Florida Claims Adjuster Exam, 6-20 All Lines Adjuster- Florida- Review 2024-2025. Q & A, Exams of Insurance law

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Florida Claims Adjuster Exam, 6-20 All Lines

Adjuster- Florida- Review 2024-2025. Questions &

Correct Answers. Graded A

A claim is made under a CGL for a slip and fall injury. Two years later the injured person comes back saying the injury has flared-up. Is the reoccurrence covered under CGL Medical Payments? Select one: A. Yes, expenses are covered because of proximate cause. B. No, slip and falls are not covered under Medical Payment coverage C. Yes, expenses are covered within three years of the injury. D. No, expenses are covered within one year of the injury. - ANSNo, expenses are covered within one year of the injury. A company had its certificate of authority revoked because of bad sales practices. This type of company is known as: Select one: A. An admitted company B. An unedited company C. An unauthorized company

D. An authorized company - ANSAn unauthorized company A company was incorporated in Massachusetts and has their home office in that state. What type of company is this when they do business in Florida? Select one: A. They are an unauthorized company B. They are a domestic company C. They are a foreign company D. They are an alien company - ANSThey are a foreign company A contract condition of the Homeowners policy which provides that the insured gets the benefit of broadened coverage if the company adopts a broader form without an increase in premium is: Select one: A. Subrogation B. Liberalization C. Assignment D. Coinsurance - ANSLiberalization

A Florida employee was sent Boston to work for one week. While in Boston, they were injured on the job. How is the injury covered under WC benefits? Select one: A. The injury is covered under Florida's WC law B. There is no coverage under either state law C. The injury is covered under Massachusetts WC law D. None of the above - ANSThe injury is covered under Florida's WC law A florist wanted coverage on business contents, which vary in amount over the course of a year. Which form best fits this situation? Select one: A. Peak Season Endorsement B. None of the above C. Value Reporting Endorsement D. An automatic increase in insurance - ANSValue Reporting Endorsement A fourth party to a bond is called a: Select one: A. Surety

B. Principal C. Indemnitor D. Obligee - ANSIndemnitor A General Lines Adjuster is required to do what? - ANSParticipate in 24 hrs of continuing education every 2 years. A homeowner could not find coverage on the open market and looked to the residual market for coverage. What Joint Underwriting Association would handle this risk? Select one: A. Citizens B. The Florida Residential Property and Casualty Joint Underwriting Association C. The Florida Workers Compensation Joint Underwriting Association D. The Florida Automobile Joint Underwriting Association - ANSCitizens A house under construction is eligible for a Homeowner Policy if: Select one: A. None of these answers are correct

B. The builder doesn?t qualify for a Commercial Property Policy C. The builder is licensed D. The insured will be the owner-occupant - ANSD. The insured will be the owner- occupant A licensee must notify the Department in writing in how many days for change of name, address, phone number or email? - ANS30 days. A selected group of hospitals and doctors in a given area who have joined together to reduce medical costs is: Select one: A. A Professional Practitioner Group B. An HMO C. A Health Managed Hospital D. A PPO - ANSA PPO Abandonment - ANSProperty insurance policies usually contain an abandonment clause, stating the insured cannot dump damaged property on the insurer and demand its full value.

Accident - ANSA sudden, unexpected event. Acme Toys has a CGL policy. They hold a party and one of the guests has a little too much to drink. If the guest injures someone and the injured party sues the Acme Toys, the CGL policy: Select one: A. Will cover if the insure has Liquor Liability Coverage B. Will not cover C. Will cover if the insured has Legal Liability Coverage D. Will cover the claim - ANSWill cover the claim Actual Cash Value(ACV) - ANSReplacement Cost minus Depreciation ACV - ANSreplacement cost minus depreciation Adjusters should advise claimants on? - ANSclaims information Adjusting - ANSProcess of disposing of an insurance claim.

Admitted Liability is: Select one: A. Requires a legal action for injuries B. None of the above C. Applicable to passengers carried for hire D. Not applicable to passengers carried for hire - ANSNot applicable to passengers carried for hire Alien Insurer - ANSInsurer is an insurer other than a domestic or foreign insurer. All Lines Claims Adjuster 6-20 - ANSInvestigates, Evaluates, and Negotiates Claims. All of the following are among the broad classes of Ocean Marine Insurance, EXCEPT: Select one: A. Cargo B. Barratry C. Freight D. Hull - ANSBarratry

All of the following are characteristics of an insurance contract EXCEPT? Personal, Private, Conditional, Adhesion? - ANSPrivate All of the following are components of negotiating EXCEPT? Select one: A. The issue should be negotiable B. There must be an exchange of value for value C. The parties should trust each other D. The claimant must be satisfied - ANSThe claimant must be satisfied All of the following are covered under Supplemental Payments in a CGL EXCEPT: Select one: A. Expenses incurred at the company's request B. Lost wages up to $100/day C. Bails bonds up to $ D. Interest on judgments - ANSLost wages up to $100/day All of the following are eligible for a Homeowner Policy, EXCEPT:

Select one: A. Renters who maintain resident in any type of building B. Dwellings owned by a corporation C. Owner-occupants of 1-4 family dwellings D. Condominium unit owners - ANSDwellings owned by a corporation All of the following are included in the definition of a building, EXCEPT: Select one: A. Floor coverings B. Wall treatments (wallpaper) C. Temporary structures on or within 100 feet of the premises D. Copy machines - ANSCopy machines All of the following are penalties for non-compliance with Workers Compensation laws, EXCEPT: Select one: A. The employer may be charged a $1000 fine, plus $100 for each day of non- compliance B. The employer may be charged with a second-degree misdemeanor

C. The employer's business property may be seized D. The employer's business may be closed - ANSThe employer's business property may be seized All of the following are true concerning Joint Underwriting Associations, EXCEPT: Select one: A. Policyholders must be unable to purchase insurance on the open market B. Citizens replaced FRP&CJUA and Florida Windstorm C. It is not possible to purchase Homeowner policies under JUA, only Dwelling policies D. JUA operations are overseen by a Board of Governors - ANSIt is not possible to purchase Homeowner policies under JUA, only Dwelling policies All of the following UM options are available to an insured, EXCEPT? Select one: A. May purchase UM coverage less than liability limits B. May purchase UM coverage more than liability limits C. May reject UM coverage in writing D. May elect non-stacked UM coverage in writing - ANSMay purchase UM coverage more than liability limits

Am employee of ABC Financing altered and cashed a check for $2000. The loss is payable under which insuring agreement? Select one: A. No coverage B. Robbery Inside the Premises C. Forgery or Alteration D. Employee Theft - ANSEmployee Theft An adjuster is required to notify a claimant when a claim is denied. The notification must be? - ANSWritten An adjuster moved from one city on Florida to another. What length of time does she have to notify FLDFS of the address change? Select one: A. 10 days B. 60 days C. 30 days

D. 45 days - ANS30 days An employee is hurt on the insured's premises. Three months later the employee dies. Are the employees funeral expenses covered under the company's CGL Medical Payments? Select one: A. Yes, the claim was made within one year time period B. No, the claim was filed too late C. Yes, the employee is automatically covered D. No, employees are not covered for Med Pay - ANSNo, employees are not covered for Med Pay An employee is injured on the job and is out of work for 10 days. How many days' wages can this employee recover? Select one: A. No recovery B. 5 days C. 3 days D. 10 days - ANS3 days

An HO-4 Policy is designed for a: Select one: A. Condo owner B. Home owner C. All of the above D. Renter - ANSRenter An insured borrows his neighbor's trailer to pick up his new furniture. Which of the following best describes the insured if he has an accident? Select one: A. His PAP will extend coverage if the proper endorsement is added B. Only the liability of the PAP extends to the trailer C. His auto is insured, but not the borrowed trailer D. His PAP extends liability to the trailer and Part D-Physical Damage extends $1,500 coverage to the borrowed trailer - ANSHis PAP extends liability to the trailer and Part D-Physical Damage extends $1,500 coverage to the borrowed trailer

An insured has $200,000 Coverage A dwelling coverage, under his HO-3 Policy. He incurs the following damage from a covered peril: fence - $5,000; gazebo - $7,500; tool shed -$15,000. What will his HO Policy will pay? Select one: A. $10, B. No coverage C. $25, D. $20,000 - ANS$20, An insured wants to fly to Canada and then down to Mexico. Will he have coverage available for this trip? Select one: A. He cannot go outside the U.S. B. There is coverage in Canada, but not in Mexico C. There is coverage in Canada, and 100 miles into Mexico D. There is coverage in Mexico, but not in Canada - ANSThere is coverage in Canada, and 100 miles into Mexico An organization that provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium is:

Select one: A. A Professional Practitioner Group B. A PPO C. A Health Managed Hospital D. An HMO - ANSAn HMO ane has a health insurance policy that prevents cancellation during the policy period, but reserves the right of the insurer to non-renew the policy once it expires. This is an example of: Select one: A. Conditionally renewable B. Noncancelable C. Optionally renewable D. Guaranteed renewable - ANSOptionally renewable Appointment - ANSThe authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf an insurer or employer. Apportionment - ANSIs a provision for computing and assigning to each of two or more contracts covering a claim its proportion of the amount of the loss.

Appraisal - ANSA written contract of or written agreement for or effecting insurance, or the certificate thereof, by whatever name called, and includes all clauses, riders, endorsements and papers which are a part thereof. Bid - ANSAggreement to fulfill a contractual obligation used frequently in construction and supplying goods. Bill sent a cashier's check through the mail, but it never arrived at the destination of the recipient. Under which bond can the cashier's check be replaced? Select one: A. Fiduciary bond B. Blue Sky bond C. Lost Instrument bond D. Payment bond - ANSLost Instrument bond Bill was employed by Jane's Flower Shoppe for two days when he receives a work related injury. Bill misses 14 days of work. How long does Bill have to wait before he can begin receiving WC benefits? Select one:

A. 14 days B. He wasn't employed long enough to have WC coverage C. 21 days D. 7 days - ANS7 days Binder - ANSActs as a temporary contract until the policy is issued. Bob has a basic health insurance policy. He has a covered accident in which he suffers an injury to his mouth that requires dental treatment. Which of the following is true? Select one: A. Dental expenses will be paid after the first $ B. Dental expenses will not be paid C. Dental expenses will be paid after the first $ D. Dental expenses will be paid - ANSDental expenses will be paid Bodily Injury(BI) - ANSPhysical harm and includes sickness or disease or death resulting there from.

Bond underwriting usually looks at the three C's which include all of the following, EXCEPT: Select one: A. Contingency B. Collateral/Capital C. Capability D. Character - ANSContingency Both commercial property and liability were combined into one policy, thus saving money on underwriting expense. What is this combination called? Select one: A. A monocline policy B. A valid policy C. A combination policy D. A package policy - ANSA package policy Building Ordinance Coverage - ANSThis endorsement covers the insured for enforcement of laws which require demolition of undamaged portions of buildings.

Bureau Adjuster - ANSEmployee or agent of an adjustment bureau which serves multiple company clients such as the GAB Business Services, Inc and Underwriters Adjusting Company both national firms. Business Auto Coverage Form - ANSUsed to insure the automobile exposures of all businesses other than garage or trucking businesses. Business Auto Policy - ANSInsurers the automobile exposures of Business. Cancellation - ANSThe insured may cancel at any time, for any reason, without advance notice. If the conpany wishes to cancel, it must provide some degree of advance notice so the insured will have time to replace the coverage. Changes - ANSAll policies provide that any changes to the policy be made by the insurer, in writing. characteristics of a contract - ANSConsideration must be given to at least one party

Claim - ANSIs the assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief. Claims Adjuster - ANSOne who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies. Clients Property - ANSOffers coverage for non-owned property for which the insured is legally liable while the property is on the premises of the insureds client. Coinsurance - ANSThe amount, generally expressed as a fixed percentage, an insured must pay against a claim after the deductible is satisfied. It's ultimately a way for the insured and insurer to share responsibility for the risk. It can also help reduce the cost of the insurance policy premium. Coinsurance can be written on an 80/20, 90/100, or 100% rule. Commercial Crime Forms - ANSCrime Insurance may be written as a separate policy, with it's own Declaration and Conditions, or as a package policy, bundled together with Employee Dishonesty.

Commercial Inland Marine - ANSHelps identify the kinds of risk which are eligible for either ocean or inland Marine insurance. Commercial Property Insurance - ANSCovers direct and indirect losses related to properties other than one to four family dwellings and farm properties. Company or Staff Adjuster - ANSAre salaried employees under the supervision of the home, branch or regional claims department of insurers. Comparative negligence - ANSReduces the insured's damages by the degree of negligence Comprehensive Coverage - ANSCovers all loss except collision or overturn. Standard deductible is $100 per car, $500 per occurrence applies to losses from theft, mischief, and vandalism. Computer Fraud - ANSWill pay for the loss of or damage to money, securities and other property resulting from using a computer to fraudulently transport from inside the insureds promises to a person or place outside the premises, which encompasses anywhere in the world.

Concealment - ANSThe failure of the insured to reveal relevant facts known to the insured in applying for insurance. Conditional Contract - ANSAlso called a hypothetical contract, is a contract agreement that only requires performance once the delineated conditions are met. This legal agreement requires prior performance of another agreement or clause in order to be enforceable. If the other agreement or condition is performed, then the conditional contract is enforceable and the parties are bound to carry out the terms of the contract. Contract bonds include all of the following, EXCEPT: Select one: A. Permit bond B. Performance bond C. Bid bond D. Maintenance bond - ANSPermit bond Contract of Indemnity - ANSPrinciple of insurance that provides that when a loss occurs, the insured should be restored to the approximate financial condition he/she occupied before the loss occurred, no better or no worse.

Coverage Territory - ANSIs the U.S. and its territories or possessions , Puerto Rico and Canada, including international waters and airspace between these places. Covered losses in a Boiler and Machinery Policy include: Select one: A. Explosion, overheating, burning and cracking B. Leaking at the valve, fitting or shaft C. The functioning of a safety device D. Depletion, deterioration and wear and tear - ANSExplosion, overheating, burning and cracking Customer Representative 4-40 - ANSMust be licensed, appointed by a General Lines Agent and may assist in transactions in the OFFICE ONLY. Damages - ANSMonetary compensation that is awarded by a court in a civil action to an individual who has been injured through the wrongful conduct of another party.

Dan has a Personal Auto Policy with Liability of 10/20/10 and basic PIP with a $1,000 deductible. He is running one day when a car strikes him. A week later he dies. Medical bills are $7,500 and lost wages are $1,000. How much, if any, will PIP pay in this claim? - ANS10,800.00 Declarations - ANSIdentifies the named insured and address, states the policy period and premium and miscellaneous information about the insured, and specifies the limits of coverage that apply. Derelict - ANSMaterial which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or component parts or both. describe a franchise deductible - ANSNo payment is made until the loss equals or exceeds the amount of the deductible and then the loss is paid in full Direct Loss - ANSPhysical harm to tangible property. Discovery - ANSAny loss discovered during the policy period or within 60 days after it's expiration is called regardless of when it occurred.

Domestic Insurer - ANSInsurer is one formed under the laws of its this state. Employee Injuries - ANSCoverage excludes liabilities under a workers compensation or similar law or arising from injuries to employees of the insured. Employee Theft - ANSProvides coverage for loss of or damage to money, securities, and other property resulting from theft committed by an employee. Theft is defined as the unlawful taking of money, securities or other property to the deprivation of the insured. Employees of ABC Manufacturing are required to wear steel-toed shoes when they are in the factory. An employee who injures their foot because they are not wearing safety shoes while in the plant would have their benefits reduced by: Select one: A. 20% B. 10% C. 25% D. 15% - ANS25%