Claim Adjusting Flashcards

What is the minimum age to obtain an insurance license in the State of Florida?

"Upon successful completion of this class, what should you do next to obtain your Insurance license?"

How can you determine how many continuing education hours you need to complete to keep your license active?

How long is this course valid for licensure purposes after their course completion date?

Which statement is FALSE?

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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:

Under Commercial Property Policies, Florida law requires an insurer to give the insured at least __________days advance written notice of non-renewal.

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.

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First developed as an extension of Ocean Marine coverage, to provide coverage for cargo traveling over land, instead of by sea.

Used to cover buildings in the course of construction:

Protects against loss of business income that results from damage to covered property from a covered cause of loss.

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:

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."

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:

The Commercial Property Contract includes all of the following, except:

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Under Crime Insurance, the insured is covered for loss by:

Employee Theft Coverage may be written in the following ways:

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:

Under Inside The Premises - Robbery or Safe Burglary of Personal Property, a special limit of __________ 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:

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:

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.

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 if the policy is written using

This form only provides coverage for losses that both occurred and were discovered during the policy period, or within one year of its expiration:

Under Crime Insurance, coverage does not apply to:

Crime Insurance is ______ over any other Insurance coverage

Which of the following can be found in a Commercial General Liability Contract?

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.

The Nuclear Energy Liability Exclusion endorsement, in general, __________ all hazards related to nuclear energy.

Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made:

Applies only to a BI or PD which occurs on or after the retroactive date, and for which the claim is received or recorded by an insured or the company during the policy period:

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?

What payment covers several areas of costs related to claims, and are payable in addition to the policy limits?

There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions:

Under a Commercial General Liability Policy, a basic limit of __________ per person applies to Medical Payments:

Three full-time employees from a local furniture company are horsing around and one is pushed into a machine that cut his foot. How will the company's General Liability respond?

A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium.

Characteristics of an HMO plan usually include:

A __________ is a selected group of hospitals and medical practitioners in a given area who have joined together in an effort to reduce medical costs.

The coverage that is intended to afford protection against catastrophic losses is defined as?

Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance:

Provides coverage for expenses, including loss of income, arising from an accident. This is defined as?

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?

This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force:

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A policy may contain a provision which states a period of time between issuance and acceptance before sickness benefits begin. This is defined as:

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?

The following are basic characteristics of a property or liability insurance contract, EXCEPT:

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(n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject:

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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. Group of answer choices

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:

The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as?

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

A policy condition, either based on information in the insured s application or inserted by the insurer, is defined as:

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Property insurance policies usually contain a(n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value:

Insurance applies separately to each insured as if other insureds did not exist. This is defined as:

All the following are eligible for full coverage (Liability, PIP, Med Pay, and Physical Damage) in the Florida Automobile (FAJUA) EXCEPT:Group of answer choices

Once a risk is assigned to a Servicing Carrier in the FAJUA, the carrier owns the premium and the losses for that risk.

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To make needed Homeowner Insurance available, Citizens must insure all risks that cannot find insurance in the voluntary market.

To be eligible for coverage under the Florida Workers Compensation JUA (FWCJUA), the applicant must have been turned down by at least two voluntary carriers and not be indebted for any previous unpaid WC premiums.

If financial responsibility doesnt exist at the time of an accident, which of the following things must happen to avoid penalties?

Personal Injury Protection, or PIP, has a __________ per person, per accident limit.

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?

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?

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:

Which of the following is not one of the "Thresholds" in the "No-Fault" law?

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Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles:

Under Mechanical Breakdown Coverage, new cars are eligible for service up to:

The Business Automobile Policy includes all of the following coverage forms except:

The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10

Jane and Sue are riding with Jim in Jim’s car. All 3 are Florida Residents who own cars and carry Basic PIP with no deductible. There is an accident and Jane has $5,000 in Medical Bills. Whose PIP will pay and how much will it pay?

Jane and Sue are riding with Jim in Jim’s car. All 3 are Florida Residents who own cars and carry Basic PIP with no deductible. Sue has $12,000 in Medical Bills. Whose coverage will pay and how much will it pay?

Robert is driving his car in Florida when he is hit by an at-fault driver. Robert has $10,000 in medical bills, carries Basic PIP with a $1000 deductible and has no Med Pay. How much will the at-fault driver have to pay for Robert’s injuries?Group of answer choices

While driving his own car, Bill is involved in an accident that is the fault of the other driver, Mike. He looks to collect for his injuries in the following order:

Jim has had an auto policy with the Wonderful Insurance Group for 3 years. 30 days before his renewal date he receives notice of the company’s intention to non-renew because of 3 negligent losses and 1 speeding ticket in the past 3 years. His driving record and claim history make this a valid non-renewal.

Which of the following are characteristics of Homeowner's Insurance?

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On a Homeowner's Policy, covers items that are not permanately attached to the dwelling. This is defined as:

Jeremy owns a home that is recently damaged due to a hurricane. The repair estimate is averaged at $25,000 and Jeremy decides to stay in a hotel becuase most of the damage is to his bedroom and kitchen. Under a Homeowner's Policy, what coverage will pay for the hotel room bill?

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All of the following are eligible for a Homeowner's Policy, except?

Which of the following is not covered under Coverage C, Personal Property?

Which of the following forms is "all-risk" on the dwelling policy?

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:Group of answer choices

Which of the following is not one of the rating factors for a Homeowner's Policy?

A lender has an insurable interest in a home and finds protection in the:

When the basic liability limits provided by the policy are insufficient for an insureds needs, two coverage forms are used to provide the additional amounts of coverage:

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:

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Any material which is or may have been a motor vehicle or mobile home, which is not a major part or major component part, 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 for its component parts, or a combination of the two.

This is defined as:

A motor vehicle or mobile home which is a total loss is defined as:

One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state.

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:

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)

An agent representing a health maintenance organization , or as to health insurance only, an insurer transacting health insurance is defined as a(n):

The District of Columbia and any state or territory of the United States in which an insurance agent maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance agent. This is defined as:

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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 customer representative appointed by a general lines agent or agency in transacting only the business of private passenger motor vehicle insurance from the office of that agent or agency is defined as:

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:

An applicant for a temporary license must be:

How many continuing education hours must an insurance adjuster complete every 2 years?

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?

Which of the following are reasons for refusal, suspension or revocation of a license or appointment?

An applicant for a license as an adjuster may qualify as an adjuster in the following fields (but not limited to):

Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices:

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:

When making any payment for damage to an automobile for a partial loss, the insurer shall have printed on the loss settlement, "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):

A licensed and appointed All-lines Adjuster may solicit business on behalf of a licensed Public Adjuster only if under the supervision of that licensed Public Adjuster.

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Which of the following are parties to a Bond?

One who undertakes to perform, to fulfill a contract or to meet an obligation is known as:

Guarantees the performance between the principle and the obligee:

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:

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Which of the following are NOT a type of bond?

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:

This bond guarantees indemnification to the obligee for any losses resulting from the principal s failure to complete the contract work in accord with specifications:

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This type of bond covers streets, sidealks, sewers, etc.:

Which of the following are characteristics of a License Bond?

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:

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:

Under Workers Compensation, Part Four Your Duties if Injuries Occur, an employer is required to:

The measure to determine disability benefits is the __________ of the employee at the time of injury:

The following are classes of disability, except:

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:

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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:

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Under workers compensations, a rate is charged for every __________ of payroll to employees.

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All of the following are components of Workers Compensation, except:

Under Workers Compensation, Employers Liability includes:

Under Employer's Liability, the minimum limits of liability are:

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?

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The voluntary or intentional relinquishment of a known right is defined as a(n):

The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to:

Duties and functions of the Department of Financial Services include all of the following except:

The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as:

One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as:

The process of disposing of an insurance claim is defined as:

Which of the following are not considered to be an adjuster:

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An adjuster who represents the financial interests of the insured named in the policy is defined as a(n):

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):

An adjuster who is self employed and not affiliated with either insurers or bureaus is defined as a(n):

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:

The adjusters basic activities in claims handling are:

The adjuster's investigation may include all of the following except:

Establishing a dollar value on a claim is defined as:

Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as:

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Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as:

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.

When investigating liability insurance claims, which of the following three major elements are determined:

Under the Florida Unfair Insurance Trade Practices Act, penalties are provided for misrepresentation of business practices, which include all of the following except:

All of the following are requirements for the "Code of Ethics," except:

Must be licensed, appointed by a General Lines Agent and can transact AUTO insurance only in the Office Only.

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.

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Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services.

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.

After pleading guilty or no contest to a felony, a licensed individual has _________ days to inform the Department?

A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative.

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A licensed General Lines Claim Adjuster is required to complete how many hours of continuing education every two years?

Defaming a competitor company or agent is not only unprofessional, it can also result in a license suspension.

An Insurance Company which is formed under the laws of the State of Illinois, and has its Home Office there, is considered a:

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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. Although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested.