FLORIDA 3-20 PUBLIC ADJUSTERS STATE LICENSE FINAL EXAM 2024-2025, Exams of Business Economics

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FLORIDA 3-20 PUBLIC ADJUSTERS

STATE LICENSE FINAL EXAM 2024-

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An insurance adjuster who works primarily outside of an office and often meets personally with the public Field Adjuster Purposefully setting fire to property. Not covered under the policy if the act is committed by the insured Arson The attempt, by an applicant to deceive an insurance company Misrespresentation Personal property that is not part of the dwelling or structure Contents An individual that is used when a claim has been questioned by either the insured or the insurer, an unbiased part is required to resolve the dispute Umpire Amount an insurer will have to pay an insured to meet the promises outlined in the insurance contract, reduction in value of insured item loss An addition, deletion or change to a legal document or policy

Amendment The section of an insurance policy identifying the insured, endorsements, coverages, limits and premiums The Declarations page Reinsureance agreement where the insurers involved will pay claims in direct relationship with the % of the risk they are insuring Co-insurance Financial investment or financial dependency that an individual or business has in a person or property Insurable interest Failure to use the care that a reasonable and prudent person would have used under that same or similar circumstance Negligence "Insurer" has an obligation to pay covered loss, "insured" has no obligation Unilateral insurance contract Uninsurable because of the possibility of either loss or gain in the risk Speculative Risk The depreciation from the total Replacement Cost due to age, use and condition. The resulting dollar amount is Actual Cash Value Non-recoverable Depreciation 626.854 (3)

The insurer and insured agree to a specific value of insured item Agreed Value Policies Someone who has care, custody or control of another's property Bailee Claim filed by policy holder against his _ First Party Claim When a person who entrusts another with an object and it results in injury to someone can be held liable for the injury to someone. Can be held liable for the injury i.e. Firearm or DWI Negligent Entrustment

Hazard that results from a conscious decision made by an insured to participate in a manner or behavior more likely to result in a loss because they have insurance Moral Hazard Used to provide temporary insurance coverage until an insurance policy can be written Binder Required by lenders to guarantee that outstanding loans against a job are paid upon completion Completion Bonds The section of an insurance policy identifying the insured, endorsements, coverages, limits, and premiums Declarations Policyholder cannot transfer the policy to someone else without written permission from their insurance company Assignment An instance, behavior or environment that increases the likelihood of a loss on an insured item Hazard Actual cause or source of an incidence of destruction, injury, or loss Peril An insurance company organized and domiciled outside the US Alien When there is an unbroken chain of events between an occurrence and a loss, then the loss is part of the original occurrence Proximate Cause Is proximate cause of all subsequent damages Original Occurance An individual who contracts with an adjusting firm as an independent contractor and handles claims for the insurance companies Independent Adjuster Action or practice of the insured party is permitted to continue because any defense against a continuation of said action or practice has been waived by the insurer Estoppel Operate for profit, collect premiums, reserve a portion of premiums to pay claims

Commercial Insurers Any person who investigates or adjusts losses on behalf of either an insurer or a self-insured Independent Adjuster The result of an insured's tort or wrongdoing. Consequences of a loss or amount or type of losses suffered Damages Requires the insured to insure the named property for a specific amount of insurance as required by the insurance company Agreed Value Physical harm to tangible property caused by peril (loss to property or person in which a covered peril is the proximate cause of damage or destruction) Direct loss The entity that is the "recipient" to the Principal Obligee Insurance contracts are written on a take it or leave it basis to the policy owner. Adhesion Event or circumstance that causes damage Occurance Coverage provides for payment of losses if civil authority denies access to the insured premises due to a covered peril Civil Authority Voluntary relinquishment of a known legal right Waiver An insurer domiciled outside the state where it writes insurance Foreign A state officer who administers the state's insurance laws and regulations Commissioner Used as a promise to accept a bid if awarded to a company Bid bond Damaged property an insurer takes over to reduce their loss after paying a claim

Salvage Factual statements upon which an insurance policy is based Representations A contract between two parties that offer the consumer little to no leeway to negotiate the terms of the contract Contract of adhesion Publication in any media by the insured about goods or services Advertisements Also known as Absolute Liability, based on the theory of the duty of making something sage that is inherently dangerous Strict Torts A house, structure, also referred to as a "primary risk" Dwelling Condition enforced by the courts to do something bound under law or in a contract Strict Torts Amount of loss paid by the policy holder Deductible Violation of an agreement between a seller and buyer in reference to the condition, content, quality, or title of an item sold Breach of Warranty Compensation, reparation Indemnify Provides property coverage on a contractor's interest in equipment intended for permanent installation while it is being transported, unloaded, and installed Installation Floater A beneficiary of a contract only as a result of the First Party's negligence Third Party Reinsurance agreement where the insurers involved will pay claims in direct relationship with the % of the risk that they are insuring Quota Share

Sharing the cost of replacement Risk Sharing A legal action filed by one or more persons on behalf of themselves and others having an identical interest in the alleged wrongdoing Class-Action A specific risk or cause of loss covered by an insurance policy, such as fire, windstorm, flood, theft, etc. Peril Dangers in a store, warehouse, or office; circumstances of risks and perils determine who is responsible for _____ Premises Liability A loss or risk the policy doesn't cover Exclusions Technique used to transfer the risk of a person, business, or organization in another through the use of a two-party contract Insurance A legal two-party document describing the relationship between the insured and the insurance company Indemnity Contract Legal document that makes some person responsible for damages their actions or products cause regardless of any fault on their part Strict Liabilty The intention to withhold relative information about the risk from the insurance company Concealment A subset of the claims function whereby suspicious losses are investigated separately from the normal claims adjusters' activities Special Investigations Unit An insurer takes no action upon realizing material changes in a contract Implied Waiver Acts committed without negligence but result in damages Intentional Tort Willful and illegal sinking of a ship at sea or its cargo

barratry Covers physical damage as well as liability and tends to be very broad in coverage Commercial Inland Marine Single insurance for only one kind of property at only one location of an insured Specific Coverage Legislative Acts or Laws Statutes The insurance company to which the risk is transferred to by the contract Second Party Hazards on private property that might attract trespassing such as swimming pools or trampolines Attractive Nuisance An approximate calculation of amount, extent, quality, magnitude, position, degree or worth of something Estimages Insurance company assesses, mitigates, and monitors the items of risk that potential customers want to insure Risk management Granting the privileges and licensing in a state based on having a license in another state that is deemed equivalent by the granting state Reciprocity Specific protection in an insurance policy Coverage An individual holding a license under the authority of the State Licensee Means any solid, liquid, gaseous or thermal irritant or contaminant including smoke, vapor, soot, fumes, acids, alkalis and chemicals Pollutants A package insurance policy that combines both property and casualty coverages into a single policy Homeowners policy Legal term applying the third party claims meaning " to pay back or to make whole"

Indemnification An agreement by one party, the guarantor to answer to a 3rd person for the debt of default of a responsible party called the Principal Surety bonds The necessary increase in living expense resulting from a loss by a covered peril, and incurred by the insured Additional Living Expense (ALE) The replacement cost of like kind and quality at the time of loss, less a reasonable amount of depreiciation Actual cash value Physical condition that increases the change of loss Physical Hazard Openness to loss or damage Exposure Any changes that broaden coverage on the edition of the policy that the insured holds will automatically apply without premiums liberalization cluse Bonds that protect an employer form losses by an employee fidelity bonds A combination of property and liability coverages of two or more separate policies in one premium Package policy Fire that is not contained in the vessel in which it was set. Example: Hostile Fire Written agreement attached to a policy to add or subtract insurance coverage Endorsement Covers a variety of issues including lease of premiums, easements, sidetrack agreements and elevator maintenance agreements. Insured contract The act o taking responsibility through agreement for something that person may not be legally liable Assumption of liability

Only applies to business income coverage and not to the extra expense coverage Actual cash value (bi) The value of the property is decreased or reduced due to damage but the property still remains some value and can be used Diminution of value Depreciation that is initially held back, then disbursed after proof of repairs being performed to bring property back to whole Recoverable depreciation Economic loss that arises as a consequence of the direct or physical loss indirect loss A statement made regarding the extent of the claim, it may be requested in accordance with the conditions of the policy Proof of loss Tangible property other than the products or work produced impaired property Works upon the principal that the more times an event is repeated, the more predictable the outcome of a specific event Law of Large Numbers To access the eligibility of a customer to receive their products, decide how much coverage the client should receive, and how much they should pay for it. Underwriting Actual cost of replacing property due to a covered peril with property of like kind and quality without depreciation replacement cost Exaggerating an otherwise legitimate claim for profit Soft Fraud Unincorporated association of members in which each member insures the other members Reciprocal insurance exchange An Agreement and Policy An ongoing assurance made by one party to another that certain facts :

Warranty Method whereby the insurer pays the amount of each claim for each risk up to a limit determined in advance, and the re-insurer pays the amount of the claim above that specified limit Exxcess of loss A person who voluntarily gives up possession of the property bailor One of the earliest forms of insurance Ocean Marine

A public adjuster may not give legal advice or act on behalf of or aid any person in negotiating or settling a claim relating to bodily injury, death, or noneconomic damages. 626.854 (5) A public adjuster may not directly or indirectly through any other person or entity solicit an insured or claimant by any means except on Monday through Saturday of each week and only between the hours of 8 a.m. and 8 p.m. on those days. 626.854 (6) An insured or claimant may cancel a public adjuster's contract to adjust a claim without penalty or obligation within 3 business days after the date on which the contract is executed or within 3 business days after the date on which the insured or claimant has notified the insurer of the claim, whichever is later. The public adjuster's contract must disclose to the insured or claimant his or her right to cancel the contract and advise the insured or claimant that notice of cancellation must be submitted in writing and sent by certified mail, return receipt requested, or other form of mailing that provides proof thereof, to the public adjuster at the address specified in the contract; provided, during any state of emergency as declared by the Governor and for 1 year after the date of loss, the insured or claimant has 5 business days after the date on which the contract is executed to cancel a public adjuster's contract. 626.854 (7) It is an unfair and deceptive insurance trade practice pursuant to s. 626.9541 for a public adjuster or any other person to circulate or disseminate any advertisement, announcement, or statement containing any assertion, representation, or statement with respect to the business of insurance which is untrue, deceptive, or misleading. 626.854 (7) (a)

The following statements, made in any public adjuster's advertisement or solicitation, are considered deceptive or misleading:

1. A statement or representation that invites an insured policyholder to submit a claim when the policyholder does not have covered damage to insured property.
2. A statement or representation that invites an insured policyholder to submit a claim by offering monetary or other valuable inducement.
3. A statement or representation that invites an insured policyholder to submit a claim by stating that there is "no risk" to the policyholder by submitting such claim.
4. A statement or representation, or use of a logo or shield, that implies or could mistakenly be construed to imply that the solicitation was issued or distributed by a governmental agency or is sanctioned or endorsed by a governmental agency. 626.854 (7) (B) For purposes of this paragraph, the term "written advertisement" includes only newspapers, magazines, flyers, and bulk mailers. The following disclaimer, which is not required to be printed on standard size business cards, must be added in bold print and capital letters in typeface no smaller than the typeface of the body of the text to all written advertisements by a public adjuster: "THIS IS A SOLICITATION FOR BUSINESS. IF YOU HAVE HAD A CLAIM FOR AN INSURED PROPERTY LOSS OR DAMAGE AND YOU ARE SATISFIED WITH THE PAYMENT BY YOUR INSURER, YOU MAY DISREGARD THIS ADVERTISEMENT." 626.854 (8) A public adjuster, a public adjuster apprentice, or any person or entity acting on behalf of a public adjuster or public adjuster apprentice may not give or offer to give a monetary loan or advance to a client or prospective client. 626.854 (9) A public adjuster, public adjuster apprentice, or any individual or entity acting on behalf of a public adjuster or public adjuster apprentice may not give or offer to give, directly or indirectly, any article of merchandise having a value in excess of $25 to any individual for the purpose of advertising or as an inducement to entering into a contract with a public adjuster. 626.854 (10)(A) If a public adjuster enters into a contract with an insured or claimant to reopen a claim or file a supplemental claim that seeks additional payments for a claim that has been previously paid in part or in full or settled by the insurer, the public adjuster may not charge, agree to, or accept from any source compensation, payment, commission, fee, or any other thing of value based on a previous settlement or previous claim payments by the insurer for the same cause of loss. The charge, compensation, payment, commission, fee, or any other thing of value must be based only on the claim payments or settlement obtained through the work of the public adjuster after entering into the contract with the insured or claimant. Compensation for the reopened or supplemental claim may not exceed 20 percent of the reopened or supplemental claim payment. In no event shall the contracts described in this paragraph exceed the limitations in paragraph (b).

626.854 (10) (b) A public adjuster may not charge, agree to, or accept from any source compensation, payment, commission, fee, or any other thing of value in excess of:

1. Ten percent of the amount of insurance claim payments made by the insurer for claims based on events that are the subject of a declaration of a state of emergency by the Governor. This provision applies to claims made during the year after the declaration of emergency. After that year, the limitations in subparagraph 2. apply.
2. Twenty percent of the amount of insurance claim payments made by the insurer for claims that are not based on events that are the subject of a declaration of a state of emergency by the Governor. 626.854 (10) (c) Insurance claim payments made by the insurer do not include policy deductibles, and public adjuster compensation may not be based on the deductible portion of a claim. 626.854 (10) (d) Any maneuver, shift, or device through which the limits on compensation set forth in this subsection are exceeded is a violation of this chapter punishable as provided under s. 626.8698. 626.854 (11) Each public adjuster must provide to the claimant or insured a written estimate of the loss to assist in the submission of a proof of loss or any other claim for payment of insurance proceeds. The public adjuster shall retain such written estimate for at least 5 years and shall make the estimate available to the claimant or insured, the insurer, and the department upon request. 626.854(12) A public adjuster, public adjuster apprentice, or any person acting on behalf of a public adjuster or apprentice may not accept referrals of business from any person with whom the public adjuster conducts business if there is any form or manner of agreement to compensate the person, directly or indirectly, for referring business to the public adjuster. A public adjuster may not compensate any person, except for another public adjuster, directly or indirectly, for the principal purpose of referring business to the public adjuster. 626.854 (13) A company employee adjuster, independent adjuster, attorney, investigator, or other persons acting on behalf of an insurer that needs access to an insured or claimant or to the insured property that is the subject of a claim must provide at least 48 hours' notice to the insured or claimant, public adjuster, or legal representative before scheduling a meeting with the claimant or an onsite inspection of the insured property. The insured or claimant may deny access to the property if the notice has not been provided. The insured or claimant may waive the 48-hour notice. 626.854 (14) The public adjuster must ensure that prompt notice is given of the claim to the insurer, the public adjuster's contract is provided to the insurer, the property is available for inspection of the loss or

damage by the insurer, and the insurer is given an opportunity to interview the insured directly about the loss and claim. The insurer must be allowed to obtain necessary information to investigate and respond to the claim. 626.854 (14) (a) The insurer may not exclude the public adjuster from its in-person meetings with the insured. The insurer shall meet or communicate with the public adjuster in an effort to reach agreement as to the scope of the covered loss under the insurance policy. The public adjuster shall meet or communicate with the insurer in an effort to reach agreement as to the scope of the covered loss under the insurance policy. This section does not impair the terms and conditions of the insurance policy in effect at the time the claim is filed. 626.854 (14) (b) A public adjuster may not restrict or prevent an insurer, company employee adjuster, independent adjuster, attorney, investigator, or other person acting on behalf of the insurer from having reasonable access at reasonable times to any insured or claimant or to the insured property that is the subject of a claim. 626.854 (14) (c) A public adjuster may not act or fail to reasonably act in any manner that obstructs or prevents an insurer or insurer's adjuster from timely conducting an inspection of any part of the insured property for which there is a claim for loss or damage. The public adjuster representing the insureds may be present for the insurer's inspection, but if the unavailability of the public adjuster otherwise delays the insurer's timely inspection of the property, the public adjuster or the insureds must allow the insurer to have access to the property without the participation or presence of the public adjuster or insureds in order to facilitate the insurer's prompt inspection of the loss or damage. 626.854 (15) A licensed contractor under part I of chapter 489, or a subcontractor, may not adjust a claim on behalf of an insured unless licensed and compliant as a public adjuster under this chapter. However, the contractor may discuss or explain a bid for construction or repair of covered property with the residential property owner who has suffered loss or damage covered by a property insurance policy, or the insurer of such property, if the contractor is doing so for the usual and customary fees applicable to the work to be performed as stated in the contract between the contractor and the insured. 626.854 (16) A public adjuster shall not acquire any interest in salvaged property, except with the written consent and permission of the insured through a signed affidavit. 626.854 (17) A public adjuster, a public adjuster apprentice, or a person acting on behalf of an adjuster or apprentice may not enter into a contract or accept a power of attorney that vests in the public adjuster, the public adjuster apprentice, or the person acting on behalf of the adjuster or apprentice the effective authority to choose the persons or entities that will perform repair work in a property insurance claim or provide

goods or services that will require the insured or third-party claimant to expend funds in excess of those payable to the public adjuster under the terms of the contract for adjusting services. 626.854 (18) Subsections (5)-(17) apply only to residential property insurance policies and condominium unit owner policies as described in s. 718.111(11). 626.854 (19) Except as otherwise provided in this chapter, no person, except an attorney at law or a public adjuster, may for money, commission, or any other thing of value, directly or indirectly: 626.854 (19) (a) Prepare, complete, or file an insurance claim for an insured or a third-party claimant; 626.854 (19) (b) Act on behalf of or aid an insured or a third-party claimant in negotiating for or effecting the settlement of a claim for loss or damage covered by an insurance contract; 626.854 (19) (c) Advertise for employment as a public adjuster; or 626.854 (19) (d) Solicit, investigate, or adjust a claim on behalf of a public adjuster, an insured, or a third-party claimant. Under a dwelling broad or special form, what is the maximum that would be paid for "loss of use"? 20% of the Dwelling Coverage Under a dwelling (DP-2 or DP-3) policy, what is the maximum % that would be paid for ALE? 20% The insurer and insured agree to a specific value of insured item Agreed Value Policies Someone who has care, custody or control of another's property Bailee When a person who entrusts another with an object and it results in injury to someone can be held liable for the injury to someone. Can be held liable for the injury i.e. Firearm or DWI Negligent Entrustment Hazard that results from a conscious decision made by an insured to participate in a manner or behavior more likely to result in a loss because they have insurance Moral Hazard

Used to provide temporary insurance coverage until an insurance policy can be written Binder The section of an insurance policy identifying the insured, endorsements, coverages, limits, and premiums Declarations Actual cause or source of an incidence of destruction, injury, or loss Peril Is proximate cause of all subsequent damages Original Occurance Action or practice of the insured party is permitted to continue because any defense against a continuation of said action or practice has been waived by the insurer Estoppel Requires the insured to insure the named property for a specific amount of insurance as required by the insurance company Agreed Value Physical harm to tangible property caused by peril (loss to property or person in which a covered peril is the proximate cause of damage or destruction) Direct loss The entity that is the "recipient" to the Principal Obligee Voluntary relinquishment of a known legal right Waiver Used as a promise to accept a bid if awarded to a company Bid bond Damaged property an insurer takes over to reduce their loss after paying a claim Salvage Factual statements upon which an insurance policy is based Representations A house, structure, also referred to as a "primary risk" Dwelling

Violation of an agreement between a seller and buyer in reference to the condition, content, quality, or title of an item sold Breach of Warranty Acts committed without negligence but result in damages Intentional Tort Willful and illegal sinking of a ship at sea or its cargo barratry Covers physical damage as well as liability and tends to be very broad in coverage Commercial Inland Marine Single insurance for only one kind of property at only one location of an insured Specific Coverage A package insurance policy that combines both property and casualty coverages into a single policy Homeowners policy Legal term applying the third party claims meaning " to pay back or to make whole" Indemnification The replacement cost of like kind and quality at the time of loss, less a reasonable amount of depreiciation Actual cash value Any changes that broaden coverage on the edition of the policy that the insured holds will automatically apply without premiums liberalization Bonds that protect an employer form losses by an employee fidelity bonds The act o taking responsibility through agreement for something that person may not be legally liable Assumption of liability A statement made regarding the extent of the claim, it may be requested in accordance with the conditions of the policy Proof of loss Tangible property other than the products or work produced impaired property

Actual cost of replacing property due to a covered peril with property of like kind and quality without depreciation replacement cost Exaggerating an otherwise legitimate claim for profit Soft Fraud Unincorporated association of members in which each member insures the other members Reciprocal insurance exchange An Agreement and Policy An ongoing assurance made by one party to another that certain facts : Warranty The attempt, by an applicant to deceive an insurance company Misrespresentation The section of an insurance policy identifying the insured, endorsements, coverages, limits and premiums The Declarations page Financial investment or financial dependency that an individual or business has in a person or property Insurable interest