FLORIDA PUBLIC ADJUSTER STATE EXAM 2024 ACTUAL EXAM, Exams of Nursing

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FLORIDA PUBLIC ADJUSTER STATE EXAM 2024

ACTUAL EXAM 230 QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES

(VERIFIED ANSWERS) | AGRADE

A legal action filed by one or more persons on behalf of themselves and others having an identical interest in the alleged wrongdoing - ....ANSWER...Class-Action A specific risk or cause of loss covered by an insurance policy, such as fire, windstorm, flood, theft, etc. - ....ANSWER...Peril Dangers in a store, warehouse, or office; circumstances of risks and perils determine who is responsible for - ....ANSWER...Premises Liability A loss or risk the policy doesn't cover - ....ANSWER...Exclusions Technique used to transfer the risk of a person, business, or organization in another through the use of a two-party contract - ....ANSWER...Insurance A legal two-party document describing the relationship between the insured and the insurance company - ....ANSWER...Indemnity Contract Legal document that makes some person responsible for damages their actions or products cause regardless of any fault on their part - ....ANSWER...Strict Liabilty The intention to withhold relative information about the risk from the insurance company

• ....ANSWER...Concealment A subset of the claims function whereby suspicious losses are investigated separately from the normal claims adjusters' activities - ....ANSWER...Special Investigations Unit An insurer takes no action upon realizing material changes in a contract - ....ANSWER...Implied Waiver Acts committed without negligence but result in damages - ....ANSWER...Intentional Tort Willful and illegal sinking of a ship at sea or its cargo - ....ANSWER...barratry

Covers physical damage as well as liability and tends to be very broad in coverage - ....ANSWER...Commercial Inland Marine Single insurance for only one kind of property at only one location of an insured - ....ANSWER...Specific Coverage Legislative Acts or Laws - ....ANSWER...Statutes The insurance company to which the risk is transferred to by the contract - ....ANSWER...Second Party Hazards on private property that might attract trespassing such as swimming pools or trampolines - ....ANSWER...Attractive Nuisance An approximate calculation of amount, extent, quality, magnitude, position, degree or worth of something - ....ANSWER...Estimages Insurance company assesses, mitigates, and monitors the items of risk that potential customers want to insure - ....ANSWER...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 - ....ANSWER...Reciprocity Specific protection in an insurance policy - ....ANSWER...Coverage Insurance contracts are written on a take it or leave it basis to the policy owner. - ....ANSWER...Adhesion Event or circumstance that causes damage - ....ANSWER...Occurance Coverage provides for payment of losses if civil authority denies access to the insured premises due to a covered peril - ....ANSWER...Civil Authority Voluntary relinquishment of a known legal right - ....ANSWER...Waiver An insurer domiciled outside the state where it writes insurance - ....ANSWER...Foreign A state officer who administers the state's insurance laws and regulations - ....ANSWER...Commissioner Used as a promise to accept a bid if awarded to a company - ....ANSWER...Bid bond Damaged property an insurer takes over to reduce their loss after paying a claim - ....ANSWER...Salvage

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 - ....ANSWER...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 - ....ANSWER...Moral Hazard Used to provide temporary insurance coverage until an insurance policy can be written - ....ANSWER...Binder Required by lenders to guarantee that outstanding loans against a job are paid upon completion - ....ANSWER...Completion Bonds The section of an insurance policy identifying the insured, endorsements, coverages, limits, and premiums - ....ANSWER...Declarations Policyholder cannot transfer the policy to someone else without written permission from their insurance company - ....ANSWER...Assignment An instance, behavior or environment that increases the likelihood of a loss on an insured item - ....ANSWER...Hazard Actual cause or source of an incidence of destruction, injury, or loss - ....ANSWER...Peril An insurance company organized and domiciled outside the US - ....ANSWER...Alien When there is an unbroken chain of events between an occurrence and a loss, then the loss is part of the original occurrence - ....ANSWER...Proximate Cause Is proximate cause of all subsequent damages - ....ANSWER...Original Occurance An individual who contracts with an adjusting firm as an independent contractor and handles claims for the insurance companies - ....ANSWER...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 - ....ANSWER...Estoppel Operate for profit, collect premiums, reserve a portion of premiums to pay claims - ....ANSWER...Commercial Insurers Any person who investigates or adjusts losses on behalf of either an insurer or a self- insured - ....ANSWER...Independent Adjuster

The result of an insured's tort or wrongdoing. Consequences of a loss or amount or type of losses suffered - ....ANSWER...Damages Requires the insured to insure the named property for a specific amount of insurance as required by the insurance company - ....ANSWER...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) - ....ANSWER...Direct loss The entity that is the "recipient" to the Principal - ....ANSWER...Obligee An individual holding a license under the authority of the State - ....ANSWER...Licensee Means any solid, liquid, gaseous or thermal irritant or contaminant including smoke, vapor, soot, fumes, acids, alkalis and chemicals - ....ANSWER...Pollutants A package insurance policy that combines both property and casualty coverages into a single policy - ....ANSWER...Homeowners policy Legal term applying the third party claims meaning " to pay back or to make whole" - ....ANSWER...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 - ....ANSWER...Surety bonds The necessary increase in living expense resulting from a loss by a covered peril, and incurred by the insured - ....ANSWER...Additional Living Expense (ALE) The replacement cost of like kind and quality at the time of loss, less a reasonable amount of depreiciation - ....ANSWER...Actual cash value Physical condition that increases the change of loss - ....ANSWER...Physical Hazard Openness to loss or damage - ....ANSWER...Exposure Any changes that broaden coverage on the edition of the policy that the insured holds will automatically apply without premiums - ....ANSWER...liberalization cluse Bonds that protect an employer form losses by an employee - ....ANSWER...fidelity bonds A combination of property and liability coverages of two or more separate policies in one premium - ....ANSWER...Package policy

An ongoing assurance made by one party to another that certain facts : - ....ANSWER...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 - ....ANSWER...Exxcess of loss A person who voluntarily gives up possession of the property - ....ANSWER...bailor One of the earliest forms of insurance - ....ANSWER...Ocean Marine An insurance adjuster who works primarily outside of an office and often meets personally with the public - ....ANSWER...Field Adjuster Purposefully setting fire to property. Not covered under the policy if the act is committed by the insured - ....ANSWER...Arson The attempt, by an applicant to deceive an insurance company - ....ANSWER...Misrespresentation Personal property that is not part of the dwelling or structure - ....ANSWER...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 - ....ANSWER...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 - ....ANSWER...loss An addition, deletion or change to a legal document or policy - ....ANSWER...Amendment The section of an insurance policy identifying the insured, endorsements, coverages, limits and premiums - ....ANSWER...The Declarations page Reinsureance agreement where the insurers involved will pay claims in direct relationship with the % of the risk they are insuring - ....ANSWER...Co-insurance Financial investment or financial dependency that an individual or business has in a person or property - ....ANSWER...Insurable interest Failure to use the care that a reasonable and prudent person would have used under that same or similar circumstance - ....ANSWER...Negligence "Insurer" has an obligation to pay covered loss, "insured" has no obligation - ....ANSWER...Unilateral insurance contract

626.854 (3) - ....ANSWER...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. Uninsurable because of the possibility of either loss or gain in the risk - ....ANSWER...Speculative Risk The depreciation from the total Replacement Cost due to age, use and condition. The resulting dollar amount is Actual Cash Value - ....ANSWER...Non-recoverable Depreciation 626.854 (5) - ....ANSWER...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) - ....ANSWER...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) - ....ANSWER...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) - ....ANSWER...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 (10) (d) - ....ANSWER...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 (14) - ....ANSWER...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 (10) (c) - ....ANSWER...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 (11) - ....ANSWER...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) - ....ANSWER...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) - ....ANSWER...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) (a) - ....ANSWER...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) - ....ANSWER...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. . Under a dwelling (DP-2 or DP-3) policy, what is the maximum % that would be paid for ALE? - ....ANSWER...20% Under a dwelling broad or special form, what is the maximum that would be paid for "loss of use"? - ....ANSWER...20% of the Dwelling Coverage 626.854 (14) (c) - ....ANSWER...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) - ....ANSWER...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) - ....ANSWER...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) - ....ANSWER...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.

Homeowners Coverage A - ....ANSWER..."Dwelling" covers the dwelling building and structures attached; also construction materials and supplies on or adjacent to the premises. Who determines how much HO- 6 coverages a Condominium Owner needs? - ....ANSWER...The Association 4 Subsections of Section I of a Property Coverage Policy - ....ANSWER...1. Coverages 2.Perils Insured Against 3.Exclusions 4.Conditions What are the two main divisions of a Home Owners Form? - ....ANSWER...Section I- Property & Section II-Liability If a unit is co-owned, May one co-owner be insured as the renter(HO-4)? - ....ANSWER...Yes A Homeowners Policy consists of(3 components): - ....ANSWER...1.Declarations 2.One of 6 Homeowners forms 3.Mandatory and optional endorsements Umbrella - ....ANSWER...Covers Excessive Liability Why is the term "Coverage Trigger" misleading? - ....ANSWER...Because it intends to refer to the time period during which the insurance contract is in effect. Basic Extended Reporting Period for CGL - ....ANSWER...60 Days after expiration Retro-Active Date - ....ANSWER...The date on which the coverage legally began. The Difference between "Occurance" and "Claims Made" CGL Coverages - ....ANSWER...The Coverage Trigger: The Occurance Form applies to BI and PD regardless of any later time at which the claim is made. The Claims-Made Form applies only to BI and PD that occurs on or after the "Retro- Active date" accident - ....ANSWER...Sudden, unexpected event Occurance - ....ANSWER...An accident, including continuous or repeated exposure to substantially the same general harmful conditions.

Four Additional Homeowners Coverages - ....ANSWER...1. Claims Expense

2. First Aid Expenses
3. Damage to Property of Others
4. Loss Assessment 627.7011 - ....ANSWER...Statute that requires that when Property Insured for replacement cost is deemed a total loss, the full replacement cost without reservation or holdback of depreciation must be paid. Statute that requires that when Property is Insured for replacement cost is deemed a total loss, the full replacement cost without reservation or holdback of depreciation must be paid. - ....ANSWER...627. When might "Loss Settlement" cover buildings under Coverages A & B to Full Replacement Cost? - ....ANSWER...If the limit of Insurance at the time of Loss is equal to 80% or more of the replacement value of the building. What is the most important Condition that has direct impact on Homeowners Coverage?

• ....ANSWER...Loss Settlement How many Perils are listed as "General Exclusions" in your textbook? - ....ANSWER... What is the standard limit of Homeowner's Coverage D for: HO-2, HO- 3 & HO-5? - ....ANSWER...30% Coverage A What is the standard amount for Coverage C - ....ANSWER...50% of Coverage A. What is the standard limit for Homeowners Coverage B? - ....ANSWER...10% of the amount Insured for Coverage A and may not be increased or decreased. Homeowners Coverage D - ....ANSWER..."Loss of Use" covers increases over normal living costs if damage from a covered Peril makes the residence unfit for occupancy. Homeowner's Coverage C - ....ANSWER..."Personal Property" covers Property, wherever it is located, that is owned or used by "an Insured". 4 Examples of "Other Structures" Per Coverage B of a Homeowner's policy(book gives

5. • ....ANSWER...1.Detached Garage. 2.Guest House. 3.Fence 4.Tennis Court 5.Storage Building Homeowners Coverage B - ....ANSWER..."Other Structures" covers private structures on the residence premises that are not attached to the main dwelling.

What does "OIR" stand for? - ....ANSWER...Office of Insurance Regulation How long does a residential property policy have to be in effect to hold the insured immune to 627.409(fraud by insured) - ....ANSWER...90 Days Statute 627.409 - ....ANSWER...Statute covering misrepresentation by the insured. Only a defense for the insurer if they didn't know and it would have affected the coverage offer. Two types of Waivers - ....ANSWER...1.Explicit 2.Implied What is the rule of law's attempt to counter balance a contract of Adhesion? - ....ANSWER...To have any ambiguities resolved in favor of the insured. Contracts wherein the parties are of unequal bargaining power are called? - ....ANSWER...Contracts of Adhesion Why is it common to have the attorney's name on the settlement draft? - ....ANSWER...Because should the insurer pay over the money solely to the claimant, the attorney may sue the company for the fee. Two main defenses against Negligence - ....ANSWER...1. Assumption of Risk 2.Comparative Negligence What are the two broad classifications of damages that a plaintiff can seek in an action for money damages? - ....ANSWER...1.Compensatory 2.Punitive What is the difference between Common Law and Statute Law? - ....ANSWER...Common Law is based on stare decisis, whereas statutory law is explicit with a statute number. 2 Types of Tort Liability - ....ANSWER...1.Negligent Liability(Unintentional) 2.Strict Liability(Intentional) Three Ways in which the limits to a liability insurance policy Insuring Agreement can be expressed? - ....ANSWER...1.single limit 2.split limit 3.Aggregate limit Beginning statement of a liability insurance policy - ....ANSWER...Insurer agrees "to pay on behalf of the insured all sums the insured becomes legally obligated to pay as damages" or equivalent wording.

What is the limit to the Public Adjuster's share of a re-opened claim - ....ANSWER...20% (626.854(10)(a)). What must Public Adjuster Contracts Contain regarding fraud by insured - ....ANSWER...Felony Warnings (626.8796) is the requirement for the Public Adjuster. 817.234 is the felony, 775.082, 775.083 & 775.084 are the punishments. What format must the advertisement disclaimer be in? - ....ANSWER...Bold caps, but no specific type size. :-)(626.854(7))(b)) How long must a Public Adjuster wait after an event that leads to a claim to contact the claimant? - ....ANSWER...48 hours. (626.854(13)) 626.8796 - ....ANSWER...Public Adjuster Fraud Statement 6 Responsibilities of the Public Adjuster - ....ANSWER...1.Evaluate 2.Substantiate 3.Determine values 4.Negotiate 5.Recommend(upgraded insurance) 6.Re-Open Claims A Public Adjuster - ....ANSWER...Aside from attorneys, Public Adjusters are the only Adjusters who legally represent the rights of the insured. What is the difference between a Bureau Adjuster and an Independent Adjuster - ....ANSWER...A Bureau Adjuster is an employee of the insurer and an Independent Adjuster is an Independent Contractor Bureau Adjusters - ....ANSWER...Serve National Insurance Firms Fee Adjusters - ....ANSWER...Offer their services on a Fee for Service Basis including Bureau Adjusters and Independent Adjusters Company or Staff Adjusters - ....ANSWER...Salaried Employees under the supervision of the insurer. 3 Types of Adjusters - ....ANSWER...1.Staff Adjusters 2.Fee Adjusters A.Independent Adjusters B.Bureau Adjusters 3.Public Adjusters What is the OIR's role? - ....ANSWER...To examine the qualification of insurance companies seeking to do business in this state.

The Department requires each adjusting form and each of it's branches to designate an Adjuster to be responsible for the supervision of all individuals within an adjusting firm. This individual is called the: - ....ANSWER...Primary Adjuster(626.8695) 7 Ethics to the code of Ethics - ....ANSWER...1. No negotiating with an attorney's client.

2. No misleading in any way. 3.No legal advice 4.No special releases, fill in the blanks only 5.No exploiting incapacitated clients 6.Advise the client of rights under the contract and by the state. How long do Insurance Companies have to pay or deny property claims? - ....ANSWER...90 Days How long do Insurance Companies have to acknowledge Claims? - ....ANSWER... Days(627.70131) 5 Practices that the Insured are protected from under the "Florida Unfair Insurance Trade Practices Act." - ....ANSWER...1.failing to act promptly 2.denying claims without reasonable investigation 3.failure to affirm or deny a claim when an insured is entitled thereto 4.failure to explain claim denials in writing 5.failure to maintain complaint-handling procedures, such as keeping accurate records of complaints. What must a release be supported by to be a binding contract? - ....ANSWER...Valuable Consideration A contract by whereby the person executing the instrument gives up a right, claim or privilege to the person against whom it might have been demanded or enforced is called a: - ....ANSWER...Release What is the maximum injury to a minor that can be settled out of court, preferably with both parents. - ....ANSWER...$15,000 (statute 744.387) What are the principles that guide apportionment to avoid controversy that could delay adjustment called? - ....ANSWER...Guiding Principles What is called when 2 or more contracts cover the same claim and have to pay proportionate amounts? - ....ANSWER...Apportionment 3.Payment of PD, BI pending 4.No Release 5.Advanced Payment 6.Structured Settlement 7.Rehabilitation, including provisions for rehabilitative treatment of the claimant.

FWUA - ....ANSWER...Florida Windstorm Underwriting Association. Merged with the FRPCJUA as Citizens. FRPCJUA - ....ANSWER...Florida Residential Property and Casualty Joint Underwriting Association. Merged with FWUA to become Citizens Citizens Property Insurance - ....ANSWER...Residual Property Insurance FIGA - ....ANSWER...Florida Insurance Guaranty Association FAJUA - ....ANSWER...Florida Automobile Joint Underwriting Association What does the Homeowners Flood Insurance Affordability Act of 2014 do? - ....ANSWER...Allows private carriers to write off four different types of Flood Coverages. 6 Rights of the Insured - ....ANSWER...1. Acknowledgement in 14 Days

2. Approval or denial in 30 Days
3. Full payment as applicable in 90 Days 4.Free Mediation 5.a neutral evaluation of a sinkhole claim 6.Availability of assistance from the department of consumer services 7.Act with no bias.