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A wide range of insurance-related terminology and concepts, including loss settlement valuation, policy conditions, coverage types, insurance associations, claims handling processes, adjuster roles and responsibilities, and various insurance-related practices and regulations. The content provides a comprehensive overview of key insurance industry terms, principles, and procedures that are essential for understanding insurance policies, claims, and the overall insurance landscape. The document delves into topics such as actual cash value, subrogation, loss payee clauses, mortgagee clauses, liability, hmos, insurance company classifications, claims adjusting, waivers, and more. This information would be highly valuable for students studying insurance, risk management, or related fields, as it offers a detailed examination of fundamental insurance concepts and terminology.
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This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force: B. Waiver of Premium - Correct answer B. Waiver of Premium "Premiums are waived" 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: D. All listed interests - Correct answer D. All listed interests Remember that the insurer is not responsible to know the degrees of interest. In the event of a loss, one payment is made by the insurer and it is up to the additional interests on working out their share. Insurance applies separately to each insured as if other insured’s did not exist. This is defined as: A. Severability - Correct answer A. Severability Property insurance policies usually contain a (n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value: B. Abandonment - Correct answer B. Abandonment A (n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject: D. Insurable Interest - Correct answer D. Insurable Interest 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. D. Liberalization - Correct answer D. Liberalization The time frame is typically 60 days. 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 - Correct answer A. Doctrine of Proximate Cause
For example, if a property insurance policy covers the peril of fire but further damage is caused by smoke, water used to extinguish, and the process of moving property away - fire is considered to be the proximate cause of all of the damage. The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as? A. Actual Cash Value - Correct answer A. Actual Cash Value A policy condition, either based on information in the insured's application or inserted by the insurer, is defined as: A. Warranty - Correct answer A. Warranty The following are basic characteristics of a property or liability insurance contract, except: C. Loss of Settlement Contract - Correct answer C. Loss of Settlement Contract The Insurer's 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 - Correct answer A. Conditional Contract "May be conditioned" Which of the following is not one of the "Thresholds" in the "No-Fault" law? B. Temporary Injury of the insured - Correct answer B. Temporary Injury of the Insured Also included: permanent injury other than scarring and disfigurement Under Mechanical Breakdown Coverage, new cars are eligible for service up to: A. 36 Months/36,000 Miles - Correct answer A. 36 Months/36,000 Miles Used vehicles: 12 Months/12,000 Miles If financial responsibility doesn't exist at the time of an accident, which of the following things must happen to avoid penalties? A. The legally valid claims of others must be satisfied (up to 10/20/10) B. The owner and operator must provide certification of future responsibility for future accidents C. Both A & B - Correct answer C. Both A & B As to required proof for future accidents by purchase of auto liability insurance, the insurer must make a filing Form SR-22 certifying that coverage is in effect, and this certification must remain on file for __________ years: B. 3 - Correct answer B. 3 The Business Automobile Policy includes all of the following coverage forms except: B. The Trailer Interchange Coverage Form - Correct answer B. The Trailer Interchange Coverage Form
Personal Injury Protection, or PIP, has a __________ per person, per accident limit. A. 10,000 - Correct answer A. 10, Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles: B. Garage Coverage Form - Correct answer B. Garage Coverage Form The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10. A. Split - Correct answer A. Split 10/20/10 = 10,000 per person injured 20,000 all injuries combined 10,000 property damage Example of straight liability limit = $30, Jeremy has a not at fault accident. If he has PIP with a $1,000 deductible, how much can he expect his PIP coverage to pay toward his medical bills that total $3,000? A. $1,600 - Correct answer A. $1, 3000 (bills) - 1000 (deductible) = 2000 x .80 (eighty percent) Frank has a not-at-fault accident, he has basic PIP, no deductible and med pay of $5,000. How much will his Med Pay contribute to medical bills of $15,000? B. $5,000 - Correct answer B. $5, Medical Payment limits apply per person; Frank will receive full amount towards medical bills. Which of the following is not one of the rating factors for a Homeowner's Policy? C. Age & Gender of Insured - Correct answer C. Age & Gender of Insured On a Homeowner's Policy, covers items that are not permanently attached to the dwelling. this is defined as: An Other Structures - Correct answer A. Other Structures Examples include sheds, fences, pool houses, detached car ports, etc. A lender has an insurable interest in a home and finds protection in the: B. Mortgagee Clause - Correct answer B. Mortgagee Clause Mortgagee - Homeowner's policy
Loss Payee - Automobile policy Which of the following forms is "all-risk" on the dwelling policy? A. DP- C. DP-3, or the Special Form Dp3 - Correct answer C. DP-3, or the Special Form When the basic liability limits provided by the policy are insufficient for an insured’s needs, two coverage forms are used to provide the additional amounts of coverage: C. Both a & b A. Excess Liability B. Umbrella C. Both A & B - Correct answer C. Both An excess liability & B umbrella Which of the following is not covered under Coverage C, Personal Property? B. A fish dies because he has been left alone for a week without food - Correct answer B. A fish dies because he has been left alone for a week without food Animals are listed as an "exclusion" under a Homeowner's policy. All of the following are eligible for a Homeowner's Policy, except? D. A business condo owned by a local insurance company - Correct answer D. A business condo owned by a local insurance company Commercial property is not eligible for a Homeowner's policy. Which of the following are characteristics of Homeowner's Insurance? D. All of the Above - Correct answer D. All of the Above 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 Also included: personal, non-business risk, no more than 2 roomers/boarders, condominium unit owners and cooperative apartment occupants 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 because most of the damage is to his bedroom and kitchen. Under a Homeowner's Policy, what coverage will pay for the hotel room bill? C. Loss of Use - Correct answer C. Loss of Use The insurer will pay any necessary and reasonable expenses associated with a daily living routine. 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 - Correct answer A. Preferred Risk Flood Policy
Although Flood Insurance is provided by the Federal Government, those who are not in a "flood zone" may purchase a preferred risk policy to cover them for a flood claim. Used only for Commercial Condominiums, it covers the unit-owners business personal property and the personal property of others in the insured's care, custody or control: C. Condominium Unit Owners Form - Correct answer C. Condominium Unit Owners Form Does not cover buildings since coverage would typically be provided under the Condo Association coverage form issued. The Commercial Property Contract includes all of the following, except: D. Commercial Loss Schedule - Correct answer D. Commercial Loss Schedule Also included: Declarations, Causes of Loss Form, Endorsements 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. Condominium Association Form - Correct answer A. Condominium Association Form This, along with Condo Unit Owners Form, is located under Condo Coverage. 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: C. Commercial Property Insurance - Correct answer C. Commercial Property Insurance (The question is the definition for this term) Under Commercial Property Policies, Florida law requires an insurer to give the insured at least __________days advance written notice of non-renewal. C. 45 - Correct answer C. 45 Also, notice must state reasons the policy is not to be renewed. When a business's personal property values fluctuate, a single, fixed amount of insurance could produce either over - or under - insurance at any given time. With this option, the limit of coverage is set at an amount somewhat higher than expected peak values. A. Value Reporting - Correct answer A. Value Reporting Replacement Cost is incorrect b/c it calculates monetary value of one's personal property
Liberalization states, "The insured gets the benefit of any broadened coverage if the company, within __________ days of inception, adopts a form revision that is broader and without increase in premium." D. 45 days - Correct answer D. 45 days Used to cover buildings in the course of construction: A. Builders Risk Policy A. Builders Risk Policy - Correct answer A. Builders Risk Policy Includes: structure being built (including foundations), fixtures and machinery, equipment to service building, owned materials and supplies used for construction. Temporary structures built or assembled on site are also included if not covered by insurance. First developed as an extension of Ocean Marine coverage, to provide coverage for cargo traveling over land, instead of by sea. A. Commercial Inland Marine Coverage - Correct answer A. Commercial Inland Marine Coverage Definition: to help identify kinds of risks which are eligible for either Ocean or Inland Marine insurance. Protects against loss of business income that results from damage to covered property from a covered cause of loss. A. Business Income Insurance Coverage. Period of restoration begins 72 hours after date of direct damage. In effect, coverage has a 72 hour deductible. Coverage ends on either - Correct answer A. Business Income Insurance Coverage
A. Declarations B. Common Policy Conditions C. Occurrence and Claims-Made Forms D. All of the Above - Correct answer D. All of the Above Also included: Nuclear Energy Liability Exclusion endorsement other endorsements may be attached There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions: A. 0% B. 0% C. 0% D. 0 Percentage Ratio - Correct answer C. 0% Under a Commercial General Liability Policy, a basic limit of __________ per person applies to Medical Payments: A. $5, B. $5, C. $5, D. $5,000 - Correct answer D. $5, Payment is for medical, dental, hospital, and funeral services incurred within one year of date of accident to persons who suffer bodily injury by accident 1. On or next to insured's owned or rented premises, or 2. Due to insured's operations. The Commercial General Liability __________ identifies 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. A. Declarations - Correct answer A. Declarations States the pertinent information of the policy The Nuclear Energy Liability Exclusion endorsement, in general, __________ all hazards related to nuclear energy. A. Excludes B. Excludes C. Excludes D. Excludes - Correct answer B. Excludes Firms involved in nuclear activities receive protection from special insurer pools organized for that purpose. 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? B. Known Loss - Correct answer B. Known Loss Insurer should have been notified and further investigation of the spill and effective clean-up would have been observed.
Applies to Bodily Injury or Property Damage which occurs during the policy period, regardless of any later time at which a claim is made: A. Occurrence Form - Correct answer A. Occurrence Form Vs. Claims-Made: applies only to BI or PD occurring on or after retroactive date for which claim is received/recorded during policy period Applies only to a or Property Damage* 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: B. Claims-Made - Correct answer B. Claims-Made Retroactive date is stated in Declarations and will normally be same date as issuing company's first claims-made effective date for insured. 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 percentage basis D. Funeral costs up to $7,500 - Correct answer A. Up to $750,000 in Death Benefits Compensation for death is payable if death results within one year of an accident or if it follows disability within five years of accident. The following are classes of disability, except: *D. Temporary Full - Correct answer D. Temporary Full Also included: Temporary Partial. The following are examples of classes of disabilities. A. Permanent Total B. Temporary Total C. Permanent Impairment The measure to determine disability benefits is the __________ of the employee at the time of injury: A. Average Weekly Wage B. Average Weekly Wage - Correct answer B. Average Weekly Wage Disability - incapacity due to injury to earn same or any other employment wages that employee was receiving at time of injury. 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. Experience Rating Plan - Correct answer A. The Experience Rating Plan This, along with Retrospective Rating Plan, is a manual rating process until premiums reach a certain level.
Under workers compensations, a rate is charged for every __________ of payroll to employees. A. $100 - Correct answer A. $ The National Council on Compensation Insurance enforces this rating. Under Workers Compensation, Part Four You’re Duties if Injuries Occur, an employer is required to: D. All of the Above A. Provide the names/addresses of injured persons and witnesses B. Promptly provide any legal papers C. Cooperate and assist as insurer requests D. All of the Above - Correct answer D. All of the Above Also included: immediate contact with insurer, providing immediate medical or other services, do nothing to interfere with insured's right of recovery, make no voluntary payments or assume any obligation except at employer's own cost. Under Workers Compensation, Employers Liability includes: A. Claims by others for the liabilities to insured’s employees B. Claims by relatives of injured employees for consequential damages C. Claims made by employees that are not subject to Workers Comp Laws 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? D. None of the above - Correct answer D. None of the Above Samantha is not an employee of the barbecue joint; Workers Comp does not apply. 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: C. Retrospective Rating Plan - Correct answer C. Retrospective Rating Plan Often referred to as Cost-Plus Programs Under Employer's Liability, the minimum limits of liability are: A. 100/100/500 - Correct answer A. 100/100/ $100,000 for all claims in each accident $100,000 per employee for disease $500,000 for all disease claims Under Inside The Premises - Robbery or Safe Burglary of Personal Property, a special limit of __________:
D. $5,000 - Correct answer D. $5,000 per occurrence applies to articles whose principal value is precious metals, precious or semiprecious stones, pearls or furs, and to the physical or intrinsic value of manuscripts, drawings or records Under Crime Insurance, losses must be discovered within 1 year. This is defined as: A. Discovery Period - Correct answer A. The Discovery Period Crime Insurance is _________ Excess over any other Insurance coverage. C. Excess - Correct answer C. Excess A situation may arise where another form of insurance will pay claim - that insurance would be primary. Cover only losses that both occurred and were discovered during the policy period, or within one year of its expiration. This is defined as: B. Loss Sustained C. Loss sustained - Correct answer B. Loss Sustained One exception to the rule is that Loss Sustained forms will also cover losses that occurred under previous (expired) crime policies and that were discovered during current policy year, as long as crime coverage had continued w/o interruption Any loss discovered during the policy period or within 60 days after its expiration (one year after expiration for losses connected with employee benefit plans) is covered regardless of when it occurred. This is defined as: C. Discovery - Correct answer C. Discovery If XYZ restaurant discovers stolen goods taken over a year ago, this is within 2 years of inception date and found within policy period so it's covered. Under Crime Insurance, the insured is covered for loss by: D. All of the above A. Theft B. Burglary C. Robbery D. All of the Above - Correct answer D. All of the Above Unless the loss is specifically excluded or limited Provides for loss of money and securities outside the premises in the care, custody and control of a messenger or armored car service resulting from theft, disappearance or destruction. This is defined as: B. Outside the Premises - Correct answer B. Outside the Premises Also covers robbery of other property under the circumstances.
Taking or attempted taking of property from within a locked safe or vault, by unlawful entry, with visible marks of forcible entry, or taking of the safe or vault from inside the premises. This is defined as: A. Safe Burglary - Correct answer A. Safe Burglary Exclusions: accounting errors, giving/surrendering property, voluntarily parting, fire (except damage to safe/vault), vandalism, transferring property to someone based on unauthorized instructions or from threat to harm Covers for all types of property, when surrendered away from the premises as a result of a threat to do bodily harm to the insured or an employee, or to a relative or invitee of either, who is (or allegedly is) being held captive. This is defined as: A. Extortion - Correct answer A. Extortion Also triggered by threats to damage the premises or property within the premises. Employee Theft Coverage may be written in the following ways: D. All May Apply A. Scheduled Persons Coverage B. Scheduled Position Coverage C. Blanket Coverage D. All May Apply - Correct answer D. All May Apply Employee Theft may be written in three ways. Which of the following are NOT a type of bond? D. Apprentice A. Contract B. Fiduciary C. Court D. Apprentice - Correct answer D. Apprentice A.Contract - fulfill obligation Fiduciary - make good to court for any deficiencies found in performance Court - protect opposing party from loss Which of the following are characteristics of a License Bond? D. All of the Above A. To guarantee the licensee will act according to laws B. Protect 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 oblige: C. Surety - Correct answer C. Surety Aka Bonding Company; Surety is a "guarantee" This bond guarantees indemnification to the oblige for any losses resulting from the principal's failure to complete the contract work in accord with specifications: A. Performance - Correct answer A. Performance
Considered a contract bond One who undertakes to perform, to fulfill a contract or to meet an obligation is known as: A. Principal - Correct answer A. Principal Oblige - needs guarantee principal will perform Surety - guarantees performance between principal and oblige 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 - Correct answer A. Bid 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. Inseminator - Correct answer A. Inseminator Known as "fourth party", may put up collateral Which of the following are parties to a Bond? D. All of the Above A. Principal B. Oblige C. Surety D. All of the Above - Correct answer D. All of the Above Principal - undertakes to perform/fulfill Oblige - guaranteed principal will perform Surety - guarantees performance *Inseminator - may act as additional party; agrees to reimburse surety for any loss This type of bond covers streets, sidewalks, sewers, etc.: B. Subdivision / maintenance bond - Correct answer B. Subdivision Falls under Maintenance Bond When a person has lost stock certificates, bonds or similar instruments, a bond is generally required by the issuing company to reissue the document. This is known as a: B. Lost Instrument Bond - Correct answer B. Lost Instrument Bond Also guarantees to save issuer from any loss growing out of lost instrument A __________ pop is a selected group of hospitals and medical practitioners in a given area who have joined together in an effort to reduce medical costs. D. PPO - Correct answer D. PPO Most plans provide that emergency treatment will be paid even if treated party does not go to service provider on approved list.
Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance: B. Hospital Indemnity - Correct answer B. Hospital Indemnity Provides coverage for expenses, including loss of income, arising from an accident. This is defined as? A. Accident Insurance - Correct answer A. Accident Insurance Typical exclusions would be: hernia, war, disease and bacterial infections, suicide attempts, air travel injuries, accidents while committing felony, accidents while under the influence 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 - Correct answer A. Conditionally Renewable Vs. Optionally: company may not cancel during term but reserves right to non-renew upon expiration Vs. Guaranteed: insurer required to renew policy at stated age typically 65; company reserves right to increase premium The coverage that is intended to afford protection against catastrophic losses is defined as? A. Major Medical - Correct answer A. Major Medical Some forms designed to supplement basic policies; others provide both basic and catastrophic coverage 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 - Correct answer C. Both A & B This helps keep premiums reasonable by eliminating chance of persons buying coverage only when they are sick Characteristics of an HMO plan usually include: A. Small of 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 Also included: broad coverage, coinsurance provisions 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 - Correct answer A. Hospitalization Expense Associated with a daily limit, not to exceed specified maximum A (n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. A. HMO - Correct answer A. HMO Referred to as an emerging and increasingly important non-insurance alternative to dealing with risk of health care costs Established in 1973, this association was created for applicants who are unable to obtain insurance in the private market: E. FAJUA - Correct answer E. FAJUA In 2002, the Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and the Florida Windstorm Joint Underwriting Association (FWUA), were combined to create: C. Citizens - Correct answer C. Citizens Passed during a legislative session in 1993, this association was created for employers who cannot obtain workers compensation insurance in the private market: A. FWCJUA - Correct answer A. FWCJUA A General Lines Agent instructs a licensed Customer Representative 4-40 to thoroughly cover the details of a new life insurance product with every Homeowner customer who calls or visits the office. The agent provides training on the new product. - Correct answer although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested. Which of the following is truck. This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services. Although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested. Which of the following is true? A. False B. False - Correct answer B. False While selling an Automobile policy to a customer, an agent tells them that they are also required to purchase an Emergency Road Service Plan, even though that is not true. This is an example of: D. Sliding - Correct answer D. Sliding A licensed General Lines Claim Adjuster is required to complete how many hours of continuing education every two years?
D. 24 - Correct answer D. 24 Once a Customer Representative 4-40 has been licensed and appointed for at least 3 years, he or she may transact insurance in the home of an existing customer. A. False B. False - Correct answer B. False After pleading guilty or no contest to a felony, a licensed individual has _________ 30 days to inform the Department? C. 30 D. 30 - Correct answer C. 30 Must be licensed, appointed by a General Lines Agent and can transact AUTO insurance only in the Office Only. B. Limited Customer Representative 4-42 - Correct answer B. Limited Customer Representative 4- Defaming a competitor company or agent is not only unprofessional, it can also result in a license suspension. A. True B. True - Correct answer A. True A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative. A. False B. False - Correct answer B. False An Insurance Company which is formed under the laws of the State of Illinois, and has its Home Office there, is considered a: A. US Domestic Company B. Foreign Company C. Alien Company D. Unadmitted Company - Correct answer B. Foreign Company A.Domestic: this state (FL) B. Foreign: other state (still in US) Callen: elsewhere One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as: C. Claims Adjuster - Correct answer C. Claims Adjuster Commonly referred to as claims auditor Establishing a dollar value on a claim is defined as:
B. Evaluation - Correct answer B. Evaluation For bodily injury and uninsured motorist claims, a settlement range will be set rather than a single dollar amount Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as: B. Salvage - Correct answer B. Salvage Efficient disposal of salvage reduces amount of loss to either insured or insurer The voluntary or intentional relinquishment of a known right is defined as a (n): A. Waiver - Correct answer A. Waiver The law recognizes two types: express and implied. The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to: D. All of the Above A. Conduct B. Work Habits C. Claim Handling Activates D. All of the Above - Correct answer D. All of the Above The adjuster’s basic activities in claims handling are: D. All of the Above A. Investigation B. Evaluation C. Negotiation D. All of the Above - Correct answer D. All of the Above Investigation - establish coverage, determine liability, and verify damages qualify Evaluation - determine fair payment in accordance with contract and law Negotiation - settlement based on facts discovered during evaluation Under the Florida Unfair Insurance Trade Practices Act, penalties are provided for misrepresentation of business practices, which include all of the following except: C. Denying claims with reasonable investigation - Correct answer C. Denying claims with reasonable investigation An adjuster who represents the financial interests of the insured named in the policy is defined as a (n): A. Public Adjuster - Correct answer A. Public Adjuster When investigating liability insurance claims, which of the following three major elements are determined: D. All of the Above A. Coverage
B. Liability C. Damages D. All of the Above - Correct answer D. All of the Above A relationship that requires maintenance of a high degree of fidelity and loyalty to the interests of the principal, whether or not the adjuster is a direct employee is defined as: A. Fiduciary - Correct answer A. Fiduciary Should always be maintained whether or not the adjuster is a direct employee An adjuster who is self-employed and not affiliated with either insurers or bureaus is defined as a (n): D. Independent Adjuster - Correct answer D. Independent Adjuster The adjuster's investigation may include all of the following D. Policy Cancellation - Correct answer D. Policy Cancellation The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as: C. Claim - Correct answer C. Claim 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 - Correct answer A. Advanced Payment The process of disposing of an insurance claim is defined as: A. Adjusting - Correct answer A. Adjusting Also "the negotiation period that results in an agreement" All of the following are requirements for the "Code of Ethics," except: B. Adjusters may negotiate with a claimant who is represented by an attorney - Correct answer B. Adjusters may negotiate with a claimant who is represented by an attorney Adjusters MAY NOT. Bad, adjuster, bad! 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 - Correct answer A. Loan Receipt Enables insurer to bring an action for recovery against a third party Duties and functions of the Department of Financial Services include all of the following except:
B. Rating and underwriting rules - Correct answer B. Rating and underwriting rules An adjuster who is a salaried employee under the supervision of the home, branch, or regional claims department of insurers is defined as a (n): A. Company or Staff Adjuster - Correct answer A. Company or Staff Adjuster Which of the following are not considered to be an adjuster: D. General Lines Adjuster - Correct answer D. General Lines Adjuster Bureau Adjusters are also considered adjusters. An applicant for a license as an adjuster may qualify as an adjuster in the following fields (but not limited to):D. All of the Above 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 Also: motor vehicle physical damage and health insurance A motor vehicle or mobile home which is a total loss is defined as: B. Salvage - Correct answer B. Salvage It cannot be restored to prior condition When making any payment for damage to an automobile for a partial loss, the insurer shall have printed on the loss settlement, A. Third Party Claim - Correct answer A. Third Party Claim Failure to use the insurance proceeds in accordance with the security agreement, if any, could be a violation of. s.812.014, Florida Statutes. This is payment for a (n): Third Party Claim The District of Columbia and any state or territory of the United States in which an insurance agent maintains his or her principal C. Home State - Correct answer C. Home State place of residence or principal place of business and is licensed to act as an insurance agent. This is defined as: home state Any material which is or may have been a motor vehicle or mobile home, which is inoperable and which material is in such condition that it’s highest or B. Derelict - Correct answer B. Derelict. Primary value is either in its sale or transfer as scrap metal or for its component parts, or a combination of the two. This is defined as: 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 - Correct answer A. Customer Representative
4-40 license The authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf of an insurer or employer is defined as: A. Appointment - Correct answer A. Appointment Licensees are given authority through the appointment process 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: D. 6 Months - Correct answer D. 6 Months How many continuing education hours must an insurance adjuster complete every 2 years? C. 24 - Correct answer C. 24 Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices’. All of the Above A. False Statements B. Unfair Discrimination C. Unlawful Rebates D. All of the Above - Correct answer D. All of the Above A customer representative appointed by a general lines agent or agency in transacting only the business of private passenger C. Limited Customer Service Representative - Correct answer C. Limited Customer Service Representative motor vehicle insurance from the office of that agent or agency is defined as: 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 - Correct answer A. Life Agent Charging an applicant for a specific ancillary coverage or product, in addition to the cost of the insurance coverage provided for, without the informed consent of the applicant is a practice of: B. Sliding - Correct answer B. Sliding Which of the following are reasons for refusal, suspension or revocation of a license or appointment. All of the Above 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
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. 30 B. 30 - Correct answer B. 30 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): D. General Lines Agent - Correct answer D. General Lines Agent 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 - Correct answer A. Health Agent An applicant for a temporary license must beach. Both A & B 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 - Correct answer C. Both A & B One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. This is defined as a (n): D. Authorized - Correct answer D. Authorized Actual Cash Value - Correct answer Replacement cost minus depreciation Subrogation - Correct answer When an insured has a right to collect damages from another party but elects to claim damages under his/her insurance policy; rights transfer to the insurer Loss Payee Clause - Correct answer Provides, in event of payment being made under the policy in relation to insured risk that payment will be made to a third party rather than the beneficiary Mortgagee Clause - Correct answer protects a lender who has an insurable interest in a home Grants special protection for the interest of a mortgage named in the policy; setting up a separate content between insurer and mortgagee Liability - Correct answer Negligence of the insured Other Structures - Correct answer Homeowner's Policy, covers items not permanently attached to main dwelling (shed, fence, etc.) Commercial Inland Marine - Correct answer Identifies risks which are eligible for either ocean or inland marine insurance Developed as extension to Ocean Marine coverage to provide coverage for cargo traveling over land instead of by sea Umbrella Policy - Correct answer - Covers much higher limit
Junk - Correct answer Any material 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 Salvage - Correct answer damaged property that may be retrieved, reconditioned and sold to reduce an insured loss. Motor vehicle or mobile home is a total loss Appointment - Correct answer Authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf Derelict - Correct answer Material 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 Implied Waiver - Correct answer May result from some act of neglect on part of the adjuster Express Waiver - Correct answer Occurs when insurer or its representative knowingly gives up a known right under insurance contract Mechanical Breakdown Coverage - Correct answer Covers repairs to mechanical parts of your vehicle that break; even covers in events not related to an accident Identify examples of peril. - Correct answer Fire, windstorm, and flood after hurricane, etc. (Something that causes a loss) How long does one have to notify the Department of Financial Services for a name and/or address change? - Correct answer 30 days What is the coinsurance clause and how might it apply to a given scenario? - Correct answer a coinsurance clause on a property policy requires the policyholder to carry, at minimum, a specified percent of the dwelling's replacement cost. Failure results in monetary penalty. Almost without exception, the percentage is 80% in coinsurance clauses of homeowner policies - this means the insured should carry 80% of replacement cost if they don't want to be penalized at the time of loss. What are the minimum requirements for the Financial Responsibility Law? (There are two) - Correct answer 1. Legal valid claims of others must be satisfied up to the 10/20/10 requirements
What are the basic PIP benefits? - Correct answer 1. Medical; 80% of reasonable expenses are paid for necessary medical, surgical, x-ray, dental, and rehab services
In Florida, windshields are replaced for free and you ARE NOT responsible for paying a deductible. What is the time frame for a Non-Renewable Temporary License? - Correct answer a period not to exceed 6 months What types of insurance licenses are offered by the Department and how do they differ? - Correct answer 1. General Lines Agent 2-20: licensed to write property/casualty, surety or health insurance.