What is the primary difference between a staff adjuster and an independent adjuster?
A staff adjuster works for an insurance company and an independent
... [Show More] adjuster works independently for themselves or for adjusting firms who represent many clients.
A couple has insured their home for $150,000. A fire ensues and guts their home, resulting in a total loss. An appraisal of the home prior to loss results in a value of $120,000, yet the adjuster is required by law to pay the couple $150,000. This is known as the application of:
The valued policy law.
The doctrine of proximate cause is defined as:
If there is an unbroken chain of events, or series of consequences, flowing from the initial loss caused by the insured peril to a subsequent loss, the insured peril causing the initial loss will be considered the "proximate cause" of the subsequent loss.
An adjuster's responsibility as a fiduciary means:
The adjuster represents, and controls, the property and financial interests of the client, to whom he/she owes a high degree of loyalty and good faith.
The Adjuster's Code of Ethics starts with a basic premise which states:
The work of adjusting engages the public trust.
Breach of contract by a carrier or its adjuster, through non-payment or non-compliance with policy requirements, could have which of the following consequences for a carrier (select one from the following):
If found guilty of a breach of contract, the carrier could be punished with a "bad faith" verdict that would cost it millions of dollars.
When you purchase insurance, you are buying:
Peace of mind that if an insured event does occur, that the insurance company will keep its promise and provide the financial protection that you purchased.
Which of the following would not be a preferred claims practice or behavior under Florida's Unfair Insurance Trade Practices Act?
Not responding to an insured's calls because you haven't made up your mind yet.
One of the most important claim handling goals of an insurance company is:
To help those who have been injured, or who have suffered loss for which the insured is responsible, while at the same time minimizing loss for the insured party and carrier.
Which of the following is NOT an example of "compensatory damages":
A jury verdict of $1,000,000 against the defendant to punish them for their reprehensible actions in causing the loss.
Which of the following statements is NOT true?
If a question of coverage arises and cannot be swiftly resolved in favor of the insured, the carrier should immediately tender the claim to its defense attorney and deny the claim.
Which of the following is NOT a defense to a claim of negligence?
Breach of Warranty
The fundamental difference in adjusting claims in the healthcare industry and in the property/casualty (i.e. workers' compensation, liability, etc.) industry is:
The relative degree of legalism involved. To adjust claims in the property and casualty industry one must have a sound foundation and understanding of various legal doctrines and issues.
Describe the difference between a peril and a hazard.
A peril is a cause of loss, like fire. A hazard is a condition that exists beforehand that increases the likelihood of such a loss, like a messy storeroom or garage that contains lots of toxic chemicals, oily rags, etc.
Negligence is described as:
Fault that arises from doing something you shouldn't have done, or not doing something you should have done.
Which of the following is one of the duties of an Insured following a loss?
Giving prompt notice of loss to the insurer
A claim in the property/casualty industry is defined as:
An assertion of an alleged legal right against a person, entity, company or insurer that carries with it a demand for money as compensation for injuries or damage
An insurance policy is often referred to as a contract of adhesion. This means:
If any of the wording or language in the policy is vague or ambiguous, if the meaning of the wording is difficult to understand or interpret, or if what is written can be interpreted to have different meanings, the law is well settled that the interpretation shall be in favor of the party who did not control its terms...in this case, the policyholder.
Assume that five years ago a couple insured their home for [its then appraised value of] $60,000. Two weeks ago they had a stove fire resulting in an estimated loss of $15,000 for repairs. The adjuster finds that the value of their home is now $100,000, but the home is still only insured for $60,000 and has a deductible of $500. The policy has an 80% coinsurance clause. How much should the adjuster pay to the couple?
10,875
Once an adjuster is licensed, he or she must maintain a continuing education requirement. Select from the following an adjuster's compliance requirement in order to stay licensed:
A newly licensed adjuster must complete 24 hours of continuing education in every two year compliance period, of which 5 hours must be taken in a properly certified 5 Hour Law & Ethics Update course.
Describe the coverages provided in a split limit policy of 10/20/10.
The coverage provides up to $10,000 of liability protection for bodily injury to any one individual, an aggregate of $20,000 for all bodily injuries regardless of how many individuals, and $10,000 for property damage.
A couple has Coverage A limits of $250,000 on their home located in Ft. Lauderdale, FL. They suffer a wind loss to their roof from a tornado spawned by Hurricane Ernesto that results in an estimate of $11,500.00 for repairs. The adjuster deducts the Florida hurricane deductible of $5,000 from the estimate and pays them $6,500 in settlement of their property claim. This is known as the application of:
A percentage deductible
The basic and primary functions of an adjuster are:
Investigating, managing, evaluating, reporting on, and negotiating and disposing of claims.
In today's society, the most important factor in the purchase of insurance is:
Trust
Which of the following is NOT one of the four critical elements of a contract?
Written evidence of the agreement and its terms. [Show Less]