Claims Adjuster Exam With 100% Correct And Verified Answers, Exams of Advanced Education

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Claims Adjuster Exam With 100%

Correct And Verified Answers

Insurance adjuster - Correct Answer-Any person who, as an independent contractor, or as an employee of an independent contractor, adjustment bureau, association, insurance company or corporation, local recording agent, managing general agent, or self-insured, investigates or adjusts losses on behalf of either an insurer or a self insured, or any person who supervises the handling of claims. Staff Adjusters - Correct Answer-On the payroll of an insurance company and are paid a salary or by hour Independent Adjuster - Correct Answer-handles claims for one or more insurance companies. They may: receive a fee based on time and expense, they may be on the payroll as a permanent employee of an independent adjusting firm, they may be paid a percentage of the loss or per diem. Public adjuster - Correct Answer-work on behalf of the insured in negotiating a claim settlement. Under current law in Texas, is legal and requiers another license. Worker's compensation Adjuster - Correct Answer-This license allows a person to adjust or supervise all workers' compensation, employers liability, United States Longshore, and Habor Works' Compensation Act, Jones Act, and all other federal acts Property and Casualty Adjuster - Correct Answer-This license allows a person to adjust or supervise claims in all areas of property and casualty insurance except workers' compensation. All-Lines Adjuster - Correct Answer-This license allows a person to adjust or supervise claims in all lines of insurance included in (1) and (2) Domestic - Correct Answer-An insurer organized, admitted, and writing insurance in Texas Foreing - Correct Answer-An insurer domiciled outside the state where it writes insurance Alien - Correct Answer-An insurance company organized and domiciled outside the US Texas Department of Insurance - Correct Answer-Who is Responsible for licensing property and casualty adjusters

10 days - Correct Answer-How many days' advance notice is an adjuster entitled to receive in the event of a hearing with the Texas Department of Insurance. 30 hours - Correct Answer-A licensed Property and casualty adjuster must complete how many hours of continuing education within his 2-year licensing period? AIC - Correct Answer-Which of the following designations exempts a person from taking the property and casualty adjuster state exam 18 years old - Correct Answer-An individual must be what age to receive the property and casualty adjuster license? 2 hours - Correct Answer-How many hours of ethics must a licensed adjuster complete every licensing period (2 years) Within 30 days of the change - Correct Answer-How soon must a licensed adjuster notify the Texas Department of Insurance (TDI) of an address change? Governor of Texas - Correct Answer-Who appoints the commissioner of Insurance? 1 or more - Correct Answer-How many companies might an independent adjuster represent? Insured - Correct Answer-A public adjuster represents which of the following? Business day - Correct Answer-This is a day other than a Saturday, Sunday, or a holiday recognized by this state. First-Party Claim - Correct Answer-Claim made by an insured or policy holder under an insurance policy or contract or by a beneficiary named in the policy or contract. Must be paid by the insurer directly to the insured/beneficiary Claimant - Correct Answer-This is the person making a claim Notice of the Claim - Correct Answer-any written notification provided by a claimant to an insurer that reasonably apprises the insurer of the facts relating to the claim. Within 15 days - Correct Answer-The insurer must acknowledge receipt of the claim, commence any investigation of the claim, request from the claimant all items, statements, and forms that the insurer reasonably believes, at that time, will be required from the claimant within how many days? within 15 business days after receiving complete information - Correct Answer-An insurer must notify a claimant in writing of the acceptance or rejection of a claim when?

Within 30 days of the date the insurer receives complete information - Correct Answer-If insurer has a reasonable basis to believe that a loss resulted from arson, the insurer must notify the claimant in writing of the acceptance or rejection of the claim 15 days - Correct Answer-In the event of a weather-related catastrophe, how long is the given extension for handling claims? 5 business days - Correct Answer-Once the company agrees to pay the claim, it must send the check or draft within how many days? 2 - Correct Answer-How many parties does an insurance contract have? Insured - Correct Answer-Who is the first party in an insurance contract? 15 days - Correct Answer-How long does an insurer have to respond to a notice of claim? C - Correct Answer-All of the following are unfair claims practices EXCEPT A. Failing to reply to a claims and inquiries within a reasonable time. B. Requiring income tax returns for all losses. C. Providing an attorney to defend the insured for a suit arising out of a covered claim. D. Denying a claim before investigating its surrounding circumstances. . B - Correct Answer-Which of the following is NOT an example of an unfair claims settlement practice? A. Insurer's failure to maintain a record of complaints made against it. B. Allowing an insured to decide whether to collect under collision instead of uninsured/underinsured motorists coverage. C. Not attempting to settle a loss once liability has become reasonably clear. D. Not answering correspondence promptly that was sent by an insured. A - Correct Answer-All of the following statements regarding claims settlement practices are true EXCEPT A. Insurers must pay claims within 15 days of receiving notice of the claim B. Insurers must acknowledge a claim notice within 15 days C. Insurers may delay acknowledgement of a catastrophe claim. D. Insurers must provide necessary claim forms when acknowledging the claims. Competent parties - Correct Answer-A party must be at least age 18, adjudged sane and sober. Agreement - Correct Answer-This is the offer and acceptance; the company accepts the risk, rejects it, or possibly modifies it through underwriting, which becomes a counteroffer.

Lawful objective - Correct Answer-This is legal purpose and consistent with public policy Consideration - Correct Answer-This is an exchange of value between parties to a contract. Consideration received by the insured is the insurer's promise to provide indemnity in the event of a loss; consideration received by the insurer is the insurance premium Contract of adhesion - Correct Answer-This is a contract drafted by the insurer in which all parties agree to adhere to the contract as a whole. When ambiguities arise, the court will rule in favor of the insured. Aleatory contract - Correct Answer-A contract in which the values exchanged are not equal Unilateral contract - Correct Answer-contract in which only one party makes a legally enforceable promise Conditional Contract - Correct Answer-The contract may be voided if all policy conditions are not met Personal contract - Correct Answer-Contract insures the person who owns the property, not the property itself. Warranties - Correct Answer-Written statements or conditions that must be true at the time of the loss, or the policy is void. Representations - Correct Answer-statements made by the prospective insured on an application for insurance that are believed to be true to the applicant's best knowledge. Misrepresentation - Correct Answer-Incorrect information given by the prospect/insured that, when corrected, DOES NOT affect coverage. Material Misrepresentation - Correct Answer-incorrect information given by the prospect/insured but, when corrected DOES affect coverage/. concealment - Correct Answer-Deliberately withholding material information from the insurer. Fraud - Correct Answer-Intentional use of deceit calculated to gain a financial advantage. Waiver - Correct Answer-Voluntary relinquishment of a known right. estoppel - Correct Answer-Involuntary relinquishment of a known right

Insurance - Correct Answer-A transfer of risk from one person/organization to an insurance company that accumulates funds (premiums) Binder - Correct Answer-This commits the company to act as if a policy has been issued. AKA a temporary insurance contract Loss - Correct Answer-This is a reduction in value or an unintentional decline in value Direct loss - Correct Answer-Immediate actual physical damage to tangible property Indirect loss - Correct Answer-Inability to use property as a result of a direct loss consequential loss - Correct Answer-loss resulting from spoilage or temperature change Liability Loss - Correct Answer-a damage/injury claim that arises out of actions that cause loss to a third party Risk - Correct Answer-This is the chance of loss or uncertainty of loss Speculative risk - Correct Answer-The chanceof gain/loss and is not insurable (EG gambling, stock market). Pure risk - Correct Answer-involves only the chance of loss and is insurable Perils - Correct Answer-actual causes of loss identified in the policy hazards - Correct Answer-Conditions that create or increase the change of loss or contribute to the loss Physical hazard - Correct Answer-visible hazards (ice on a sidewalk) moral hazards - Correct Answer-hazards derive from intentional, dishonest, or illegal actions of a person. morale hazards - Correct Answer-Derive from carelessness or indifference. Law of large numebrs - Correct Answer-there must be a large number of homogeneous or like exposure units to predict future losses accurately. Declrations, insuring agreement, conditions, exclusions (DICE) - Correct Answer-The four part of an insurance contract declarations - Correct Answer-this defines who is the insured named insured/his rep, insurer, payee/lienholder - Correct Answer-Parties to the contract

Period of coverage - Correct Answer-How long protection or coverage remains in force. Policy limits - Correct Answer-The amount of protection Limit of liability - Correct Answer-The dollar amount stated on the insurance contract representing the maximum amount that can be paid for a covered loss. Deductibles - Correct Answer-the amount of loss under an insurance policy that an insured must pay or absorb before the insurance company pays its portion of the loss Insuring agreement - Correct Answer-This is the insuarnce company's promise to pay Causes of loss form - Correct Answer-The perils insured against Insured - Correct Answer-Who the insurer promises to protect in addition to the named insured Insurable interest - Correct Answer-Proof that someone stands to lose financially if a loss occurs resident relative - Correct Answer-Someone related to the named insured by blood, marriage, or adoption, who lives in the named insured's household. Conditions - Correct Answer-Duties or responsibilities of the insured/insurer Payment of claim - Correct Answer-Defines the method of calculating the settlement Duties - Correct Answer-Describe those of the insured in the event of a loss Subrogation rights - Correct Answer-The rights of the insurer, who has settled the insured's loss, to recover from an at-fault third party. Right of salvage - Correct Answer-The insurer may take possession of totaled property after a financial agreement is settled upon between the parties involved. Liberalization Clause - Correct Answer-Specifies that if the insurer broadens coverage with no increase in premium, that broadening of coverage will apply to existing policies without the need for an endorsement. Duty to defend - Correct Answer-Insurer's duty to assume the expense of defending the insured in litigation and lawsuits, even if the suit is frivolous. Concurrent - Correct Answer-Two different policies insuring the same perils nonconcurrent - Correct Answer-two different policies insuring separate perils

Primary policy - Correct Answer-When multiple policies cover the loss, this policy will pay first up to it's limit of liability or the amount of the loss. Excess policy - Correct Answer-When multiple policies cover the loss, this policy is the one that will pay after the limits of the primary coverage have been exhausted within two years and one day of the loss. - Correct Answer-if the insured wishes to sue the insurer, the lawsuit must be started when? Exclusions - Correct Answer-Section of the policy listing the perils, property not covered, or both. Supplementary payments - Correct Answer-apply to liability policies; they are paid in addition to policy limits. (BAILED) Bonds - Correct Answer-premiums paid with no limit (BAILED) Aid - Correct Answer-first-aid expenses at the scene of an accident with no limit (BAILED) Interest - Correct Answer-On judgments against insured with no limits (BAILED) Loss of earnings - Correct Answer-up to $250 per ady to assist in defending or investigating a claim (BAILED) Expesnes - Correct Answer-incurred at requrest of insurer (BAILED) Defense and investigation costs - Correct Answer-Paid with no limit (BAILED) Endorsements - Correct Answer-Modifications made to coverage Jewel - Correct Answer-Jewel's home is insured by XYZ insurance Company. last year, she made the final mortgage payment to FBN Mortgage Company. Jewel is considering selling her home to her niece, Cynthia. Who has an insurable interest in the home? Indemnity - Correct Answer-Principle that states that an insured should be restored after a loss to approximately the same financial position as before the loss is known as B - Correct Answer-Which of the following would NOT generally be included in the supplementary payments portion of a liability policy? A. Loss of earnings. B. Damage to property owned by the insured. C. First aid to others at the time of an accident. D. Expenses the insured incurs at the company's request as part of an investigation or defense.

Conditions - Correct Answer-Which part of an insurance policy personalizes the policy as to whom and what are insured? An adhesion contract - Correct Answer-An insurance policy is prepared by the insurance company, with little or no input from the insured. This means that an insurance policy is D - Correct Answer-Endorsements are used to do all of the following EXCEPT A. add coverage. B. Delete coverage. C. Modify coverage. D. cancel the entire policy. Payable in addition to the policy limit of liability - Correct Answer-In liability policies supplementary payments are