Rhode Island Insurance Adjuster Study Guide Latest 2023 – 2024 (Verified Content), Exams of Advanced Education

Download Rhode Island Insurance Adjuster Study Guide Latest 2023 – 2024 (Verified Content) and more Exams Advanced Education in PDF only on Docsity!

Rhode Island Insurance Adjuster Study Guide

Latest 2023 – 2024 (Verified Content)

Executory - Both sides perform certain acts to make contract enforceable. Endorsement - Used to add, delete, or change any policy parts. May alter content of declarations and insurance agreement. May contain conditions exclusions, and definitions. Subrogation - Used when insurer paid a covered claim on behalf of insured caused by another party. Entitled to insured's right of recovery from negligent party. Agreed value - Agreed upon by insured and insurer. Insuring agreement - Describes covered perils, risks assumed, nature of coverage, makes reference to contractual agreement between insurer and insured. In package policy, each different coverage form includes its own insuring agreement. Reservation of rights - Insd fails to report claim in timely fashion. Compromises insurance company's ability to investigate. Sends "" letter. "" letter tells insd that the company will investigate but might deny due to late reporting. Exclusions - Property, perils, hazards, or loss arise from specific causes not covered under policy. Non-waiver - Retention of known right. Insured/insurer must sign. Proof of loss - Formal statement made by insured to insurance company regarding loss. Places sufficient information concerning loss before company to enable it to determine liability under policy. Hazard - Increases seriousness of loss or likelihood loss will occur. Proximate cause - Unbroken chain of events cause loss. Arbitration - Appears in auto policies to resolve disputes for underinsured/uninsured. Settle dispute between insurance companies involving 3rd party liability claims. Risk - Possibility (uncertainty) loss may occur and reason people buy insurance.

Coinsurance - Method of requiring insured to insure @ least 80% of value of property in exchange for premium discount. If carries less than amount needed, penalty will occur in case of partial loss. Limitations - May eliminate or reduce coverage, but under certain circumstances or when specified conditions apply. Market value - Price market will support. Ex: Antiques claims usually adjusted this way. Negligence - Lack of reasonable care required to protect others and or their property from unreasonable chance of harm. Salvage - Insurer pays loss on behalf of insd, insurer entitled to salvage to reduce claim Liability - Responsibility for loss of another's property and law requires them to make financial restitution. Reporting form - Insured reports values of company (monthly) of insured contents. Requires 100% coinsurance clause. Blanket coverage - One limit applies to both building and contents. More than one location is insured under single limit. Foorseeability - Test to determine proximate cause. Asks if person causing injury should have foreseen consequences. Liberalization - States policy or endorsement are broadened and no additional premium required, then all exist similar policies and endorsements constructed to include broad coverage. Foreign insurer - Formed under laws of U.S. or specific state of U.S. Declarations sheet - Section of policy includes identity, address, policy term, amount of insurance or limits, premium, any deductible applicable. Direct loss - Direct consequence of peril. Ex: Fire causes damage to apartment Indirect loss - Loss results from covered peril.

Ex: Loss of rental income as result of fire Concealment - Failure to reveal relevant facts know to insured when applying for insurance. Indemnity - Claimant should be restored to approximate financial condition that existed before loss, no better and no worse. Applies to 1st and 3rd party claims. Abadonment clause - Insured cannot abandon property to insurance company in exchange for full insured value Domestic insurer - Insurer formed and domiciled under laws of particular state. Punitive damages - Exemplary damages awarded by court and intend to punish. Binder - Temporary evidence coverage is in effect until policy issued. Written or oral. Tort - Civil wrong, violates rights of others. Stated amount - Agreed amount of insurance, stated on policy. Stated value - Cannot pay more than policy limits Replacement cost - Purchase new without depreciation Special damages - Med expenses and loss of wages or costs of other known expenses Aleatory - Insurance contract contingent of uncertain event (loss) Cause of loss forms - States perils to be insured against Warranty - Policy condition based on information given by insured in an application Breach of warranty - Incorrect statement by insured which may void coverage Deductible - Self insured party of an insured loss. 1st party claims. Insured must bear the loss. Estoppel - Intentionally or unintentionally creates impression of a fact existing, innocent party relies on this impression and is damaged as a result, guilty party may be legally prohibited from asserting fact doesn't exist.

Comparative negligence - Allow injured party to collect from another party for a loss, even when injured party contributed to their loss. Damages reduced by extent of injured parties negligence. Insurable interest - Lawful, substantial, economic interest in preservation of property. 4 factors to establish negligence - - Legal duty owed

• Breach of legal duty owed
• Proximate cause
• Damages Modified comparative - No recovery if person is either equally responsible or more responsible for resulting injury. To recover, must be no more than 50% @ fault. Conditions - Sets provisions, rules, duties, and obligations. Commonly describe policy period, territory, right for each party to cancel policy. Named perils - Specifically described perils to be insured against. Open perils - Does not list perils but provides broader coverage. All perils are covered except perils listed in exclusions Twisting - Get someone to cancel policy in order to sell them another policy Contributory negligence - Individual contributes to their loss in any way, then another cannot be held liable for the loss General damages - Pain and suffering, punitive damages, loss of consortium, disfigurement, and disability. Cost not immediately known, usually negotiated. Intangible damages. Insured - Those who has insurable interest in property and would suffer financial loss if property were damaged by insured peril. Includes family members without listing names. Can include lien holder

Waiver - Voluntarily relinquish known right Contract of adhesion - Company is author of contract and insured must accept as it Rebating - Buyer of policy receives anything from agent Scheduled coverage - Separate limit per insured item applies Diminished value - Owner entitled to difference between value of property before and after accident Misrepresentation - Untrue statements made by insured during app process ACV (Actual Cash Value) - Cost to replace less depreciation Appraisal clause - Dispute in property claim, both parties select appraiser to determine value of loss. If appraisers do not agree an umpire is selected to make decision. Each pay for own appraiser and split umpire cost, Peril - Potential cause of loss Pair or set clause - Pair or set is lost, loss is valued as fair proportion of total value. Other insurance - Other sources of recovery for covered claim. Some primary, some excess. Each will pay % of limit for claim Once repairs have been made - When can an insured collect full replacement cost on a structure? Pure comparative - RI Negligence standard? Within 15 days - RI: How often must contact claimant if more time is needed to investigate? 10 days - RI: How long insurer have to reply to claimant? 15 days with written response - RI: How long to reply to inquiry from department of insurance regarding a claim? 30 days - RI: How long does insurer have to report vehicle theft? 21 days - RI: If operator of motor vehicle is involved in accident where person is injured/killed or PD is over $500.00, how long do they have to report to DMV? 25/50/25 - RI: Minimum limits

3 years - RI: If adjuster license where revoked, how long must you wait to reapply? 4 years - RI: How long is RI license good for? 21 days - RI: How long do you have to respond to any inquiry from dept? 5 years - RI: How long must retain records after termination of transaction? Licensee, 30 days. - RI: Who reports legal name, address, or information submitted changes to department? How long do you have? 12 months without written exam - RI: How long can you remain a RI adjuster if license expires? 120 days unless extended by director - RI: How long can emergency license be issued by director H0-1 - Basic Most states have dropped

• Fire
• Lightning
• Internal explosion H0-3 - Open peril on structure Broad peril on contents 80% coinsurance on structure to get full replace value ACV on contents unless endorsed H0-4 - Renters coverage Broad peril on contents H0-5 - Open peril on structure Open peril on contents 80% coinsurance on structure to get full replace value ACV on contents unless endorsed H0 315 - Collapse coverage Additional coverage as separate peril

H0 (Cover A) - Dwelling Replace cost w/ 80% coinsurance Insd selects limits H0 (Cover B) - Other structure 10% of coverage A for 1 or 2 family dwelling 5% of coverage A for 3 or 4 family dwelling H0 (Cover C) - Personal property 50% Cov A 1 or 2 family dwelling 30 Cov A 3 family dwelling 25$ Cov A 4 family dwelling *Special limits on money, watercraft, trailers, theft of jewelry, furs, and gun theft H0 (Cover D) - LOU 30% Cov A on H0-2, -3, - 30% Cov C on H0- 50% Cov C on H0- 10 Cov A on H0- 30 months - Use of non-OEM parts allowed under unfair claims when vehicles are older than? Commercial package policy - Covers 2 or more lines of business by combining commercial lines coverage parts. *Worker's comp not included 30 days - Replacement auto must be disclosed to insurer within X days? Yacht policy - 65 foot sailboat 60 foot boat with an outward motor

Visitors - Med pay on H0 policy is for Personal article floater - Inland marine policy Can provide coverage for breakage Ex: Furs, silver, cameras, postage stamps

• Policy number
• Effective dates
• Name of insured
• Location/description on property - Decs page contents
• Decs
• Insuring agreement
• Conditions
• Exclusions - Insurance policy contents Act of God, Contributory *Intentional acts are not a defense - RI: Defense to negligence Promissory of warranty - Made at time of application, insured refrains from doing certain activity Legal hazard - Legal environment increases loss frequency Physical hazard - Tangible characteristic of property, person, or operations that leads to loss Morale hazard - Condition of carelessness increases loss Moral hazard - Condition increases likelihood person will intentionally cause a loss Ex: embezzlement Vicarious liability - Secondary liab Person liab for negligent act of other person Strict liab - Liab due to special circumstances, do not need to prove negligence Split deductible - One deduct for comp, one for collision

Absorbing deductible - Apply deduct to loss insd has suffered before applying any coverage limits Inland marine - Coverage for goods in transit Enforces rules, regulations, and laws - Duties of insurance commissioner 12:01 AM - Policy inception begins at what time? Reg 73 - Insurer must respond within 10 days Insurance commissioner must have response within 15 days After POL, has 15 days to pay or deny claim If denying claim, must send letter Unfair claims practices act - Adjuster must thoroughly investigate loss prior to settlement Insurer operates in unfair manner, prosecuted by IRA (Insurance Regulatory Act) *Waiting on witness statement is not an unfair act 3 years: BI, med claims, wrongful death 10 years: PD, contract - RI: Statute of limitations Uninsured PD deductible? - $200. 10 days - How many days to respond for policy information?