Insurance Concepts and Terminology, Exams of Advanced Education

Download Insurance Concepts and Terminology and more Exams Advanced Education in PDF only on Docsity! Claims Adjuster 2024exam With 100% Correct And Verified Answers The following are basic characteristics of a property or liability insurance contract, EXCEPT: A. Personal Contract B. Conditional Contract C. Loss Settlement Contract D. Contract of Adhesion - Correct Answer-C. Loss Settlement Contract The Insurers responsibility to pay for a property loss may be conditioned on the insured having used reasonable means to avoid the loss, to protect the property against further loss, and to give the insurer proof of the loss is defined as? A. Conditional Contract B. Adhesion Contract C. Indemnity Contract D. All of the Above - Correct Answer-A. Conditional Contract A(n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject: A. Conditional Contract B. Personal Contract C. Economic Contract D. Insurable Interest - Correct Answer-D. Insurable Interest The __________ states that when there is an unbroken connection between an occurrence and damage that grows out of the occurrence, then the resultant damage is all a part of the occurrence. A. Doctrine of Proximate Cause B. Doctrine of Perils & Hazards C. Insurance Policy Handbook D. Doctrine of Property Insurance - Correct Answer-A. Doctrine of Proximate Cause Frank owned a home that was destroyed by a hurricane. Both ABC and XYZ Banks were listed as additional interests on his homeowner policy. The insurance company will make a payment to: A. The first mortgagee, ABC B. The Insured C. Jointly to ABC and XYZ D. All listed interests - Correct Answer-D. All listed interests The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as? A. Actual Cash Value B. Replacement Cost C. "Old For New" D. None of the Above - Correct Answer-A. Actual Cash Value Insurance applies separately to each insured as if other insureds did not exist. This is defined as: A. Severability B. Conditional C. Warranty D. None of the Above - Correct Answer-A. Severability States that if the insurer adopts a revision which would broaden coverage without additional premium within some period of time prior to the policy period or during the policy period, the insured receives the benefit of such broadened coverage. (Usually 60 days) A. Cancellation Clause B. Policy Period C. Pro Rata D. Liberalization - Correct Answer-D. Liberalization Property insurance policies usually contain a(n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value: A. Pro Rata B. Abandonment C. Liberalization D. All of the Above - Correct Answer-B. Abandonment A policy condition, either based on information in the insured's application or inserted by the insurer, is defined as: A. Warranty B. Misrepresentation C. Concealment D. None of the Above - Correct Answer-A. Warranty The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10 A. Split B. Single C. Straight D. None of the Above - Correct Answer-A. Split Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles: A. Servicing Coverage Form B. Garage Coverage Form C. Truckers Coverage Form D. None of the Above - Correct Answer-B. Garage Coverage Form The Business Automobile Policy includes all of the following coverage forms except: A. The Garage Coverage Form B. The Trailer Interchange Coverage Form C. The Truckers Coverage Form D. The Business Auto Coverage Form - Correct Answer-B. The Trailer Interchange Coverage Form Under Mechanical Breakdown Coverage, new cars are eligible for service up to: A. 36 Months/36,000 Miles B. 24 Months/36,000 Miles C. 12,000 Months/12,000 Miles D. 12 Months/36,000 Miles - Correct Answer-A. 36 Months/36,000 Miles Which of the following are characteristics of Homeowner's Insurance? A. Protects against economic loss to residences and household property, and legal liabilities B. Owner-occupants of 1-4 family dwellings C. Renters who maintain residential occupancy in any type of building D. All of the Above - Correct Answer-D. All of the Above When the basic liability limits provided by the policy are insufficient for an insureds needs, two coverage forms are used to provide the additional amounts of coverage: A. Excess Liability B. Umbrella C. Both A&B D. None of the Above - Correct Answer-C. Both A&B On a Homeowner's Policy, covers items that are not permanently attached to the dwelling. This is defined as: A. Other Structures B. Excess Structure C. Personal Property D. Dwelling - Correct Answer-A. Other Structures A lender has an insurable interest in a home and finds protection in the: A. Loss Payee Clause B. Mortgagee Clause C. Lender Clause D. Additional Insured Clause - Correct Answer-B. Mortgagee Clause Jeremy owns a home that is recently damaged due to a hurricane. The repair estimate is averaged at $25,000 and Jeremy decides to stay in a hotel becuase most of the damage is to his bedroom and kitchen. Under a Homeowner's Policy, what coverage will pay for the hotel room bill? A. Fair Rental Value B. Value Obligation C. Loss of Use D. Insurers Duties - Correct Answer-C. Loss of Use Which of the following is not one of the rating factors for a Homeowner's Policy? A. Type of Construction B. Location of Risk C. Age & Gender of Insured D. Proximity to Fire Department - Correct Answer-C. Age & Gender of Insured All of the following are eligible for a Homeowner's Policy, except? A. An apartment tenant B. A condominium owner C. Four-family dwelling owner-occupant D. A business condo owned by a local insurance company - Correct Answer-D. A business condo owned by a local insurance company An insured who wishes to purchase flood insurance, but is located in a moderate or low risk flood zone may do so by purchasing a: A. Preferred Risk Flood Policy B. Standard Flood Policy C. Universal Flood Insurance D. None of the Above - Correct Answer-A. Preferred Risk Flood Policy Which of the following is not covered under Coverage C, Personal Property? A. A fire breaks out in the residence and an overnight guest loses his clothes in a fire B. A fish dies because he has been left alone for a week without food C. The insureds daughters tennis racket is stolen from her locker D. The insureds suitcase and clothing, valued at $1,500, are stolen from his hotel room - Correct Answer-B. A fish dies because he has been left alone for a week without food Which of the following forms is "all-risk" on the dwelling policy? A. DP-1, or the Basic Form B. DP-2, or the Broad C. DP-3, or the Special form D. None of the Above - Correct Answer-C. DP-3, or the Special form Sometimes referred to as commercial fire and allied lines, this is the form of insurance that covers direct and indirect losses related to properties other than one- to four-family dwellings and farm properties: A. Business Property Insurance B. Building Property Insurance C. Commercial Property Insurance D. None of the above - Correct Answer-C. Commercial Property Insurance The Commercial Property Contract includes all of the following, except: A. Common Policy Conditions B. Commercial Property Conditions C. Coverage Form D. Commercial Loss Schedule - Correct Answer-D. Commercial Loss Schedule Under Commercial Property Policies, Florida law requires an insurer to give the insured at least __________days advance written notice of non-renewal. A. 25 B. 90 C. 45 D. None of the Above - Correct Answer-C. 45 Insures a condominium association against direct physical loss or damage to buildings, business personal property and personal property of others in the care, custody or control of the association and located at the premises: A. Includes B. Excludes C. Prohibits D. Summarizes - Correct Answer-B. Excludes What payment covers several areas of costs related to claims, and are payable in addition to the policy limits? A. Supplementary B. Liability C. Personal Injury D. All of the Above - Correct Answer-A. Supplementary Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made: A. Occurrence Form B. Claims-Made Form C. Premises and Operations Exposure D. None of the Above - Correct Answer-A. Occurrence Form There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions: A. 50% B. 10% C. 0% D. A Percentage Ratio - Correct Answer-C. 0% Applies only to a BI or PD which occurs on or after the retroactive date, and for which the claim is received or recorded by an insured or the company during the policy period: A. Occurence B. Claims-Made C. Operations Completed D. None of the Above - Correct Answer-B. Claims-Made Toxic wastes escaped from a gas station disposal tank. The insured operator discovers the leak and cleans up the spill. Unfortunately, the waste quickly seeped into the ground and has caused illness among the residents of a neighboring community This is an example of? A. Loss Known B. Known Loss C. Claims-Made D. None of the Above - Correct Answer-B. Known Loss Under Workers Compensation, Part Four Your Duties if Injuries Occur, an employer is required to: A. Provide the names and addresses of injured persons and witnesses B. Promptly provide any legal papers C. Cooperate and assist as the insurer requests D. All of the Above - Correct Answer-D. All of the Above Samantha eats uncooked chicken at a local barbecue joint and becomes violently ill. Which of the following workers compensation benefits would pay for this occurrence? A. A products and completed operations form B. A premises and operations form C. An owners and contractors protective liability form D. None of the above - Correct Answer-D. None of the above The measure to determine disability benefits is the __________ of the employee at the time of injury: A. Average Monthly Wage B. Average Weekly Wage C. Average Daily Wage D. Income Estimate - Correct Answer-B. Average Weekly Wage Under Employer's Liability, the minimum limits of liability are: A. 100/100/500 B. 100/500/1000 C. 500/100/500 D. 100/500 - Correct Answer-A. 100/100/500 The following are classes of disability, except: A. Permanent Total B. Temporary Total C. Permanent Impairment D. Temporary Full - Correct Answer-D. Temporary Full Under Workers Compensation, Employers Liability includes: A. Claims by others for the liabilities to insureds employees B. Claims by relatives of injured employees for consequential damages C. Claims made by employees that are not subject to Workers Compensation Laws D. All of the Above - Correct Answer-D. All of the Above Mandatory for risks exceeding certain annual premiums, recognizes the prior loss experience of the risk and applies either a debit for unfavorable experience or a credit for better-than-expected loss results. This is defined as: A. The Experience Rating Plan B. The Retrospective Rating Plan C. The Risk Plan D. None of the Above - Correct Answer-A. The Experience Rating Plan All of the following are components of Workers Compensation, except: A. Up to $750,000 in Death Benefits B. Reimbursement for Medical Expenses incurred C. Reimbursement for lost wages on a percentage basis D. Funeral costs up to $7,500 - Correct Answer-A. Up to $750,000 in Death Benefits An optional alternative providing for adjustment of premium after expiration, based on a guaranteed basic premium to the insurer to which is added the actual losses incurred by the insured. This is defined as: A. Cost-Plus Rating Plan B. Experience Rating Plan C. Retrospective Rating Plan D. None of the Above - Correct Answer-C. Retrospective Rating Plan Under workers compensations, a rate is charged for every __________ of payroll to employees. A. $100 B. $1,000 C. $10 D. $500 - Correct Answer-A. $100 Under Crime Insurance, the insured is covered for loss by: A. Theft B. Burglary C. Robbery D. All of the Above - Correct Answer-D. All of the Above Crime Insurance is _________ over any other Insurance coverage. A. Primary B. Secondary C. Excess Which of the following are characteristics of a License Bond? A. To guarantee the licensee will act according to the laws B. Protect the public from unfair business practice C. Proper collection and payment of taxes D. All of the Above - Correct Answer-D. All of the Above Guarantees the performance between the principle and the obligee: A. Principal B. Obligee C. Surety D. All of the Above - Correct Answer-C. Surety This type of bond covers streets, sidewalks, sewers, etc.: A. Sidewalk B. Subdivision C. Supply D. None of the Above - Correct Answer-B. Subdivision May act as part of the bonding party and agrees to reimburse the surety for any loss it may suffer from having bonded the principal: A. Indemnitor B. Surety C. Obligee D. None of the Above - Correct Answer-A. Indemnitor This bond guarantees indemnification to the obligee for any losses resulting from the principal s failure to complete the contract work in accord with specifications: A. Performance B. Bid C. Court D. Maintenance - Correct Answer-A. Performance Which of the following are NOT a type of bond? A. Contract B. Fiduciary C. Court D. Apprentice - Correct Answer-D. Apprentice This form of bond is required to accompany a bid for a contract which will require that the successful bidder furnish further bond if awarded the job: A. Bid B. Performance C. Court D. Maintenance - Correct Answer-A. Bid This type of provision states the insurer can refuse to renew the policy only under certain conditions. The policy must state the conditions under which the policy will not be renewed. This is defined as? A. Conditionally Renewable B. Guaranteed Renewable C. Optionally Renewable D. None of the Above - Correct Answer-A. Conditionally Renewable A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. A. HMO B. PPO C. Major Medical Plan D. All of the Above - Correct Answer-A. HMO A policy may contain a provision which states a period of time between issuance and acceptance before sickness benefits begin. This is defined as: A. Waiting Period B. Elimination Period C. Both A & B D. None of the Above - Correct Answer-C. Both A & B Characteristics of an HMO plan usually include: A. Small or Non-existent Deductibles B. Fewer Exclusions C. Insurance services to members through employed physicians D. All of the Above - Correct Answer-D. All of the Above This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force: A. Waiver of Subrogation B. Waiver of Premium C. Waiver of Value D. None of the Above - Correct Answer-B. Waiver of Premium A __________ is a selected group of hospitals and medical practitioners in a given area who have joined together in an effort to reduce medical costs. A. HMO B. Major Medical Insurance C. Coinsurance D. PPO - Correct Answer-D. PPO Provides indemnification to the insured for basic hospitalization of room and board in the hospital, nursing care, laboratory fees, operating room, medical supplies, etc. This is defined as? A. Hospitalization Expense B. Hospital Indemnity C. Accident Policy D. All of the above - Correct Answer-A. Hospitalization Expense The coverage that is intended to afford protection against catastrophic losses is defined as? A. Major Medical B. HMO C. PPO D. None of the Above - Correct Answer-A. Major Medical Provides coverage for expenses, including loss of income, arising from an accident. This is defined as? A. Accident Insurance B. Hospitalization C. Hospital Policy D. None of the Above - Correct Answer-A. Accident Insurance Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance: A. Hospitalization B. Hospital Indemnity C. Hospital Services D. All of the Above - Correct Answer-B. Hospital Indemnity All the following are eligible for full coverage (Liability, PIP, Med Pay, and Physical Damage) in the Florida Automobile (FAJUA) EXCEPT: A. Members of the Armed Forces stationed in Florida who own a Private Passenger Vehicle. D. 24 - Correct Answer-D. 24 After pleading guilty or no contest to a felony, a licensed individual has _________ days to inform the Department? A. 15 B. 60 C. 30 D. 45 - Correct Answer-C. 30 A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative. A. True B. False - Correct Answer-B. False The voluntary or intentional relinquishment of a known right is defined as a(n): A. Waiver B. Estoppel C. Avoidance of Performance D. None of the Above - Correct Answer-A. Waiver All of the following are requirements for the "Code of Ethics," except: A. Adjusters should not give legal advice B. Adjusters may negotiate with a claimant who is represented by an attorney C. A witness who requests a copy of a statement given must be provided with one D. Adjusters will keep an unprejudiced and open mind - Correct Answer-B. Adjusters may negotiate with a claimant who is represented by an attorney The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to: A. Conduct B. Work Habits C. Claim Handling Activities D. All of the Above - Correct Answer-D. All of the Above Under the Florida Unfair Insurance Trade Practices Act, penalties are provided for misrepresentation of business practices, which include all of the following except: A. Failing to act promptly B. Failure to explain claim denials in writing C. Denying claims with reasonable investigation D. Failure to maintain complaint handling procedures - Correct Answer-C. Denying claims with reasonable investigation Duties and functions of the Department of Financial Services include all of the following except: A. Approve the issuance of licenses B. Rating and underwriting rules C. Claims Supervision D. Investigate Charges of Unethical Behavior - Correct Answer-B. Rating and underwriting rules When investigating liability insurance claims, which of the following three major elements are determined: A. Coverage B. Liability C. Damages D. All of the Above - Correct Answer-D. All of the Above The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as: A. Adjustment B. Summons C. Claim D. None of the Above - Correct Answer-C. Claim A written statement given by the insured to the insurer acknowledging that money received in the settlement of damages is received, not as a final payment, but as an advance pending an outcome of a claim against the person responsible for the damage. This is defined as a(n): A. Loan Receipt B. Subrogation Loan C. Full Release Statement D. Partial Release Statement - Correct Answer-A. Loan Receipt One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as: A. Insurance Agent B. General Lines Agent C. Claims Adjuster D. All of the Above - Correct Answer-C. Claims Adjuster Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as: A. Junk B. Salvage C. Covered Property D. Peril - Correct Answer-B. Salvage The process of disposing of an insurance claim is defined as: A. Adjusting B. Claims Management C. Adjustment D. None of the Above - Correct Answer-A. Adjusting Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as: A. Advanced Payment B. Full Release Settlement C. Non-Advanced Payment D. Scheduled Payment - Correct Answer-A. Advanced Payment Which of the following are not considered to be an adjuster: A. Employee or Staff Adjuster B. Independent Adjuster C. Public Adjuster D. General Lines Adjuster - Correct Answer-D. General Lines Adjuster Establishing a dollar value on a claim is defined as: A. Negotiation B. Evaluation C. Adjusting D. None of the Above - Correct Answer-B. Evaluation An adjuster who represents the financial interests of the insured named in the policy is defined as a(n): A. Public Adjuster B. Bureau Adjuster C. Fee Adjuster D. Independent Adjuster - Correct Answer-A. Public Adjuster The adjuster's investigation may include all of the following except: B. Certified C. Domiciled Insurer D. Authorized - Correct Answer-D. Authorized Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices: A. False Statements B. Unfair Discrimination C. Unlawful Rebates D. All of the Above - Correct Answer-D. All of the Above An individual appointed by a general lines or agency to assist that agent or agency in transacting the business of insurance from the office of that agent or agency is defined as: A. Customer Representative B. General Lines Agent C. Adjuster D. None of the Above - Correct Answer-A. Customer Representative An applicant for a license as an adjuster may qualify as an adjuster in the following fields (but not limited to): A. All lines of insurance except life and annuities B. Property and Casualty C. Workers Compensation Insurance D. All of the Above - Correct Answer-D. All of the Above An agent who transacts any one or more of the following types of insurance: Property, Casualty, Surety, Marine, and Health is defined as a(n): A. Customer Service Representative B. Adjuster C. Health Agent D. General Lines Agent - Correct Answer-D. General Lines Agent Which of the following are reasons for refusal, suspension or revocation of a license or appointment? A. Lack of Qualifications B. Failure to Pass State Examinations C. Fraudulent or Dishonest Practices D. All of the Above - Correct Answer-D. All of the Above An agent representing a health maintenance organization , or as to health insurance only, an insurer transacting health insurance is defined as a(n): A. Health Agent B. Health Representative C. HMO Agent D. None of the Above - Correct Answer-A. Health Agent Every licensee shall notify the department, in writing, after a change of name, residence address, principal business street address and/or mailing address within how many days? A. 60 B. 30 C. 15 D. 90 - Correct Answer-B. 30 The District of Columbia and any state or territory of the United States in which an insurance agent maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance agent. This is defined as: A. Business Territory B. Home Territory C. Home State D. None of the Above - Correct Answer-C. Home State How many continuing education hours must an insurance adjuster complete every 2 years? A. 12 B. 20 C. 24 D. 14 - Correct Answer-C. 24 An individual representing an insurer as to life insurance and annuity contracts, including agents appointed to transact life insurance, fixed-dollar annuities, or variable contracts by the same insurer is defined as: A. Life Agent B. Life Representative C. General Lines Agent D. None of the Above - Correct Answer-A. Life Agent An applicant for a temporary license must be: A. A natural person at least 18 years of age B. A US citizen or legal alien who possesses work authorization C. Both A&B D. None of the Above - Correct Answer-C. Both A&B A customer representative appointed by a general lines agent or agency in transacting only the business of private passenger motor vehicle insurance from the office of that agent or agency is defined as: A. Automobile Agent B. Automobile Representative C. Limited Customer Service Representative D. Limited Customer Service Agent - Correct Answer-C. Limited Customer Service Representative The Department may issue a nonrenewable temporary license authorizing the appointment of a general lines insurance agent, life agent, or an industrial fire or burglary agent, for a period not to exceed: A. 1 Year B. 6 Weeks C. 1 Month D. 6 Months - Correct Answer-D. 6 Months What is the minimum age to obtain an insurance license in the State of Florida? A. 21 B. 18 C. No minimum D. 25 - Correct Answer-B. 18 How long is this course valid for licensure purposes after their course completion date? A. Forever B. 2 years C. 3 years D. 4 years - Correct Answer-A. Forever "Upon successful completion of this class, what should you do next to obtain your Insurance license?" A. Retain your original Certificate of Completion with your important records. B. Schedule your fingerprint reservation C. Apply online at https://aalf.fldfs.comLinks to an external site. D. All of the above - Correct Answer-D. All of the above