PROGRESSIVE FLORIDA CLAIMS ADJUSTER EXAM QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 A C, Exams of Nursing

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A couple had Coverage A limits of $250K on their home located in FL. A tornado spawned by Hurricane Ernesto damaged their roof resulting in estimated repair costs of $11,500. The adjuster deducted the FL hurricane deductible of $5,000 from the estimate and paid them $6,500 in settlement of their property claim. This is known as the application of: - CORRECT ANSWERS a percentage deductible (hurricane deductible) A restaurant was damaged after a grease fire irrupt it in the kitchen. Damage to the structure total $78,300 in law/damage to personal property totaled $14,000. The owners commercial property policy provide coverage a limit of $250,000 and coverage see limits of $100,000 with a deductible of $1000. How much will the policyholder be paid? - CORRECT ANSWERS 91, A couple hasn't shared their home for $150,000. A fire and Susan guts their home resulting in a total loss. An appraisal of the home prior to los results in a value of $120,000 if the adjuster is required by law to pay the couple $150,000. This is known as the application of: - CORRECT ANSWERS The valued policy law Assume that five years ago a couple ensure their home for it so that appraise value of $60,000. Two weeks ago a pipe burst in the home resulting in an estimated loss of $15, in water damage. The adjuster find the value of their home is now $100,000 for the home is still only insured for $60,000 and there's a deductible of $500. A policy has an 80% coinsurance clause how much the adjuster pay the couple? - CORRECT ANSWERS $10, Describe the coverage s provided in a split limit policy of 10/20/10 - CORRECT ANSWERS 10,000 max bodily injury individual, 20,000 max bodily injuries regardless of how many individuals, 10,000 max for property damage Negligence is described as: - CORRECT ANSWERS fault that arises from doing something you shouldn't have done, or not doing something you should have done Which of the following is not a defense to a claim of negligence? - CORRECT ANSWERS breach of warranty

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Which of the following is not an example of "compensatory damages": - CORRECT ANSWERS A jury verdict of $1 million against the defendant to punish them for the reprehensible actions in causing the loss Which of the following is not a law that affects one's legal liability? - CORRECT ANSWERS Valued policy law Which of the following statements is not true? - CORRECT ANSWERS If a question of coverage arises, and cannot be swiftly resolved in favor of the insured, the carrier should immediately tender the claim to its defense attorney, and deny the claim Which of the following is not a defense to a claim of negligence? - CORRECT ANSWERS breach of warranty What is the difference between a peril and a hazard? - CORRECT ANSWERS Peril is the cause of loss. Hazard is a condition that creates or increases the chance of loss. A couple has coverage a limit of $250,000 on their home located in Miami Florida. They suffer a wind loss to the roof from a tornado Spond by hurricane Irma that results in an estimate of $12,700 for repairs. The adjuster to docs the Florida hurricane deductible of $5000 from the estimate and pays them $7700 in settlement of their property claim this is known as the application of: - CORRECT ANSWERS Percentage deductible Floridas code of Ethics under 69B-220.201(3) begins with an important statement that provides a basis for the very sensitive nature of what an adjuster does. Select that statement from below: - CORRECT ANSWERS The work of adjusting engage is the public trust The most important factor to consider, when purchasing an insurance policy is: - CORRECT ANSWERS Trust

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Assume that five years ago a couple ensure their home for that appraised value of $60,000. Two weeks ago they had a stove fire resulting in an estimated lost of $15,000 for repairs. The adjuster find the value of the home is now $100,000 but the home is still only insured for $60,000 and has a deductible of $500. The policy has an 80% coinsurance clause. How much should the adjuster pay the couple? - CORRECT ANSWERS $10, Claim - CORRECT ANSWERS An assertion of an alleged legal right against a person, entity, company or insurer that carries with it a demand for money as compensation for injuries or damage What are you really buying when you purchase insurance? - CORRECT ANSWERS Peace of mind Why is insurance such a unique product? - CORRECT ANSWERS It is a financial product. The purchase of a promise base totally on trust that is absolutely essential in today's world. First foremost and always what is an adjuster's most important objective in today's world of insurance? - CORRECT ANSWERS To help those who have been injured, or who have suffered a loss that is covered by the insurance contract or for which an insured policy holder is responsible while at the same time minimizing loss for the insured party and or carrier In today's society, the most important factor in the purchase of insurance is - CORRECT ANSWERS Trust What would Joe do as an adjuster? - CORRECT ANSWERS INVESTIGATE, EVALUATE, AND SETTLE INSURANCE CLAIMS ON BEHALF OF AN INSURER OR INSURED. Joe saw an ad in the paper..... difference between an adjuster who works in the healthcare industry versus an adjuster in the property/casualty, insurance industry. What would you say? - CORRECT ANSWERS Healthcare adjusters are processors, who reimburse medical bills if they fall within a list of approved conditions or treatment. A property/casualty adjuster

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evaluates a legal responsibilities, determines what or how much is owed and pays or settles claims. If Joe, where to go to work for an insurance company, what kind of adjuster with Joe be? - CORRECT ANSWERS A company/staff adjuster Joe is really intrigued by his neighbors work and ask him who he works for. His neighbor told him that he owns his own adjusting company and adjust claims are several different companies. In other words he takes claim assignments from whoever calls. What kind of adjuster is he? - CORRECT ANSWERS An independent adjuster Joe's neighbor tells him that field adjusting is "the best job in the insurance industry". Joe doesn't envision himself sitting behind a desk, so he is intrigued by this as well and white lines of business business with Joe need to experience to have the greatest chance of getting a good field adjusting job - CORRECT ANSWERS Multi-line adjusting Joe sister is a nurse who works in a nearby hospital. As he talks to her about his interest, she asked him what type of adjusting she would be most qualified for if she were interested, which kind of adjusting would present her with the greatest opportunity? What would you tell her? - CORRECT ANSWERS Worker's compensation Joe's neighbor told him that he really prefers working with litigated claims dealing with the lawyers, getting it in negotiations and going to depositions and trials. What kind of claims does Joe's neighbor prefer? - CORRECT ANSWERS Liability adjusting If Joe, we're just strictly handle, hurricane tornado hellfire, and other claims of this nature, what line of business would Joe be adjusting - CORRECT ANSWERS Property While driving home from an interview, Joe was rear ended. He's not injured so he makes a claim against the other drivers insurance policy for damages to his vehicle. The person taking the claim advises Joe that he will be contacted within 24 hours by an adjuster. From what type of adjuster will Joe likely hear? - CORRECT ANSWERS An auto physical damage adjuster

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The claims manager told Joe a story of one of the best adjusters he had ever known, and how he had been forced to fire the man because he just would not document to clean files with ongoing status. What kind of responsibility did the adjuster fail to fulfill? - CORRECT ANSWERS Communicating and reporting The claims manager then told Joe a story about one adjuster who made a deal with a body shop to pay the adjuster $100 for every damaged automobile that he referred, referred for repair. The adjuster is ultimately fired. What responsibility did that adjuster fail to fulfill? - CORRECT ANSWERS Fiduciary responsibility The claims manager also told about a young adjuster who lost his temper and cursed out an insured policyholder. He was arguing about a claim the adjuster has denied. The insured policyholder sued the company and collected $50,000 for slander in the embarrassment caused the insured what responsibility did that adjuster fail to fulfill? - CORRECT ANSWERS Agency: the power to bind Which of the following is NOT one of the basic adjusting functions? - CORRECT ANSWERS Inspection Which of the following best describes the functions of claims evaluation? - CORRECT ANSWERS Establishing a dollar value for a claim In which of the following settlement types, would you pay what is owed and invite the claimant to contact you with any further expenses or questions? - CORRECT ANSWERS No release "walk away" True or false; an adjuster's claim file is considered "work product" and therefore confidential

• CORRECT ANSWERS False The main components of the investigative process are: - CORRECT ANSWERS Inquiry verification and comparison

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The adjusters code of ethics starts with a basic premise, which states: - CORRECT ANSWERS The work of adjusting engages the public trust Which of the following would not be a preferred claims practice or behavior under Florida's unfair insurance, trade practices act? - CORRECT ANSWERS Not responding to an insured's calls because you haven't made up your mind yet Upon conclusion of a claims, investigation and adjuster determines if there was no coverage in effect for the loss and denies the claim. The adjuster later received notification that he in the carrier being sued due to a violation of Florida's unfair insurance trade practices act. Which of the following actions in the adjusters claim handling process would be considered a violation of the act? - CORRECT ANSWERS The adjuster inform the policyholders attorney of the denial over the phone, closed the file and moved onto his next case Which of the following is not one of the four critical elements of a contract - CORRECT ANSWERS Written evidence of the agreement and its terms. An insurance policy is often referred to as a contract of adhesion. This means: - CORRECT ANSWERS If any of the wording or language in the policy is vague or ambiguous, if the meaning of the wording is difficult to understand or interpret, or if what is written can be interpreted to have different meanings, the law is well settled that the interpretation shall be in favor of the party who did not control its terms...in this case, the policyholder. Breach of contract to buy a carrier or it's adjusters, through non-payment, or noncompliance with policy requirements, could have which of the following consequences for a carrier: - CORRECT ANSWERS If found guilty of a breach of contract, the carrier could be punished with a bad faith verdict that would cost it millions of dollars Which of the following is not a fundamental part of an insurance policy: - CORRECT ANSWERS endorsement Which of the following is one of the duties of an insured following a loss? - CORRECT ANSWERS giving prompt notice of loss to the insurer

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What is the difference between a peril and a hazard? - CORRECT ANSWERS Apparel is a cause of loss like fire. A hazard is a condition that exist beforehand that increases the likelihood of such a loss like a messy store room or garage that contains lots of toxic chemicals, oily rags etc The doctrine of proximate cause is defined as: - CORRECT ANSWERS if there is an unbroken chain of events, or series of consequences, flowing from the initial loss caused by the insured peril to a subsequent loss, the insured peril causing the initial loss will be considered the "proximate cause" of the subsequent loss A couple, Helen sure they're home for $250,000. A fire and Susan guts their home resulting in a total loss. An appraisal of the home prior to the loss results in a value of $180,000 at the adjuster is required by law to pay the couple $250,000. This is known as the application of: - CORRECT ANSWERS The valued policy law Whether it is done by a carrier or to adjuster a breach of contract is taking very seriously. This could be done through nonpayment, or even noncompliance with policy requirements. Which of the following consequences would a carrier face due to a breach of contract: - CORRECT ANSWERS Bad faith Describe the coverage is provided in a split limit policy of 10/20/10 - CORRECT ANSWERS Up to $10,000 of liability protection for bodily injury to anyone individual 20,000 for all bodily injuries regardless of how many individuals and 10,000 for property damage The primary difference between a staff adjuster in an independent adjuster is: - CORRECT ANSWERS A staff adjuster works for an insurance company in an independent adjuster, works independently for themselves, or for adjusting firms who represent many clients Which of the following would be considered "work product"? - CORRECT ANSWERS Written communication between an adjuster and defense counsil

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There are many differences between adjusting claims in the healthcare industry and in the property/casualty, i.e. workers comp liability, etc. industry one of the fundamental differences is: - CORRECT ANSWERS The relative degree of legalism involved Define the doctrine of proximate cause: - CORRECT ANSWERS When an initial loss caused by an insured peril, that triggers, one or more subsequent losses, the payroll, causing the initial loss is the proximate cause of both initial and subsequent losses And insured policy is often referred to a contract of adhesion. This means: - CORRECT ANSWERS If any wording or language in the policy is vague or ambiguous, if the meaning of the wording is difficult to understand, or interpret, or if what is written, can be interpreted to have different meanings the law as well settled that the interpretation shall be in favor of the party, he did not control it's terms in this case, the policyholder In the property/casualty industry, a claim is defined as: - CORRECT ANSWERS And assertion of alleged legal right against a person, entity, company, or insure that carries without a demand for money as compensation for injuries or damage Which of the following is not one of the four critical elements of a contract? - CORRECT ANSWERS Written evidence of the agreement and its terms. Negligence can best be described as: - CORRECT ANSWERS Fault that arises from doing something you shouldn't have done or not doing some thing you should've done Which of the following is not an example of compensatory damages? - CORRECT ANSWERS A jury verdict of $1,000,000 against the defendant to punish them for their reprehensible actions in causing the loss. Which of the following statements is not true? - CORRECT ANSWERS If a question of coverage arises, and cannot be swiftly resolved in favor of the insured, the carrier should immediately tender the claim to its defense attorney, and deny the claim

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Insurance company has many goals and standards for claim handling. One of the most important goals of an insurance company is: - CORRECT ANSWERS Help those who have suffered a loss for which the insured is legally responsible The basic and primary functions of an adjuster are: - CORRECT ANSWERS investigating, evaluating, reporting, negotiating and disposing of claims An adjuster has many responsibilities. The adjuster's responsibility as a fiduciary means: - CORRECT ANSWERS The adjuster represents and controls the property and financial interest of the client to whom he/she owes a high degree of loyalty in good faith When you purchase insurance you are buying: - CORRECT ANSWERS peace of mind that if an insured event does occur, that the insurance company will keep its promise and provide the financial protection that you purchased Under Florida's unfair insurance trade practices act, which of the following would not be considered a preferred claims practice? - CORRECT ANSWERS Not responding to an insurance calls because you haven't made up your mind yet After a loss, and insured has certain responsibilities, laid out within the insurance contract. Which of the following is one of the responsibilities of an insured after a loss? - CORRECT ANSWERS Giving prompt notice of loss to the insurer In a personal auto policy liability coverage only protects - CORRECT ANSWERS Those individuals meeting the definition of an "insured" under policy Matt has an automobile policy with 50/100/50 policy limits, hits a car with three occupants, and all are hurt. They all sue. The first sues and collects $25,000; the second sues and collects $60,000; and the third sues and collects $37,500. The car Matt hit has $13,500 in damage. The insurance company spends $9,500 on a law firm defending the suit. Ignoring PIP, Med Pay or UM issues, how much is the maximum amount that the company would pay for the loss?

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(A) $145,

(B) $135,

(C) $123,00 - CORRECT ANSWERS $123,

Your insured runs a red light and hits another vehicle. Damage to the insured car is $7, and your policy has a $500 collision deductible. Damage to the other vehicle is $5,750 and is undriveable. Repair takes 3 weeks and the claimant incurs $657.00 in rental car charges. Fortunately the claimant was not injured seriously and has not seen a doctor. You think that if you handle the PD claim promptly and fairly, no injury claim will be made. How much will you pay for the property damage claim? - CORRECT ANSWERS $ 6, When coverage symbols number one or number 21 are used to describe autos for which coverage is provided under the business auto or garage policies to which type of autos are the symbols referring? - CORRECT ANSWERS Any auto Which of the following symbols is used to provide coverage for specifically describes autos under a business auto policy? - CORRECT ANSWERS 7 Jack's auto has a garage policy with $100,000 in liability symbol 21 garage keepers with a $40,000 limit a $100 comprehensive deductible and a $500 collision deductible. One day a customer brings his car in for repair. It is left parked outside the shop until it can be worked on. An unknown driver loses control of his car hits the customers car and leave the scene. Damage to the customers car is $1500. The customer has no insurance what would be payable by the garage policy for this claim? - CORRECT ANSWERS $1000 paid under the garage keepers coverage Sunshine auto sales and service has a standard garage policy with symbol 21 for liability coverage. All of the following claims would be covered under sunshine's policy, except: - CORRECT ANSWERS John is test, driving a new car when he sideswipes another car. The other driver, who is injured Sue's Jon. Jon tenders the claim to sunshine's insurance carrier

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to provide his defense. He does not want to use his own carrier for fear of premium increase. Harold's auto repair has a garage keepers policy to cover the businesses commercial auto exposures. After reviewing his policy notice is the symbol 22 next to a liability, physical damage comprehensive and physical damage collision coverage. What does the symbol mean? - CORRECT ANSWERS Owned autos only What was one of the initial intentions behind the development of no-fault/PIP benefit laws?

• CORRECT ANSWERS To help reduce litigation by preventing lawsuits for less serious automobile related bodily injury claims In Florida what is the minimum PIP limit of the owner of a motor vehicle must carry? - CORRECT ANSWERS $10, Basic PIP provides for what benefits, in addition to a death benefit? - CORRECT ANSWERS 80% medical 60% loss wages 100% replacement services What benefits does the basic PIP policy provide in the event of death? - CORRECT ANSWERS $5000 in addition to medical and disability benefits Jon has a PAP with liability limits of 10 - 20-10 basic PIP with no deductible and med. Pay with a $1000 limit. He is driving his car during a thunderstorm loses control on a wet street and runs off the road into a tree. He is injured and incurs $13,232 in medical bills. How much will Jon's policy pay under what coverage? - CORRECT ANSWERS $11, Mary Jo has an PAP With basic PIP coverage a deductible of $500 in property damage limits of $10,000. She has a bicyclist who is riding on the right side of the road and veerers into the lane in front of her. Are any of the bicyclist medical expenses and lost wages, covered under any part of Mary Jo's policy? - CORRECT ANSWERS Yes

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If an insured has the basic $10,000 in PIP coverage, and no deductible and after an automobile accident incurs $2300 in medical expenses $1300 and lost wages and $300 and expense for general housekeeping services. How much would you pay in response to claim filed for PIP? - CORRECT ANSWERS $ If an insured has $10,000 in PIP coverage with a deductible of $500 and after an auto accident incurs $5000 in medical expenses and $3000 in lost wages before dying from complications directly related to the accident. How much PIP coverage is available to pay the death benefit to the insurance beneficiaries or state? - CORRECT ANSWERS $ The named insured and his best friend are involved in an accident in the named insured vehicle vehicle carries basic PIP limits of $10,000 additional PIP of $25,000 extended PIP coverage and a $1000 deductible. The named insured's injuries resulting medical expenses of $14,360 and lost wages of $6375. If you were handling his PIP claim how much would you pay in PIP benefits? - CORRECT ANSWERS $ Referencing the scenario in the previous question, assume that the passengers injuries result in medical expenses of $16,850 and lost wages of $5250. If you were handling the passengers, PIP claim, how much would you be willing to pay under the named insured PIP coverage? - CORRECT ANSWERS $10, The trigger of coverage defined as "an accident, including continuous, and repeated exposure to the same. Generally, harmful conditions" is known as: - CORRECT ANSWERS An occurrence Of the following, who would not be an insured under a commercial general liability policy? - CORRECT ANSWERS The CEO's mother while visiting her son at company HQ The basic premise of a general liability insuring agreement states that: - CORRECT ANSWERS The policy will respond if an insured person or entity is legally liable for bodily injury or property damage that occurs within the policy. And is not otherwise excluded from coverage.

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An elderly customer slips and falls on spilled salt that fell from the store shelf, injuring her hip. What kind of claim will be filed under the store CGL policy? - CORRECT ANSWERS A premises liability claim A roofing contractor is installing a new roof on a building when one of the insured's employees accidentally types of bucket of tar off the side of the roof. It falls 30 feet onto a car that is parked on the side of the building below. What kind of claim is this and what kind of policy would respond? - CORRECT ANSWERS And operations claim to be addressed by the insured's general liability policy Your company insures a heating and air conditioning contractor. Three days after the company, installs an air conditioner in the attic of the customers residence, the air conditioner falls through the laundry, room, ceiling and damages the ceiling washer, dryer cabinets and flooring. Damages are appraised at $26,500. When the claim for PD arrives what kind of claim is it and what kind of policy will respond? - CORRECT ANSWERS A completed operations claim filed under the general liability policy The per occurrence limit of a commercial general liability policy is the maximum amount that a policy will pay for: - CORRECT ANSWERS All bodily injury, and or property loss is that arise from each individual occurrence The aggregate limit of a commercial general liability policy is the maximum amount that a policy will pay for: - CORRECT ANSWERS All bodily injury and/or property losses that occur within the policy period An insured's employee is injured when he falls off a ladder. A claim for his injuries is submitted to the insured's general liability carrier. How should they respond? - CORRECT ANSWERS There is no coverage. Injuries to employees are excluded under the GL and covered under the employer's Worker's Compensation policy Books-a-trillion bookstore held an annual holiday party for their employees. Attendance is voluntary. One of the employees became intoxicated at the party and was involved in an auto accident on their way home. The occupants of the other vehicles to the bookstore for allowing their employees become intoxicated and drive. The bookstore filed a claim under at

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CGL policy. Would this claim be covered or excluded? - CORRECT ANSWERS Yes, it is covered. The CGL policy only excludes liquor liability if the insured is in the business of serving alcohol and the bookstore is not. Which of the following coverages would homeowner's personal liability not provide? - CORRECT ANSWERS Coverage for the dwelling and all personal property within it? Which of the following would not be covered under a homeowners or personal liability policy? - CORRECT ANSWERS A resident of your insurance household accidentally cut herself with a knife while preparing dinner Which of the following exposures would be covered under a homeowners policy? - CORRECT ANSWERS OPERATING A MOTORIZED CART PURCHASED FOR A DISABLED SPOUSE. The best defense to a claim of defamation i.e., libel slander is: - CORRECT ANSWERS That what was said or written was the truth Which of the following would be covered under personal injury liability coverage? - CORRECT ANSWERS You write an editorial for newspaper, stating that the neighborhood lawn care company engages in unethical business practices. The owner sues you. Boiler and machinery, insurance provides protection against: - CORRECT ANSWERS The costs of repair or replacement of a company's heavy machinery such as boilers, hot water or steam boilers, refrigeration or air conditioning equipment, generators and compressors, transformers and turbines, and other machinery. Which of the following causes of loss would be excluded under the boiler and machinery policy? - CORRECT ANSWERS Flood A hospital has a commercial grade... - CORRECT ANSWERS Expediting expenses

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An insurance company safety engineer... - CORRECT ANSWERS Suspension condition If, over a period of time, one of the insurance cashiers or to steal over $1500 from cash purchase is not processed through the register which of the following coverages would reimburse the insured for such a loss? - CORRECT ANSWERS Employee theft or dishonesty The insured's cashier is kidnapped and taken hostage... - CORRECT ANSWERS None - extortion is excluded by all coverages without endorsement Security stolen from the insured will be valued at the current valuation on: - CORRECT ANSWERS The day the loss was discovered How would a business that has a high turnover of employees best handle? It's exposure for employees theft or dishonesty - CORRECT ANSWERS Blanket coverage Burglary is different from robbery in that: - CORRECT ANSWERS BURGLARY REQUIRES EVIDENCE OF FORCED ENTRY. Two of the three parties to a surety bond include: - CORRECT ANSWERS A principal and obligee One who guarantees the performance or payment of one party, who is obligated by contract to another, is called a: - CORRECT ANSWERS Surety When a public adjuster is required to provide a bond to guarantee performance, the public adjuster becomes which party to the bonding agreement? - CORRECT ANSWERS Principal The state department requiring a public adjuster to secure a bond would be considered which party to the binding agreement? - CORRECT ANSWERS Obligee

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A major difference between a surety bond in an insurance policy is: - CORRECT ANSWERS The surety has recovery rights against the purchaser of the bond in the event of a loss Which of the following is required in order for an employee to be eligible for workers' compensation benefits? - CORRECT ANSWERS As long as the injury resulted from an accident while at work the injury is covered by workers comp regardless of fault In general, an employees who suffers an occupation injury and collects workers comp benefits during recuperation... - CORRECT ANSWERS Gives up the right to sue the employer for personal injury and pain and suffering and can sue only for workers comp benefits Coverage of workers' compensation policy provides for: - CORRECT ANSWERS Payment of all benefits required of the employer under the law of the state in which an employee is injured A lost time case is defined as: - CORRECT ANSWERS An injury that results in more than seven (7) days off work, or for which indemnity benefits would otherwise be due, such as a medical only claim that results in a permanent impairment. Maximum Medical Improvement (MMI) means: - CORRECT ANSWERS A date in time when an employee's recuperation from injury is as good as it is going to get. An "injury" is defined to mean: - CORRECT ANSWERS Personal injury, or death by "accident", arising out of work performed in the course of employment Under Worker's Compensation law, the rule that applies when an injury aggravates a pre- existing condition is: - CORRECT ANSWERS You take em as you find em... meaning you must pay for the aggravation until the injury returns to its pre-injury state Worker's Compensation provides coverage for: - CORRECT ANSWERS Physical injuries only including mental or psychiatric conditions, if they've been precipitated or caused by physical injury

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Under work comp, heart attacks and strokes aren't compensable unless: - CORRECT ANSWERS The employee is doing extraordinarily heavy or exerting work immediately prior to the attack. You're on the way to work one morning and are injured in an automobile accident. Is your injury covered by workers comp? - CORRECT ANSWERS No If a traveling employee's business trip includes an overnight stay, and the employee is injured in accident while traveling to dinner that evening: - CORRECT ANSWERS For traveling employees, the law considers the conduct of business to include, not just literal work activities, but also while so engaged, such normal and necessary "essential" activities as eating, sleeping, and other reasonable "personal comforts". Therefore, the injury is compensable. Two employees take their morning break at 10 AM and on the way downstairs to the café, one of the employees falls down the stairs and break her arm. What doctrine would be determinative of compensability and make her injury covered by work comp? - CORRECT ANSWERS Her injury is compensable under the personal comfort doctrine Which of the following would result in a denial of Worker's Compensation benefits? - CORRECT ANSWERS An employee who intentionally injures himself in order to collect disability benefits The sole purpose of a disability benefits is to: - CORRECT ANSWERS Replace on a temporary or permanent basis a portion of the wages, lost, or loss of earning capacity suffered as a result of occupational injury Temporary total disability benefits are calculated by taking: - CORRECT ANSWERS .6667 of the employee's pre-injury Average Weekly Wage (AWW). Medical benefits, to treat an occupational injury are owed: - CORRECT ANSWERS For the life of the employee of the treatment is related to the occupational injury necessary to cure injury, reasonable, and the amount given and amount charged

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Worker's Compensation death benefits are: - CORRECT ANSWERS Limited to $150,000 of benefits to dependence and $7500 a funeral benefits All of the following are true of workers compensation in Florida, except: - CORRECT ANSWERS In the event of an accidental death, maximum compensation benefits of $100,000 and funeral expenses of 7500 or owed David has an automobile policy with 50/100/50 policy limits, hits a car with three occupants, and all are hurt. They all sue. The first sues and collects $20,000; the second sues and collects $70,000; and the third sues and collects $35,000. The car David hit has $14,500 in damage. The insurance company spends $10,000 on a law firm defending the suit. Ignoring PIP, Med Pay or UM issues, how much is the maximum amount that the company would pay for the loss? - CORRECT ANSWERS $124, Your insured runs a red light and hits another vehicle. Damage to the insured car is $7, and your policy has a $500 collision deductible. Damage to the other vehicle is $5,750 and is undriveable. Repair takes 3 weeks and the claimant incurs 757.00 in rental car charges. Fortunately the claimant was not injured seriously and has not seen a doctor. You think that if you handle the PD claim promptly and fairly, no injury claim will be made. How much will you pay for the property damage claim? - CORRECT ANSWERS $7307. Amy has a personal auto policy with liability limits of 25 - 50- 25 basic PIP with no deductible and med pay with a $2000 limit. She is driving her car during a bad thunderstorm loses control on a wet street and runs off the road into a tree. She's injured incurs $14,235 in medical bills. How much will Amy's policy pay and under what coverage? - CORRECT ANSWERS $12,000 - 10k PIP - 2k MedPay Jake and Mary take their morning break at 10 AM and on their way downstairs to the café Mary falls down the stairs and breaks her arm. What doctrine would be determinative of compensability and make her injury covered by work comp? - CORRECT ANSWERS Her injuries compensable under the personal comfort doctrine

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Bay Breeze Grill is known for its oysters. A customer eat some oysters and falls extremely ill. Where are the cover of July for such an event. - CORRECT ANSWERS Premises and operations One who guarantees a performance or payment of one party, who is obligated by contract to another, is called a: - CORRECT ANSWERS Surtery A lost time case is defined as: - CORRECT ANSWERS An injury that results in more than seven (7) days off work, or for which indemnity benefits would otherwise be due, such as a medical only claim that results in a permanent impairment. If an insured has the basic $10,000 in PIP coverage and no deductible and after an automobile accident occurs $2300 in medical expenses $1300 and lost wages and $300 in expense for general housekeeping services. How much would you pay in response to a claim filed for PIP? - CORRECT ANSWERS $2, All of the following are true of Florida workers' compensation except: - CORRECT ANSWERS In the event of an accidental death, maximum compensation benefits of $100,000 and funeral expenses of $7500 are owed What does Worker's Compensation provide coverage for: - CORRECT ANSWERS Physical injuries, only including mental or psychiatric conditions if they've been precipitated, are caused by physical injury Jerry has an HO-3 policy with $100,000 in liability coverage and $1000 in med pay carried by citizens property insurance corporation. He also has two vehicles that are insured under a Geico personal auto policy with 100/300/100 limits, basic PIP, no UM rejection and $1000 in medical payments coverage. Jerry and his wife Diane are listed as a primary drivers on both vehicles. One day Jerry 17-year-old son and his girlfriend are washing the family car so they can use it to go on a date that evenin - CORRECT ANSWERS Contact Jerry and advise him that, although this claim is not covered by his homeowners policy, it would likely be covered under his auto insurance policies, med pay coverage, and refer him to his auto carrier

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Temporary total disability benefits are calculated by taking: - CORRECT ANSWERS .6667 of the employee's pre-injury Average Weekly Wage (AWW). Big Joe's auto sales & service.... - CORRECT ANSWERS $1,000 from the garage keepers coverage A container of salt falls and spilled on the floor at a local convenience store. An elderly customer shopping and slips on the spilled salt injuring her hip. What kind of claim will be filed under the convenience store CGL policy? - CORRECT ANSWERS Premises liability One of your insured's 18-wheelers is hauling a tank of gasoline and overturns, spilling its contents over the road and into the storm drains. The costs of emergency response and clean up are submitted by the EPA to your insured and your insured turns the claim in under its CGL policy. How would the policy respond? - CORRECT ANSWERS Pollution, even if sudden and accidental, is excluded by the CGL policy, so the claim is not covered. This claim also arose out of the operation of the insured's automobile risk, and is also excluded under the GL. Casual labor is defined as: - CORRECT ANSWERS Work that requires less than 10 days to complete, at a total labor cost of less than $500, and is not work that is part of the employer's normal business. John (your insured) is a roofing contractor. Jon is putting a new flat roof on a building in one of Jon's employees accidentally tips a bucket of tar off of the side of the roof. If I was 30 feet onto a car that is parked on the side of the building below. When the claim for property damage comes in what kind of claim is it and what kind of policy will respond? - CORRECT ANSWERS An operations claim to be addressed by the insured's general liability policy Danielle (your insured) invites a group of ladies over to our home for a pampered chef party. After the party was over, and everyone was leaving one of her elderly guess fell when she stepped off the front porch and fell on the sidewalk. She sprained her ankle and skin her knee. Her medical expenses were $1430 for ER treatment medication's in a couple of follow- up visits with her doctor. Danyell has an HO - three homeowners policy with $300, liability limit in a $5000 med pay limit. Your - CORRECT ANSWERS Your insurance medical

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payments coverage would pay at 100% of the gas medical expenses incurred as a result of her injury on your insured's premises up to $5000 The rule under Worker's Compensation law that applies when an injury aggravates a pre- existing condition is: - CORRECT ANSWERS You take them as you find them meaning you must pay for the aggravation until the injury returns to its pre-injury state Bay breeze grill wants to add a bar and sell alcoholic beverages. To protect themselves from the risk of over serving customers and getting dragged into lawsuits rising from intoxicated customer is your drivers. What kind of coverage should it make sure it has? - CORRECT ANSWERS Liquor liability coverage endorsed onto its general liability policy Shopper hits her head on a low hanging shelf in a grocery store. You've been asked to handle the claim. After talking to both her and you're insured on the telephone, you really don't think there is any liability. Do you think the best way to handle the case is to pay your medical bills without emitting a liability and try a walk away settlement. How would you do it? - CORRECT ANSWERS Tell her you'll pay her bills and wish her well. Ask her to call you if she has any questions. When they arrive, pay the bills under the CGL's medical payments coverage. John has an auto policy with basic PIP coverage a deductible of $500 and property damage limits of $10,000. He hits a bicyclist who's riding on the right side of the road and veers until the lane in front of him. He tries to avoid him, but there's traffic coming from the opposite direction and he hit some causing a total loss of the bicycle valued at $425 and injuries to the bicyclist resulting in $3500 in medical expenses and $827 and lost wages. You receive a phone call from the claimant a - CORRECT ANSWERS $425.00 "An incident, including continuous and repeated exposure to the same. Generally, harmful conditions" is a trigger of coverage known as.: - CORRECT ANSWERS An occurrence In general and employee suffers an occupational injury, and collects Worker's Compensation benefits during recuperation: - CORRECT ANSWERS Gives up the right to sue the employer for personal injury in pain and suffering and consume only for Worker's Compensation benefits

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Boiler and machinery, insurance provides protection against: - CORRECT ANSWERS Repair or replacement of a company's heavy machinery such as boilers, refrigeration or air conditioning equipment, and other machinery arising from the sudden failure of such equipment. Part I: coverage of the Workers' Compensation policy provides for: - CORRECT ANSWERS Payment of all benefits required of the employer under the law of the state in which an employee is injured A theft of money insecurities from a cash, register, safe as well as clear evidence of forced entry into the insurance premises is known as: - CORRECT ANSWERS Burglary inside the premises Which of the following would result in a denial of Worker's Compensation benefits? - CORRECT ANSWERS An employee who intentionally injured himself in order to collect disability benefits The most basic premise of a general homeowners or personal liability, insuring agreement states that: - CORRECT ANSWERS The policy will respond if an insured person or entity is legally liable for bodily injury or property damage that occurs within the policy. And it's not otherwise excluded from coverage. Jack's body shop owns two tow trucks, one with a standard tow package.... Symbol #1 is listed next liability coverage. - CORRECT ANSWERS Yes. Liability coverage is provided for any auto which includes Jack's tow trucks. An insured's employee is injured in an automobile accident. A claim for injuries and submitted to the general liability carrier. How should they respond? - CORRECT ANSWERS There is no coverage as injuries to employees are excluded under the GL. They are covered under the employers Worker's Compensation policy.

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Auto experts company has a business auto policy with symbol #1 indicated for liability coverage. Which autos are covered under the policy? - CORRECT ANSWERS Any auto You were involved in an automobile accident on your way to work one morning. Is your injury covered by workers comp? - CORRECT ANSWERS No. Traveling to and from work is considered a personal risk and injuries that occur during this period are not covered by workers comp. The central Florida insurance agency has a business auto policy with $100,000 in liability with coverage symbol #1. They also have collision other than collision and basic personal injury protection with a $500 deductible and coverage symbol #2. The company owns two vehicles, a 2005 Ford expedition in a 2003 Lexus. One day the company's office manager was taking Alexis to the bank to make some deposits and was broadsided buy a vehicle running a red light. Injuries were severe in the office man - CORRECT ANSWERS The collision claim is covered, but the PIP claim is not as it is excluded. The employees injuries would be covered under Worker's Compensation. If an employee is to be eligible for Worker's Compensation benefits of the following is required: - CORRECT ANSWERS As long as the injury resulted from an accident, while at work, the injury is covered by Worker's Compensation, regardless of fault East coast auto sales has a standard garage policy with symbol 21 for liability coverage. All of the following claims would be covered under East Coast policy except: - CORRECT ANSWERS David who owns his own fully insured cars test driving a new car when he sideswipes another car and hurts a driver Mary. Mary Sue David. David tenders the claim to East Coast claiming he is covered under their policy in the East Coast should provide his defense. He does not want to use his carrier for fear of a premium increase. A traveling employees Business trip includes an overnight stay the employees injured in an accident while traveling to dinner that evening. Are the injuries compensable under workers comp? - CORRECT ANSWERS For traveling employees, the law considers the conduct of business to include not just literal work activities, but also while so engage such a normal necessary essential activities as eating, sleeping and other reasonable personal comfort. Therefore the injuries compensable.

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Which of the following is not one of the supplementary payments provided by the CGL? - CORRECT ANSWERS Bail bond costs arising out of an automobile accident while on company business Maximum medical improvement (MMI) means: - CORRECT ANSWERS A date in time when an employee's recuperation from injury is as good as it is going to get. A controverted case is: - CORRECT ANSWERS A claim for which the employer or carrier has denied compensability AKA liability for all workers compensation benefits Heart attacks and strokes aren't compensable under workers comp unless: - CORRECT ANSWERS The employees doing extraordinarily heavy or exerting work immediately prior to the attack David and his best friend Trevor are involved in an accident and David's vehicle. The vehicle carries basic PIP limits of $10,000 additional PIP of $25,000 extended PIP coverage and a $1000 deductible. Trevor's injuries result in medical expenses of $16,850 in lost wages of $5250 if you were handling Trevors PIP claim how much would you be willing to pay under David's PIP coverage? - CORRECT ANSWERS $10,000 Joey owns big Joe's lawn care and maintenance. He owns three work trucks.... Symbol #1 next to liability, #7 next to physical damage coverage, and Joey's personal vehicle is only vehicle listed. On Monday morning while leaving lawn care, maintenance appointment, Joeys employee, Seth is rear ended by another vehicle, damaging the rear tailgate and the bed. Unfortunately, the other driver was uninsured. Joey called his insurance carrier to file a claim for the damages. Is there coverage for th - CORRECT ANSWERS No the company work trucks are not specifically described for physical damage Over a period of time, one of the insured's cashiers seals over $1500 from cash purchases not processed through the register which of the following coverages would reimburse the insured for such a loss? - CORRECT ANSWERS Employee theft or dishonesty

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Homeowner's policies usually insure property for which of the following: - CORRECT ANSWERS Fire, lightning windstorm and explosion A 10' x 20' workshop within which a homeowner stores, his tools, his lawnmower his woodworking equipment, and fishing rods is damaged by fire after gas can explodes. Under what part of his homeowners HO -3 policy would damage to the workshop be covered? - CORRECT ANSWERS Coverage B - other structures Which of the following would not be covered under coverage C, personal property? - CORRECT ANSWERS The dead fish when the insured accidentally overturns his tropical fish tank and all the fish die from lack of oxygen And insured has an HO-3 homeowners policy with $125,000 in personal property (contents) coverage and a $500 deductible. While on a trip to Denver for a family reunion a thief steals, her wedding ring and pearl necklace from her hotel room. The total value of this jewelry is $12,500. How much will her homeowners policy pay? - CORRECT ANSWERS $1500 which is the limit available for jewelry Dwelling insurance is intended for: - CORRECT ANSWERS Individuals and companies seeking only to protect their financial interests in the property You receive a claim for a fire loss. One of the damaged items included in the claim for personal property is a $12,500 collection of antique fire arms and $2500 and related accessories. Your policy contains a typical HO-3 coverage form with no particular endorsements that would affect your decision. Is this loss covered and to what extent? - CORRECT ANSWERS Yes, there is coverage. The loss limitation on fire arms and related equipment applies to theft only. The entire $15,000 loss is covered subject only to the overall lost deductible along with other personal property. A peril is: - CORRECT ANSWERS A cause of loss Which of the following would not be covered by the limited HO-2 policy? - CORRECT ANSWERS Your son comes home from college for the summer and leaves his television set