TX ADJUSTER TEST | 111 Questions with 100%
Correct Answers
TX ADJUSTER TEST | 111 Questions with 100%
Correct Answers
Subrogate Subrogation is the
... [Show More] right for an insurer to legally pursue a third
party that caused an insurance loss to the insured. This is done as a means
of recovering the amount of the claim paid by the insurance carrier to the
insured for the loss. - Correct Answer -While investigating a claim, you
determine that the loss was caused by a defective mechanism in the
dishwasher. You would attempt to_________________________?
Appraisal - Correct Answer -What is the process when an insurer and an
insured have a dispute regarding the amount of damage?
Material Misrepresentation - Correct Answer
-__________________________________________________is a significant
misstatement in an application form. If a company had access to the correct
information at the time of application, the company might not have agreed
to accept the application.
Age, Condition and Life Expectancy - Correct Answer -As an adjuster, you
should base depreciation on these three factors?
Umpire - Correct Answer -An_________________ is a person hired by the
property owner to settle the claim with insurance company on their behalf.
HO-A - Correct Answer -This type of policy provides coverage only for those
perils that are listed in the policy?
Additional Living Expenses - Correct Answer -_________________________ are
extra charges covered by homeowner's policies over and above the
policyholder's customary living expenses.
Occurrence - Correct Answer -_______________________is an event that results
in an insured loss/damages?
Actual Cash Value - Correct Answer -What is value of your property, based on
the current cost to replace it, minus depreciation?
Incurred Expenses - Correct Answer -Expenses that have already sustained
and that have not yet been paid are known as
____________________________________.
Declarations Page - Correct Answer -________________________________is the
part of the written insurance policy that states all the policy's specific's,
including the name of the policyholder, the type of property insured, the
premiums, and the term limits for the coverage.
Negligence - Correct Answer -What is the failure to use that degree of care
which an ordinary person of reasonable prudence would use under similar
circumstances?
Overhead and Profit - Correct Answer -______________________________is the
amount of money dedicated to a general contractor's cost of doing a
business and earning a profit.
Third Party Loss - Correct Answer -____________________________is a situation
involving a person other than an insurer and the insured.
Reserves - Correct Answer -What is the amount representing actual or
potential liabilities kept by and insurer to cover debts to policyholder?
First Party Loss - Correct Answer -This loss involves only the insurer and the
insured?
Liability - Correct Answer -What is the responsibility to another for one's
negligence?
Severity - Correct Answer -_____________________ is the size of a loss, the
extent of damages.
Premium - Correct Answer -___________________________ is the amount paid by
an insured to an insurance company to obtain or maintain an insurance
policy
Replacement Cost - Correct Answer -__________________________________is the
cost associated with replacing property at the current market price.
Policy Period - Correct Answer -The period of a policy is in force, from the
beginning or effective date to the expiration date is the
________________________________?
deductible - Correct Answer -The amount the insured must pay in a loss
before any payment is due is known as the
____________________________________.
Adjuster - Correct Answer -A person who investigates and settles insurance
claims is the ______________________?
$5000.00 - Correct Answer -Mary Johnson has an HO-B policy. Her coverage A
limit of liability is $250,000 and her coverage B limit is $125,000. Her policy
has a 2% deductible. What is her deductible?
Coverage A - Correct Answer -If your policyholder has a 1% deductible, this
percentage would be taken from what coverage?
10% of COV B - Correct Answer -The Homeowner's policy provides coverage's
for Personal Property that is away from the residence premises. The total
limit of liability for off premises losses is ______________________________?
at the residence or elsewhere - Correct Answer -When handing a
homeowner's content claim, you should establish if the loss happened
__________________________________________ to help determine the total limit of
liability that will apply to the claim.
$14,220 - Correct Answer -Your policyholder has a Homeowner's Policy with
the following limits on it COV A limit is $158,000 COV B limit is $90,000 His
home has a detached garage. His home and detached garage were
completely destroyed in a fire loss. What is the maximum that he can receive
for his detached garage? $15,800 MINUS A 1% DEDUCTIBLE=
Total Loss is $4950.00 less 1% deductible OF $85,000 = $850.00 = $4100.00
- Correct Answer -COV A limit is $85,000 COV B limit is $ 46,000Your
policyholder lives in Houston, Texas. While on vacation in Detroit, Michigan
someone steals the following
items from his house in Houston. How much will you pay for this loss?
Electronics $1,600, Clothing $850, Golf Clubs $1,500, Shoes $600, Luggage
$400,
Loss is $7850 is the total loss. 1% of COV A =$750.00 Amount to be paid is
$7100.00 - Correct Answer -COV A limit is $75,000 COV B limit is $36,000
Your policyholder lives in Houston, Texas. While on vacation in Detroit,
Michigan someone steals the following items from his house in Houston. How
much will you pay for this loss? Electronics $1,600, Clothing $850, Business
Laptop $3000 ONLY PAYS $2500, Music CD's $500, Golf Clubs $1,500, Shoes
$900
1. Money or Bank Cards 2. Valuable Papers, deeds, stamps BULLIONS etc. 3.
Jewelry Watches or furs - Correct Answer -Name 3 things that are subject to
"Special Limits of Liability" under the HO-B
Coverage A - Correct Answer -Under a HO-B policy, the dwelling/structure is
covered for what types of losses?
Coverage B - Correct Answer -Under a HO-B policy, the contents are covered
under what Coverage?
1)Fire and Lightening, 2) Sudden and Accidental Damage from Smoke, 3)
Windstorm , Hurricanes and Hail, 4)Explosion 5) Aircraft 6) Vandalism and
Malicious Mischief 7) Riot and Civil Commotion 8) Collapse of a building, or
part of a building 9) accidental discharge overflow of water or Steam form
plumbing, heating, air conditioning, system or household appliance 10)
Falling objects, 11) Freezing, 12) theft or attempted theft - Correct Answer
-List the 12 named perils that contents are covered for under the HO-B?
$250 - Correct Answer -What is the maximum amount for coverage for a
covered loss to a tree?
Not Covered Found on HO-B PG 2 Under Property - Correct Answer -Your
policyholder sustained a theft loss. His roommate's personal laptop, plasma
television and
Sony stereo were all stolen. What are you going to tell him regarding his
roommate's property?
(Explain your answer and cite where you found it in the policy)
personal property contained in a building unless
direct force of wind or hail makes an opening in a roof or wall and rain, snow,
sand or dust enters
through this opening and causes the damage. - Correct Answer -Under
Section I Exclusions, what does Exclusions c. (3). Say?
NO. She is OVER 21. - Correct Answer -Your aunt is caring for a 22 year old
female. Is this 22 year old female an Insured under the
HO-B policy?
$0 not covered - Correct Answer -Your policyholder misplaced his watch
somewhere in his house. The watch costs $800. How
much are you going to pay him?
Floods are not covered - Correct Answer -During the storm, your
policyholder's dwelling sustained 12ft of flood water. He provides you
with receipts for his Additional Living Expenses. The expenses are all
reasonable. What do you tell
the policyholder?
$0 not covered Found in SECTION 1 Exclusions
C1 - Correct Answer -During a recent windstorm, your policyholder's cloth
awning sustains damage. The damage to
the cloth awning is $400. How much can you pay for the cloth awning?
Not GO!! - Correct Answer -While working on a claim with an approved
vendor, he invites you to the Cowboys game.
What should you do?
Professionally - Correct Answer -When dealing with a customer, you should
always behave_________________?
Timely Follow Up - Correct Answer -________________________is critical to keep
your Policy holder informed during the claims process.
Show them where it is in the policy. - Correct Answer -While handling an auto
claim, your policyholder seems confused about your coverage
determination. At this time, what should you do?
To organize the claims so you know dates, times and facts for each claim. -
Correct Answer -Why should you keep a chronological detailed log of all the
activity on a claim?
done in Writing - Correct Answer -Full or partial denial of claims must be
__________________________.
Customer Service - Correct Answer -Claim adjusting is what type of
profession:
Adjuster Me and Insured - Correct Answer -When setting appointments,
getting an agreed time should be a balance between what?
own Merits - Correct Answer -You should always handle claims based on their
_____________________________?
Perceived! - Correct Answer -Your actions do matter, you should always be
aware of how you are
Safe, Secure and Sanitary - Correct Answer -To what standard will FEMA
repair a home to?
Dwelling, Contents, Debris Removal and ICC (Increased Cost of Compliance) -
Correct Answer -What are the 4 sections of the Flood Policy?
80% of the Replacement Cost - Correct Answer -In order for a building to
apply for Replacement Cost, it must be at least be insured
for_______________________?
$250,000 - Correct Answer -What is the maximum amount of coverage you
can get on a building under the Flood policy?
$0 - Correct Answer -What is the maximum amount a person can receive for
Additional Living Expenses (ALE) under the Flood Policy?
No - Correct Answer -Stevens Jones has excess continuing education hours in
a reporting period. Can he carry the
hours over?
False 30 Hours - Correct Answer -True OR False?Licensees must obtain 40
hours of Continuing Education every 3 years?
a. Consumer Protection
b. Adjuster Ethics - Correct Answer -The Texas Department of Insurance
specifically requires the adjuster applicants complete at
least two hours of continuing education in:
Go online and renew. - Correct Answer -Mike's license expires in two weeks.
What should he do to renew his license?
a. All Lines
b. Property
c. Property and Casualty
d. Surety
e. Workers Compensation - Correct Answer -What are the types of adjusters
licenses approved for insurance in Texas?
NO - Correct Answer -Do you have to be a resident of Texas to obtain a Texas
Adjuster's License?
Complete and comply
audited by TDI - Correct Answer -The Texas Department of Insurance does
not track completion of continuing educations hours,
but you must ---------------------------- in the event you are
_______________________________.
18 years - Correct Answer -To qualify to become an adjuster in Texas, you
must be at least _____________________ of age.
$50.00 - Correct Answer -In the event you do not complete the adjuster CE
requirements, you will be fined __________________ per hour.
False 24hours - Correct Answer -True or False: As an adjuster, you have up to
48 hours to make reasonable contact with your
insured?
If Homeowner has 3 or more non-weather related claims w/in a 3 year period.
- Correct Answer -An insurance company can refuse to renew a policyholder
under what circumstances?
False - Correct Answer -True OR False? Is it a violation of the Unfair Claim
Settlement Practices Act to provide the policyholder with the
pertinent information regarding their claim
Issue a full denial of the claim within 5 days. Promptly! - Correct Answer -If
you deny a claim you must?
a. Acknowledge the Claim
b. Begin the Investigation
c. Request all items needed to evaluate the claim. - Correct Answer -Within
15 days after we receive written notice of your claim we must:
5 Days - Correct Answer -Once you have accepted or rejected an insurance
claim, you have_____________ to issue the payment or issue the written denial
letter.
?You need type of specialist to assist with the investigation. ie structural
engineer - Correct Answer -During the course of your investigation, you may
request an additional 45 calendar days to complete your investigation under
what circumstances?
False - Correct Answer -True OR False? Failing to settle claims when liability is
reasonably clear is an accepted claim handling practice?
False - Correct Answer -True OR False? As an adjuster, you should advise a
claimant as to their legal rights.
True - Correct Answer -True OR False? As an adjuster, you should not contact
a claimant represented by an attorney.
False - Correct Answer -True OR False? As an adjuster, you should advise a
claimant against seeking legal advice.
NO - Correct Answer -Jacob was participating in the company softball
tournament. During the game, he twists his
ankle trying to run to 3rd base. Is this covered under Texas Worker's
Compensation?
YES - Correct Answer -. Donyalle disagrees with the coverage determination
of her Worker's Compensation claim;
can she hire an attorney and take the matter to court to get resolved?
a. if they 'are injured on the job
b. have a work related injury or illness. - Correct Answer -Worker's
Compensation benefits will pay under what circumstances?
a. You were intoxicated at-the time of the injury
b. You injured yourself on purpose at while trying to injure- someone else
c. You were injured by another person for personal reasons;
d. You were injured by an act of God
e. Your injury occurred during horseplay; or Your injury occurred while
voluntarily participating in an off-work activity. - Correct Answer -You cannot
receive Worker's Compensation benefits if:
Be on the approved DRs. List kept by the Division of Worker's Comp - Correct
Answer -You have the right to an initial choice of Doctor. The Doctor you
choose must?
30 Days - Correct Answer -You must tell your employer within
_________________of the date you were injured.
8 days - Correct Answer -An employer must report the injuries within
______________ of the injury.
Underwriting - Correct Answer -The process an insurance company uses to
decide whether to accept or reject an application for a policy.
Staff Adjuster - Correct Answer -Employee of the insurance company's claim
department is__________________
Reserves - Correct Answer -A company's best estimate of what it will pay for
claims. The amount that represents actual potential liabilities kept by an
insurer to cover debts to the policyholders.
Loss History Companies view "loss history" as an indication of an insured's
propensity for a claim in the future. - Correct Answer -Refers to an insured's
history of losses (claims) with other companies, or the company they are
currently with. A company will consider "loss history" when underwriting a
new policy or considering a renewal of an existing policy.
Insurer - Correct Answer -The insurance company
Insured - Correct Answer -The party to an insurance arrangement whom the
insurer agrees to indemnify for losses, provide benefits for, or render
services to.
HO-B - Correct Answer -A type of Homeowner's policy that provides coverage
to Coverage A Structure for All Risks of Physical Loss, unless specifically
excluded from Coverage B personal Property on a Named Peril basis.
Public Adjuster - Correct Answer -A person hired by the insured to settle the
claim with the insurance company on their behalf is?
Premium - Correct Answer -The amount paid by an insured to an insurance
company to obtain or maintain an insurance policy.
Perils Insured Against - Correct Answer -These are the specific causes of loss
that are covered under the policy.
Notice of Loss - Correct Answer -Notice required by insurance companies
immediately after an accident or other loss. Part of the standard provisions
defining a policyholder's responsibilities after a loss
Loss Payee - Correct Answer -The party to whom money or insurance
proceeds is to be paid in the event of loss, such as the lien holder on an
automobile or the mortgagee on real property
Non-Renewal - Correct Answer -A decision by an insurance company not to
renew a policy
Material Misrepresentation - Correct Answer -The party to whom money or
insurance proceeds is to be paid in the
event of loss, such as the lien holder on an automobile or the mortgagee on
real property
Deductible - Correct Answer -The amount the insured must pay in a loss
before any payment is due from the company
Continuing Education Requirement - Correct Answer -State-level requirement
that insurance licensees periodically complete a minimum number of hours
of insurance-related education in order to be eligible for license renewal
Depreciation - Correct Answer -The act of lowering an item's value due to use
or wear and tear. Depreciation is based on Age, Condition and Life
Expectancy
HO-A - Correct Answer -A type of Homeowner's policy that provides coverage
to both Coverage A structure and Coverage B Personal Property on a Named
Peril basis.
Fraud - Correct Answer -Fraud is any intentional lying or misrepresentation by
the policyholders or claims adjusters in order to inflate a claims payment or
receive a claims payment that would otherwise not be paid.
Expiration Date - Correct Answer -The date on which an insurance policy
expires
Endorsement - Correct Answer -An endorsement is a specific addition to a
policy that alters the coverage and therefore the price of that policy.
Endorsements can either add or remove specific types of coverage.
Exclusion - Correct Answer -Provision in an insurance policy that indicates
what is denied coverage. Examples of Exclusions are: Wear and Tear, Rust,
Rot, Contamination, and Mechanical Breakdown
Act of God - Correct Answer -An event arising out of natural causes with no
human intervention which could not have been prevented by reasonable
care or foresight. Examples are floods, lightning, and earthquakes.
Bodily Injury - Correct Answer -Physical injury to a person
Actual Cash Value - Correct Answer -The value of your property based on the
current cost to replace it minus depreciation
All Risk Insurance - Correct Answer -The term All-Risk Insurance" is used to
mean insurance against loss of or damage to property arising from any cause
except those that are specifically excluded?
Additional Living Expenses - Correct Answer -Extra charges covered by
homeowner's policies over and above the policyholder's customary living
expenses due to damage by a covered peril that makes the home
temporarily uninhabitable.
Accident - Correct Answer -An unforeseen, unintended event; something
unexpected. [Show Less]