Claims Adjuster Exam (2023 – 2024) With Complete Solutions, Exams of Advanced Education

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Claims Adjuster Exam (2023 – 2024) With Complete Solutions Multi Peril-Package - Any policy which provides property & liability coverage (not homeowner) ISO policy - Sold in Texas, but not Texas form Only Texas DP 1 - Mainly the only TDP sold, now with plethora of endorsements Texas Standard Fire Policy - Granddaddy of all Texas property policies Business auto coverage e.g. - Owner of a taxi to cover collision damage Inland Marine (build milk policy) would cover e.g. - 3k gallons of milk in tanker truck Texas Standard, Standard Fire & Business Owner - Would all cover damage to something like a gift card shop fire Tx Personal Auto Policy e.g. - Owner of family far, for potential injury to other people Trucker's policy - Trucking company, for potential damage to other people's trailers which the trucking company may be pulling Actual Cash Value (ACV) - Replacement cost less depreciation Garage Liability e.g. - For valet parking service to have appropriate liability coverage it needs what kind of policy? Flood, workers comp, crop, costal wind among others - Types of casualty claims I will be unable to handle under license I'm studying for Ocean Marine Hull coverage - Would have to be written for an insured to cover potential collision damage to insured's ship Covered (if it's not written) - It's safe to assume that if something is not excluded in writing it's appropriate to assume that the loss is? 15/15/5 rule - 15 calendar days to send notice you received claim 15 business days to resolve case 5 days to pay claim (if applicable) Options for High Risk Drivers? - Texas started TAIPA Risk pool Minus PIP ($2,500) Uninsured/underinsured motorist coverage - What does TAIPA provide? When can you get TAIPA - Once you've been rejected by 2 or more insurance companies Commercial General Liability coverage - Covers basically any risk imaginable that would "cause" bodily injury or property damage E.g. Customer slip-fall; hit by debris; escalator lurching;poison get well card Exclusions--clarify policy as well as... - Insuring agreement--clarifies the policy as well as... Declarations Page e.g. - Where will you find where the damaged property is located? E.g. Promptly or immediately e.g. - When must first party loss be reported to insurer? E.g. Falling objects, Water loss (flood is not the answer) - What would not be covered as direct loss in any of the least expensive policy forms (limited, standard, basic)? E.g. Firefighters during a fire e.g. - Direct loss from water would be covered if caused by...? E.g. Texas Standard Fire Policy, Standard Fire Policy e.g. - Small Texas retail store would have to buy one of these 2 if they did not want liability policy...? e.g. Aviation is another place you find this policy - Where else other than ocean marine policies will you find "hull coverage...? Named insured, spouse if living in same household e.g. - Most exclusions in policy take away something then give it back by saying "does not apply to you or any family member."..... Who is "you"?.... E.g. surety bond is this type e.g. - Name a type of bond that one party guarantees with money the performance of another party to another 3rd party? E.g. Personal Injury Protection would require this - A written letter of rejection if coverage in policy were rejected Flood would result - What would result from rising water which has touched eart? Paying premiums - Is the first thing insured must to have coverage prior to any loss Liability will respond to demands of... E.g. - Auto insured has lost control of auto & caused damage to parked car. which covered in policy will respond to demands of parked car? E.g. You will find this phrase in insuring agreement e.g. - Other than declaration, where in broad form policy will you find phrase "collapse of building"? E.g. Personal injury Protection e.g. - Name of coverage offer in auto policy that would pay medical bills incurred by insured as result of at fault accident e.g. None will pay, even policy described as it is not "full coverage"--no such thing - Insured has full coverage on home, auto, & boat--falls down stairs at home, seriously injures knee, which policy might pay medical bills? show Insurable interest in order... - to buy insurance policy on property or on life of another person must... Combustion or Rapid Oxidation - Fire is defied as this and this accompanied by heat and flame or visible glow Known as Gap Coverage - In an umbrella policy there is a provision that allows for payment in case underlying policies exclude coverage for even which is.... You have 91 days - In an umbrella policy there is a provision that Personal Injury examples - Libel slander & wrongful detention (among others) are examples of what? Insured and covered persons - Medical payments coverage on auto policy provide medical benefits for injury to... Persons and property - Vacancy of commercial building or residential property is described as property with... Replacement cost less depreciation - Actual Cost Value can also be defined as the current Subrogation definition: - Standing in the shoes of he insured and exercising the insured's common law rights to recover paid damages from legally responsible 3rd party defines what? Transfer, reduce, retain or avoid are the 4 ways to... - Four methods of handling a pure risk Friendly fire--classified as - Fire that is intentionally set & remains within its intended boundaries is classified as Companies do not deal with this risk - List all the ways Insurance deals with this risk Provides coverage that was excluded on an underlying policy - What is the function of Gap Coverage in an Umbrella Policy> Insurance for Insurance companies - Reassurance in very simple terms... Fire, vandalism & malicious mischief, are suspended - Policy condition that causes us to be concerned about building being vacant beyond a period of (usually) 60 days Withheld (recoverable) depreciation - Although "holdback" is not a term used in property, commonly used by adjuster... what does it refer to in terms of claim payment