欺诈保险公司，因此属于 Moral Hazard。

4. 不诚实、贪婪或缺乏诚信

例如：

• 编造车祸；
• 伪造受伤证明；
• 故意制造损失。

都属于 Moral Hazard。

Moral Hazard 与 Morale Hazard 的区别

这是 RIBO Level 1 非常爱考的陷阱！

Morale Hazard（士气危险）例子

有保险后：

• 不锁门；
• 钥匙留在车内；
• 不安装防盗系统；
• 对财物保护不够谨慎。

虽然没有恶意，但因为“反正有保险”，导致损失发生机会增加。

与 Physical Hazard 的比较

RIBO Level 1 考试记忆口诀

Physical = Things

（东西、环境造成风险）

Morale = Carelessness

（粗心大意造成风险）

Moral = Dishonesty

（不诚实造成风险）

最经典例题

Question:

An insured intentionally exaggerates the amount of damage in a claim. This is an example of:

A. Physical Hazard
B. Morale Hazard
C. Moral Hazard
D. Fundamental Risk

✅ 答案：C. Moral Hazard

因为 故意欺诈、虚报损失、纵火骗保 都属于 Moral Hazard（道德危险）。

Hint: please pick the BEST answer1.

Consideration is…

a. The law of insurance

b. A promise between parties

c. A contract’s binding forced.

d: An exchange of something of value

2. A stock company is…
   a. A company that invests in other companies
   b. A company owned by stockholders who provide the capital to start and run the
   company
   c.
   Is owned by customers of the company
   d. A company that owns livestock
3. The most basic form of coverage is coverage from fire losses. The Insurance Act in Canada also
   ensures there is coverage for…
4. The difference between pure and speculative risk is…
   a. Speculative risk is insurable but pure risk is not
   b. Speculative risk means that there is a chance to gain or lose whereas one can only lose with pure risk
   c. Speculative risk means that there is only the chance to lose whereas pure risk means
   you have a chance to win too
   d. Speculative risk is a term invented by marine insurance companies in 1864
5. A legally enforceable agreement between 2 or more parties is a…
   a. A contract
   b. An agreement
   c. A will
   d. A contract of consideration
6. What are the 4 methods of dealing with risk?
   
7. A reduction in value is called a…
   a. Loss
   b. Unlucky situation
   c. Claim
   d. Transfer
8. What elements must be present to constitute a legal contract?
   a. Parties to the contract, the contract itself, consideration
   b. Parties to the contract, a written document, consideration, and legal purpose
   c. Agreement, consideration, legality of object, legal capacity, genuine intention
   d. Competent parties, consideration, warranty, and legal purpose
9. The act of intentionally giving up some right or privilege is…
   a. A representation
   b. A transfer
   c. A waiver
   d. Subrogation
10. Insurance purchased by an insurance company is called
    a. Reinsurance
    b. Risk avoidance insurance
    c. Full protection
    d. Umbrella insurance
11. The main purpose of an insurance contract is to… Allow the spread of risk
12. A person has a few options when dealing with financial risk: avoidance, retention, control, and transfer. Which is usually the best option for most people?
    a. Avoidance
    b. Retention
    c. Transfer
    d. Control
13. Who below has the legal capacity to enter into an insurance contract?
    a. Buck’s Consulting
    b. Black’s Hardware
    c. Tess’ Restaurants Ltd.
    d. Jerry’s Convenience
14. A binder is…
    a. An interim contract of insurance
    b. Permitted for all risks
    c. Binds the insured to certain terms specified by the insurer
    d. Binds the insured to certain terms specific by the brokerage
15. What does an insurer issue when both parties have agreed to change certain policy terms? An endorsement
16. In Canada, the insurance industry is regulated on both a federal and provincial level. The provincial government is responsible for…
    a. Supervising the terms of insurance contracts
    b. Licensing insurance companies to do business in the province
    c. None of the above
    d. Both a and b
17. Solvency means… The ability of an insurer to pay all insured losses
18. What are the fiduciary responsibilities of a broker? Unearned commissions are to be held in trust and paid back if the policy is cancelled before expiry. Premiums collected must be forwarded to the insurer.
19. According to the Insurance Act when does a contract of insurance takes effect? 12:01 am standard time at the address of the named insure
20. The removal clause is a common policy clause that requires insurers extend coverage to another location where the insured’s property is kept when…
21. After the insurer had indemnified the insured for loss, the insurer has the legal right to recover from the at fault party. This right is known as… subrogation
22. When is a misrepresentation OK and not considered a violation of your statutory conditions?
23. What is the definition of misrepresentation? A misstatement or fraudulent omission of a material factto the prejudiceof the insurer
24. Regarding the statutory condition around termination, which 1 of the 4 provisions is wrong?
    a. Your client does not have to give the insurer any prior notice to cancel
    b. On termination, the insured is not entitled to a premium refund
    c. The insurer has the right to change the policy administration costs so refunds are calculated on a short-rate basis
    d. Written request for termination, signed by all parties named on the policy must be provided to insurer
25. What are the consequences of claims fraud when discovered by the insurer? (i.e. if your client claimed something that wasn’t actually damaged in the house fire) The claim is VOID
26. What is the insurer’s duty if they choose to repair property instead of issue a cash payment? When the insurer chooses to repair property, it must give written notice within 30 days of receiving the Proof of Los
27. An insurance contract is only legally enforceable when it has all of these 3 elements: Insurable interest, utmost good faith, indem
28. A broker’s most important duty is to… A broker must always be truthful and disclose all material facts about the client’s risk to the insurer

29. What is the role of the broker in the insurance process? An intermediary between the client and the insurer
30. The law requires that brokers exercise “reasonable skill, care and diligence”. If they don’t errors and omissions claims may arise. The main reason for E&O claims is… Failing to identify client’s loss exposures and offering adequate coverage
31. The primary function of an underwriter is to… Select risks that are most likely to be profitable for the insurer
32. When an underwriter looks at the financial and claims history of the applicant, they are looking for…
    a. Morale hazard
    b. Moral hazard
    c. Physical hazard
    d. Risks
33. Insurance policies are designed to insure against “direct damage” only. Yesterday, a fire destroyed 65% of your client’s apartment building. What is the likely not covered in this situation? Loss of rental income
34. What is a condition? A requirement to do or not do something
35. What is a warranty? And give 1 example of a common warranty. A promise that something is true and will remain true (i.e. a locked vehicle warranty)
36. What is the definition of insurance? The undertaking by one person to indemnify another against loss or liability in respect to a certain risk or peril
37. What is the definition of contract? An agreement between people to do or not do something
38. What is the definition of risk? Chance of financial loss
39. What is the principle of indemnity? The principle of indemnity ensures that people receive the actual amount of their loss –no more, no less
40. What is an insurance binder? A temporary agreement where the insurer agrees to provide certain coverages pending the issuance of a policy
41. What is an agency agreement? A contract between the insurer and the brokerage
42. What is a void contract? A contract where one cannot legally support its intended purpose. In this case, the contract never existed
43. What is a peril? Cause of loss
44. What is the difference between a direct loss and an indirect loss? A direct loss occurs when a peril directly attacks the object of insurance. Indirect losses are losses that arise as a consequence of a direct loss
45. What is a valued policy? This is where the insured and insurer agree on the cash value of the property. If a loss occurs, this is the amount that would be paid.
46. What is insurable interest? One has insurable interest if they would suffer financially from a loss
47. What is utmost good faith? With insurance contracts, you must maintain a higher standard of honesty than with other contracts. This applies to the insured, insurer and the broker
48. What is a fiduciary? Someone who has a special position of trust when handing the affairs or funds of another
49. What is the difference between a friendly fire and a hostile fire? A friendly fire is a fire contained in its proper receptacle. Once that fire passes outside its boundaries, it becomes a hostile fire. (ie. a spark escapes the fireplace and burns the carpet)
50. What is the difference between pro-rata and short rate forms of premium return calculation? Pro-rata means calculating the premium refund by dividing the amount of premium paid by the number of days left remaining on the policy. Short rate is pro-rata minus any administrative charges or cancellation penalty.
51. What is the insured’s responsibility when it comes to providing notice of loss? The insured or his representative must immediately report the loss to the insurer in writing
52. What is proof of loss? A formal verification, under oath, of the details and amounts claimed.
53. What is fraud? A deliberate attempt to deceive with the aim of financial gain.

54. What is a deductible and why does it exist? The amount the insured is required to absorb for each loss before insurer pays out. A deductible exists to reduce the number of petty claims
55. Explain the idea of subrogation. When an insurer pays a claim for a loss caused by a 3rdparty, the insurer is allowed to place itself “into the insured’s shoes” and take on their legal rights (ie. to sue the responsible party)
56. What is considered “personal property”? Contents of the dwelling, personal property used by insured while on premises and contents usual to the ownership/maintenance of the dwelling.
57. What is the definition of a vacant property? All occupants have moved out with no intention of returning and no new occupants.
58. What is theft? All means of taking property without owner’s consent.
59. What is an endorsement? A written agreement between the insured and the insurer to change some terms of the insurance contract.
60. What is the difference between criminal law and civil law? Criminal law deals with wrongs against society. Civil law is for disputes between individuals/legal entities.
61. What is a tort? A wrong done by another person’s breach of legal duty
62. Provide 3 examples of tort : Trespass, nuisance, defamation, false arrest, invasion of privacy, or negligence (非法侵入、妨害公共秩序、诽谤、非法逮捕、侵犯隐私或疏忽)
63. 3 elements of a tort: Duty owed, duty breached & damages resulted (proximately) (应尽义务、违反义务及由此造成的损害（直接或间接）)
64. Which type of tort is insurable? Unintentional torts
65. What is strict liability and when does it apply? Strict liability assumes a person is guilty until proven innocent. This typically applies to cases where the person is doing something inherently dangerous
66. What is negligence? Carelessness: not doing what a reasonable man in the same situation would have done, or doing something a reasonable man would not have done
67. There are 4 broad types of people who might seek to enter your premises. What are these 4, define them and explain the duty you owe to each. a.Trespasser: entering without permission from occupieri.Duty owed: no legal duty owed but cannot set traps or cause intentional harmb.Licensee: someone entering for their own purpose with permission from occupieri.Duty owed: warn of any hazards known to occupier that licensee would not expectc.Invitee: invited in for benefit of the occupieri.Duty owed: protect against dangers down or might reasonably discover
68. What is the liability of a landlord in a building with multiple tenancy? Responsible for common areas
69. How do you determine the liability of a bailee for customer’s goods? Under the 2 types of civil law: a. Tort law: must exercise ordinary care b. Contract law: for responsibilities assumed under contract
70. Explain the liability of employers for the tort of their employees :Employers are generally liable unless: a. Employees delegated their work without employer’s consent b. While on a frolic of their own c. Employee used property without authorization for their own purpose
71. Explain the concept of general average : Provides payment for ocean marine losses voluntarily incurred to save the entire venture. The parties whose property was saved would contribute to repay the sacrificed party.
72. Identify 3 categories of risk : Personal risk, property risk, liability risk (GPT said Pure Risk Speculative Risk Fundamental Risk)
73. Explain the statutory condition of salvage. The insured is legally required to take reasonable steps to protect property from further damage.
74. What is a physical hazard and provide 3 examples. Condition related to premises (construction, occupancy, housekeeping) (GPT Icy sidewalks Faulty electrical wiring Defective machinery (or smoking in bed))
75. A moral hazard is… Subjective characteristics of the applicant that could cause a peril — Moral Hazard（道德危险 – 欺诈）
76. What is the main difference between “named perils” and “all risk” policies as typically provided by insurers. Named perils cover FSWILLER only. All risks covers all direct losses not excluded
77. What are the 3 types of property insured under a commercial property policy? Building, stock and equipment
78. Briefly explain explosion coverage under homeowners form. Covers damage caused by hot water heaters and domestic boilers not due to water hammer
79. Briefly explain smoke coverage Covers losses out of sudden, unusual and faulty operation of stationary furnace
80. What do homeowners forms typically exclude in the context of impact by aircraft or land vehicles? Damaged caused by insureds
81. What do homeowners forms typically exclude in the context of windstorm and hail? Excludes loss or damage to antennae and satellite dishes.
82. What do homeowners forms typically exclude in the context of theft? Excludes theft by tenant, employee or member of household.
83. What are 5 coverages in broad form that aren’t in named perils forms? a. Vehicle impact to insured’s building when driven by insured b. All sources of smoke damage excluding industrial operations c. Water damage due to freezing or rupturing of water lines d. Theft e. Collapse (excluding earthquake or faulty workmanship)

84.What are 5 factors insurers look at to determine the base rate for commercial property? Construction, protection, occupancy, location, claims history

85.A “building” is defined as… a. Fixed structures b. Additions/extensions c. Permanent fittings d. Materials on premises for regular maintenance e. Growing plants inside the building for decoration Building = Permanent structure attached to the ground, including fixtures and permanently installed equipment.

86.Stock is defined as… Stock is merchandise held in storage or for sale, raw materials, and goods in process or finished goods.

RIBO 最爱考的区别

Building

Permanent structure attached to the ground.

Contents

Property used to operate the business.

Stock

Property the business makes, stores, or sells.

87.What is the formula for calculating co-insurance? Did/should x amount of loss Insurance Carried÷Insurance Required×Loss

88.What is the reinstatement clause? Same amount of insurance after the loss as before the loss

Don’t confuse:

89.When can an insurer not subrogate against you? An insurer cannot subrogate against its own insured.

（保险公司不能向自己的被保险人行使代位求偿权。）

90.What responsibilities does an insured have under the property protection systems clause? Maintain protective systems and notify the insurer of any impairment or suspension.

The insured must maintain all protective devices and systems in working order and notify the insurer of any impairment or suspension of those systems.

91.What are 2 key coverages under boiler and machinery (aka equipment breakdown)? Property Damage Coverage Business Interruption Coverage

92.Do business interruption policies cover any perils excluded the corresponding property policy? No. Business interruption insurance only covers losses resulting from an insured peril covered under the corresponding property policy.

Business Interruption requires:

Direct physical loss or damage caused by an insured peril.

即：

必须先有：

1. Direct physical damage（直接财产损失）
2. Covered peril（承保风险）

然后才触发营业中断赔偿。

Excluded Peril + Endorsement → Covered Peril

Covered Peril → Business Interruption may respond

93.What is the basic difference between the earning form and the profits form?

Earnings form ends when property has been replaced. Profits form ends when income is restored to pre-loss levels

Earnings form looks at gross income (sales-based), while profits form looks at net profit (profitability-based).

在**营业中断保险（Business Interruption）**里，这两个形式的基本区别是：

• Earnings form（收入/营业额形式）：
  赔偿的是企业在中断期间损失的总收入（gross earnings / 销售额），通常会扣除一些节省下来的费用。
  👉 重点：看的是“少赚了多少营业收入”
• Profits form（利润形式）：
  赔偿的是企业损失的净利润 + 持续发生的固定费用（fixed expenses）。
  👉 重点：看的是“利润少了多少 + 还要继续付的成本”

一句话总结：

• Earnings form = 营业收入损失
• Profits form = 净利润 + 固定支出损失

94.What is bodily injury? Physical injury associated with external causes

Definition (RIBO Exam Answer):

Bodily injury means physical injury, sickness, disease, or death suffered by a person.

中文：

Bodily Injury（人身伤害） 指一个人遭受的：

• Physical injury（身体受伤）
• Sickness（疾病）
• Disease（病症）
• Death（死亡）（如果由受伤或疾病导致）

95.What does it mean when an insurer agrees to pay supplementary payments? What is the purpose and give 3 examples.

Supplementary payments: pays for investigating, settling or defending a claim

• a. Cost of defense
• b. Reasonable expenses insured incurred to help in investigation and defense
• c. Court costs
• d. Interest from date of judgement to payment (based on limit of insurance only

当保险公司同意支付 Supplementary Payments（补充赔偿/附加费用） 时，表示保险公司除了支付赔偿金（Damages）外，还会支付与抗辩索赔相关的一些额外费用，而且这些费用通常不计入责任保险的赔偿限额（policy limit）。

常见的 Supplementary Payments 包括

1. Legal defence costs
   • 律师费
   • 法庭诉讼费用
2. Court costs
   • 法院收费
   • 诉讼相关费用
3. Interest on judgments
   • 判决前或判决后的利息（依保单规定）
4. Premiums for appeal bonds or release bonds
   • 上诉保证金或解除扣押所需保证金的保费
5. Reasonable expenses incurred by the insured
   • 被保险人因配合案件产生的合理费用，例如：
     • 出庭交通费
     • 停车费
     • 误工补偿（若保单规定）

RIBO 考试重点

赔偿（Damages） 与 Supplementary Payments 是两回事：

例如：

• Liability Limit = $1,000,000
• 第三者赔偿 = $900,000
• 律师费 = $150,000

保险公司通常会支付：

• $900,000（赔偿金）
• $150,000（Supplementary Payments）

虽然总共支付 $1,050,000，但因为律师费属于 Supplementary Payments，通常不会减少可用于赔偿的 $1,000,000 责任限额。

96.Liability coverages on the homeowners forms do not usually insure damage arising out of business activities, what are the 3 exceptions?

The 3 exceptions:

a. Personal actions during work not directly related to job

b. Rental portions of your home (up to 2 roomers/boarders)

c. Temporary or part-time business of an insured person under 21

但有 3 个常见例外（Exceptions）：

1. Activities of a Minor Child

未成年子女偶尔从事的小型业务活动。

✅ 例子：

• Babysitting
• Lawn mowing
• Newspaper delivery

这些通常仍受个人责任险保障。

2. Part-Time Business Activities

兼职业务，收入有限且规模较小。

✅ 例子：

• 偶尔做家教
• 偶尔做簿记工作
• 临时翻译工作

（具体金额和条件以保单条款为准。）

3. Volunteer Activities

义工或非营利性质的活动。

✅ 例子：

• 社区组织义工
• 教会义工
• 慈善机构志愿服务

由于不是为了获取商业利润，通常不被视为业务活动。

RIBO 考试标准答案

Three common exceptions to the business pursuits exclusion under a homeowners liability policy are:

1. Business activities of a minor child.
2. Part-time or incidental business activities.
3. Volunteer or charitable activities.

考试口诀

Minor – Part-time – Volunteer

（小孩、兼职、义工）

这是 Homeowners Liability 章节中关于 Business Pursuits Exclusion 最常考的三大例外。

97.Name 3 workers compensation plan benefits: Necessary health care costs, lost earnings, death benefit

RIBO 考试常见答案：

1. Income Replacement Benefits
   • 替代因工伤或职业病导致无法工作的收入损失。
   • 例如：受伤后无法工作，获得工资补偿。
2. Medical and Rehabilitation Benefits
   • 支付医疗费用及康复费用。
   • 包括医生、医院、药物、物理治疗等。
3. Survivor (Death) Benefits
   • 如果工伤导致员工死亡，向配偶和受抚养人提供赔偿。
   • 可能包括一次性死亡赔偿金和持续收入补助。

98.What is an elimination period? A period of self-insurance between the start of disability and the start of benefits

✅ Key words to remember:
“Waiting period before benefits begin.”

99. Who has insurable interest under Accident & Sickness insurance? The insured himself & spouse, employee, child, anyone with pecuniary interest, dependents

在 Accident & Sickness Insurance（意外及疾病保险） 中，Insurable Interest（可保利益） 指的是如果被保险人受伤、生病、失去工作能力或死亡，投保人会遭受经济损失，因此有合法理由购买保险。

RIBO 考试标准答案

以下人员通常具有可保利益：

1. 自己（Yourself）

每个人都对自己的生命和健康具有无限可保利益。

✅ 例如：

• 为自己购买伤残收入保险（Disability Income Insurance）
• 为自己购买重疾保险（Critical Illness Insurance）

2. 配偶（Spouse）

夫妻之间通常自动具有可保利益。

✅ 例如：

• 丈夫为妻子购买意外保险
• 妻子为丈夫购买疾病保险

3. 父母与未成年子女（Parents and Minor Children）

父母通常对未成年子女具有可保利益。

✅ 例如：

• 父母为孩子购买意外医疗保险

4. 雇主与雇员（Employer and Employee）

如果员工因疾病或伤残无法工作会导致企业经济损失，雇主具有可保利益。

✅ 例如：

• Key Person Disability Insurance（关键员工伤残保险）

5. 债权人与债务人（Creditor and Debtor）

债权人对债务人的健康或生命在债务金额范围内具有可保利益。

✅ 例如：

• 银行要求借款人购买贷款保障保险

考试常考陷阱

❓ Can you buy Accident & Sickness insurance on a stranger?

❌ 不可以。

必须存在：

• 家庭关系（Family relationship）
• 经济依赖关系（Financial dependency）
• 商业关系导致经济损失（Economic loss）

否则没有可保利益。

RIBO 一句话背诵版

Insurable interest exists when a person would suffer a financial loss if another person became injured, sick, disabled, or died.

常见对象：

SELF + SPOUSE + CHILDREN + EMPLOYER/EMPLOYEE + CREDITOR/DEBTOR

100.Who qualifies as a dependent under travel insurance? Anyone under 20 (26 if in college), unmarried, living with and receiving full support from insured. Or anyone with mental of physical deformity.

在 Travel Insurance（旅行保险）中，Dependent（受抚养人） 通常指依赖被保险人经济支持的人。RIBO考试常考的是以下定义：

Dependent 的常见资格

通常包括：

1. 配偶（Spouse）

• 合法结婚的配偶；
• 同居伴侣（Common-law spouse），通常要求连续同居一定时间（如12个月）。

2. 子女（Children）

未婚且依赖父母经济支持的：

• 亲生子女（Natural child）
• 继子女（Stepchild）
• 合法收养子女（Adopted child）
• 正在办理收养手续的儿童（Child placed for adoption）
• 法定监护的儿童（Ward or legal guardian child）

3. 年龄限制

不同保险公司略有不同，但常见为：

RIBO 考试记忆法

考试答题模板

Q: Does a parent automatically have an insurable interest in an adult child?

A: No. A parent only has an insurable interest in an adult child if the parent would suffer a financial loss due to the child’s injury, disability, sickness, or death.

这类题的关键词通常是 financial loss（经济损失）。只要能证明经济损失，就可能有可保利益；仅有亲属关系通常不足以构成对成年子女的可保利益。