California All Lines Adjuster Exam Questions 2023 Rated A+ Guaranteed Success., Exams of Nursing

Download California All Lines Adjuster Exam Questions 2023 Rated A+ Guaranteed Success. and more Exams Nursing in PDF only on Docsity!

Latest 2023

Pure risk - correct answer ✅Risk with no chance of gain Can only result in either loss or no loss Can be insured Exposure - correct answer ✅Extent to which an item, person, or organization is open to damage or loss Evaluating exposure - correct answer ✅Expressed in dollars or units Determining factor in issuing a policy and setting a premium Hazard - correct answer ✅A condition increasing the likelihood or severity of a loss Peril - correct answer ✅The actual cause of loss or damage Insurable risk - correct answer ✅Adequate premiums Definable risk Unexpected losses

Latest 2023

Substantial loss Exclusions Law of large numbers Adequate Premiums - correct answer ✅Potential loss can't be too much for insurer to pay Insurer must b able to cover claims and expenses If premiums must be set too high, the risk is not insurable Difneable risk - correct answer ✅Insurer can define exact conditions under which the item is covered by the policy Item it's self is defineable Item has precise value Unexpected loss - correct answer ✅Unforeseeable Unexpected Reasonably unpreventable Random in nature

Latest 2023

Substantial loss - correct answer ✅Must cause substantial economic hardship Exclusions - correct answer ✅Insurer must be able to exclude large scale disasters and catastrophic events Law of large numbers - correct answer ✅Insurer must be able to cover large numbers of similar risks Spreads risk across more policies Helps insurers predict losses more accurately Similar risks can mean, cars houses, persons lives, similar business etc Adverse Selection - correct answer ✅when someone buys health insurance because they know they will probably file a claim 4 risk management techniques - correct answer ✅Avoidance Reduction Transference Retention

Latest 2023

Risk avoidance - correct answer ✅Eliminates risk by not taking action that involves risk Risk reduction - correct answer ✅Taking measures to reduce risk that is involved Also called risk mitigation Risk Transference - correct answer ✅Management of sever risk by transferring risk to someone else Most common example is Insurance Risk retention - correct answer ✅Acknowledging the risks and preparing to handle the unexpected losses as they occur Policy Period - correct answer ✅The time frame, beginning with the inception date to the expiration date, during which insurance coverage applies.

Latest 2023

Binder - correct answer ✅Providing temporary coverage until the policy is issued Blanket coverage vs specific coverage - correct answer ✅Blankets cover more than one property, type of property, or coverage under a single limit Specific limits - limits that apply to on specific type of property Representation - correct answer ✅Statement of fact Missrepresentation - correct answer ✅A false, distorted or deceptive statements Warranty - correct answer ✅Promise or garuntee certain conditions are met Warranties are found on the conditions page If policy holder breaks up warranty the insurer can deny coverage Concealment - correct answer ✅Concealment is hiding the truth Deliberately withholding information

Latest 2023

Waiver - correct answer ✅Voluntarily surrender of a right, claim, or privilege Expressed waiver - correct answer ✅In writing or signed Implied waiver - correct answer ✅assumed based on actions Estoppel - correct answer ✅Legal principle that prevents an insurer from denying coverage if the insured has reasonably come to believe that he has such coverage based on insurers practices Types of hazards - correct answer ✅Physical, Moral, Morale, legal Moral hazard - correct answer ✅Results from the policy holders deliberate decision Involves reckless behavior because of the financial security offered by insurance Is a type of behavioral hazard

Latest 2023

Morale hazard - correct answer ✅Occur when someone exhibits risky behavior because of having insurance. Physical hazard - correct answer ✅Physical conditions that increase the chance of loss. Types of physical hazards - correct answer ✅Environmental - pot holes in road Material - asbestos in a old house Operational - poorly managed engine Occupant - working in a coal mine Legal hazard - correct answer ✅Increased chance of loss because of legal action fraud - correct answer ✅Deceiving an insurer to profit from an insurance policy Hard and soft fraud - correct answer ✅Hard fraud - planning or faking a loss

Latest 2023

Soft fraud - exaggerating a claim to inflate the indemnity proximate cause - correct answer ✅Unbroken chain of events between an occurrence and a loss - then that occurrence is the proximate cause of the loss occurrence - correct answer ✅An event, incident, or condition that causes damage Occurrence as proximate cause - correct answer ✅The original occurrence causes damage that leads to more damage Direct loss - correct answer ✅Physical harm to tangible property Indirect loss - correct answer ✅Economic loss that results from the direct or physical loss Non-waiver agreement - correct answer ✅- Also used when the insurer thinks coverage may not apply to a claim

Latest 2023

• allows insurer to keep its right to deny coverage
• must be signed by the policy holder (but insurer may not force a policy holder to sign) Two types of damages - correct answer ✅punitive and compensatory Compensatory Damages - correct answer ✅Money awarded for tangible and intangible economic losses Special damages - money awarded for tangible losses - proven by medical bills etc General damages - awarded for non quantifiable damages Punitive damages - money awarded to punish egregious misconduct The Statute of Limitations - correct answer ✅Law limiting time an injured party has to file a complaint after an occurrence

Latest 2023

Wrongful death act - correct answer ✅when someone dies because of a negligent act, allows family to sue Workers compensation - correct answer ✅Restrict right of an employee to sue his employer for injuries that occurred on the job Automobile no fault laws - correct answer ✅Restrict an individual's rights to sue the driver of a motorized vehicle Breach of product warranty - correct answer ✅If a product is not suitable for its intended purpose and causes injury or damage. Waiver of Sovereign Immunity - correct answer ✅Allows individuals to sue gov entities in certain cases Agent - correct answer ✅One who receives the authority to act on behalf of someone else

Latest 2023

Sales agent - correct answer ✅Contracted to sell and service insurance policies on behalf of the insurer Adjusters - correct answer ✅Contracted to settle claims that arise against the insurer Power to bind - correct answer ✅What the agent says or does can bind the insurer Agents should take the utmost care in what they say and do Even if the agent makes mistakes, the insurer may have to accept them Responsibilities of an agent - correct answer ✅Adhere to or follow the contract Use reasonable judgement Provide all necessary information and documentation to the insurer Three types of authority - correct answer ✅express, implied, apparent

Latest 2023

Express Authority - correct answer ✅Authority directly granted to an agent via the contract -sell polices -collect premiums -issue binders

• offer discounts
• cancel insurance Implied Authority - correct answer ✅A form of indirect authority The authority that the public reasonably believes the agent to have
• portraying self as a representative
• wearing a name tag with a company logo
• handing out company business cards
• words and actions that go hand in hand with express authority and are usual in order to perform an agents duties Apparent Authority - correct answer ✅When the insurer does not correct its agent even when the agent may be acting in error
• granted when the insurer does not act

Latest 2023

• by not correcting the agent, the insurer implies consent Types of sales agents - correct answer ✅Independent agent Exclusive agent General agent Direct writer Independent agent - correct answer ✅Self employed Offer insurance form more than one company at a time They can compare and give rate quotes from different companies. Find a policy that suits the customer Exclusive agent - correct answer ✅Also called a captive agent
• commissioned
• represents only one insurer and only their policies

Latest 2023

General agent - correct answer ✅Works for one insurance company Trains and supervises agents for that company Direct writer - correct answer ✅Salaried employee Works for one company Insurance claims - correct answer ✅Demand for payment in accordance with terms of the policy First party claims - correct answer ✅Claim filed by a policy holder against his or her own insurance policy Third party claims - correct answer ✅Claim filed against an insurance policy by a third party not named on that policy acknowledgement - correct answer ✅Insurer require by law to respond

Latest 2023

Begin investigating all pertinent facts and issues Investigation - correct answer ✅Finding the proximate cause of the loss Examining all damages Noting circumstances Taking witness statements Determining liability Deciding wether claim is valid Evaluation - correct answer ✅Consider policy limit and deductibles Calculating lender interest Determining the value of the loss Applying all financial provisions of the policy Adjustment - correct answer ✅If a claim is accepted, the insurer must pay promptly after notifying that the claim will be paid If claim is denied the insurer must explicitly state reasons for denial

Latest 2023

Insurable Interest - correct answer ✅Only parties with insurable interest can insure a property or person You can only insure something that has some financial interest to you Lender interest - correct answer ✅A lenders financial stake in an insured item Lender Interest Provisions - correct answer ✅Allow the lender to be listed as a payee on the policy Endure the lender is notified if the policy is canceled, reduced, or expires Provide compensation for the lender in the event of an act or an omission by insurer party Permit lender to pay premiums to maintain coverage Limits on lender provisions - correct answer ✅Lender may only collect up to its financial interest in a property

Latest 2023

Lender may never change or cancel an insurance policy Actual Cash Value - correct answer ✅Same as fair market value and depreciation value ACV offers lower premiums for less coverage Formula: replacement cost minus depreciation Depreciation formula - correct answer ✅allocation of original costs over the estimated useful life of a tangible asset 3 Types of Deductibles - correct answer ✅Fixed Percentage Franchise Fixed deductible - correct answer ✅Specific set amount percentage deductible - correct answer ✅Insured party pays a percentage of the total cost, insurance pays rest

Latest 2023

Franchise Deductible - correct answer ✅Policy kicks in only after a loss exceeds a predetermined amount If losses are above the deductible then insurance pays 100% broad evidence rule - correct answer ✅ACV does not simply come down to RC minus depreciation Takes into account any evidence available to determine value Coinsurance - correct answer ✅ Valuation - correct answer ✅Process of estimating an items worth Replacement cost policy - correct answer ✅No depreciation. Based on replacement cost at the time of loss Higher premiums

Latest 2023

Used on home insurance mostly Replacement cost - correct answer ✅Cost to replace at today's market value Actual Cash Value (ACV) - correct answer ✅Replacement cost minus accumulated depreciation Annual Depreciation - correct answer ✅Replacement cost divided by items useful life span Accumulated Depreciation - correct answer ✅An items annual depreciation Multiplied by its age Valued Policy - correct answer ✅Assigns a set value to each insured item Co-insurance penalty - correct answer ✅If property is underinsured, the insurer will only cover a percentage of partial losses

Latest 2023

If multiple partial losses occur, the low premiums are not enough for the insurer to cover all the damages Calculating co insurance penalty - correct answer ✅Had / should X the loss Negligence - correct answer ✅Failure to use a reasonable degree of care in a particular situation- includes both wrongful acts and acts of omission 4 elements of negligence - correct answer ✅1. Defendant had a legal duty to act or not act in a prescribed manner

2. The defendant failed to act accordingly
3. The plaintiff suffered actual loss or injury due to the defendants action or inaction
4. The loss or injury to the plaintiff was a direct result of the breach of duty of the defendant

Latest 2023

Degrees of Liability - correct answer ✅Full liability- the insured party is 100% at fault for damages to a third party Partial liability - the insured party is only partially at fault, or shares fault, with a third party. The third party had some parts in his own damages No liability - the insured party has 0% or no liability Assumption of risk - correct answer ✅Claimant knew he had the potential to experience damage Contributory Negligence - correct answer ✅A legal defense that may be raised when the defendant feels that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff. Comparative Negligence - correct answer ✅A theory in tort law under which the liability for injuries resulting from negligent acts is shared by all parties who were negligent (including the injured party), on the basis of each person's proportionate negligence.

Latest 2023

Dangerous Instrumentality Doctrine - correct answer ✅States that anyone involved in the use of inherently dangerous products or machines is held 100% liable for their own damages. strict (absolute) liability - correct answer ✅liability is imposed regardless of negligence or fault Policy limit - correct answer ✅The maximum amount the insurance company will pay for covered losses Single limits - correct answer ✅Establishes maximum payout for liability damages caused by the policy holder Split limits - correct answer ✅Establishes 3 different limits on how much the policy will pay out

1. Maximum payout for bodily injury for each person injured
2. Maximum payout for multiple persons
3. Maximum payout for property damage

Latest 2023

Aggregate limits - correct answer ✅2 limits

1. Max payout for damage or injury per occurrence
2. Maximum payout amount the policy will pay per term Res Ipsa - correct answer ✅Means "the thing speaks for itself" and is only applied n rare instances when no one knows how exactly the accident happened Statutory law - correct answer ✅Based on written laws What is insurance? - correct answer ✅protection against financial loss what is a premium - correct answer ✅a scheduled amount to be paid for an insurance policy. What are premiums used for - correct answer ✅premiums are collected into a "pool" or "reserve to pay out claimants when needed.

Latest 2023

how can insurance companies afford to pay for an individuals catastrophic loss? - correct answer ✅the insurer collects premiums from all policy holders and uses them to pay out the claims of a few. what is Indemnity - correct answer ✅payment for damages, that is not more or less than the amount caused by the damage. principle of idemnity - correct answer ✅insurance will pay no more or less than the actual financial loss suffered indemnification may also include - correct answer ✅repairs to property reimbursement for additional living expenses rental cars and hotels costs directly associated with a loss 4 Parts of Legal Contract - correct answer ✅1. Agreement

2. Consideration
3. Competent Parties
4. Legal Purpose

Latest 2023

legal contract - agreement - correct answer ✅mutual intent by offeror and offeree six special characteristics of insurance contracts - correct answer ✅1. Personal

2. adhesion
3. utmost good faith
4. aleatory
5. unilateral
6. conditional what kind of contract is an insurance policy? - correct answer ✅Personal contract what is a contract of adhesion - correct answer ✅the insured must accept the entire contract with all of its terms and conditions