Claims Adjuster Exam Questions and Answers, Exams of Compensation and Reward Management

Download Claims Adjuster Exam Questions and Answers and more Exams Compensation and Reward Management in PDF only on Docsity! Claims Adjuster Exam Questions with 100% Correct Answers 2023 Guaranteed A+.  Frank owned a home that was destroyed by a hurricane. Both TD Bank and Bank of America were listed as additional interests on his homeowner policy. The insurance company will make a payment to:  The first mortgagee, TD Bank  The Insured  Jointly to TD Bank and Bank of America  All listed interests - correct answer D. All listed interests  Insurance applies separately to each insured as if other insureds did not exist. This is defined as:  Severability  Conditional  Warranty  None of the above - correct answer A. Severability  Property insurance policies usually contain a(n) __________ clause,  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.  Doctrine of Proximate Cause  Doctrine of Perils & Hazards  Insurance Policy Handbook  Doctrine of Property Insurance - correct answer D. Doctrine of Property Insurance  The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as?  Actual Cash Value  Replacement Cost  "Old for New"  None of the Above - 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:  Warranty  Misrepresentation  Concealment  None of the Above - correct answer A. Warranty  The following are basic characteristics of a property or liability insurance contract, except:  Personal Contract  Conditional Contract  Loss of Settlement Contract  Contract of Adhesion - 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,  If financial responsibility doesn't exist at the time of an accident, which of the following things must happen to avoid penalties?  The legally valid claims of others must be satisfied (up to 10/20/10)  The owner and operator must provide certification of future responsibility for future accidents  Both A & B  None of the Above - 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:  1  3  4  2 - correct answer B. 3  The Business Automobile Policy includes all of the following coverage forms except:  The Garage Coverage Form  The Trailer Interchange Coverage Form  The Truckers Coverage Form  The Business Auto Coverage Form - correct answer B. The Trailer Interchange Coverage Form  Personal Injury Protection, or PIP, has a __________ per person, per accident limit.  10,000  20,000  1,000  Depends on the damaged property - correct answer A. 10,000  10/20/10  $3,000 - correct answer A. $1,600  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?  $15,000  $5,000  $3,000  $0, Frank is not-at-fault - correct answer B. $5,000  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?  Type of Construction  Location of Risk  Age & Gender of Insured  Proximity to Fire Department - 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:  Other Structures  Excess Structures  Personal Property  Dwelling - 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:  Loss Payee Clause  Mortgagee Clause  Lender Clause  All of the following are eligible for a Homeowner's Policy, except?  An apartment tenant  A condominium owner  Four-family dwelling owner-occupant  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?  Protects against economic loss to residences and household property and legal liabilities  Owner-occupants of 1-4 family dwellings  Renters who maintain residential occupancy in any type of building  All of the Above - correct answer D. All of the Above  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?  Fair Rental Value  Value Obligation  Loss of Use  Insurers Duties - 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:  Preferred Risk Flood Policy  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:  Condominium Association Form  Condominium Unit Owners Form  Condominium Insured Owner Form  None of the Above - 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:  Business Property Insurance  Building Property Insurance  Commercial Property Insurance  None of the Above - 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.  25  90  45  None of the Above - correct answer C. 45  Construction Replacement Policy  None of the Above - 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.  Commercial Inland Marine Coverage  Personal Inland Marine Coverage  Ocean Commercial Coverage  None of the Above - 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.  Business Income Insurance Coverage  Business Income Replacement Coverage  Business Income Actual Value Coverage  None of the Above - correct answer 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 1. date when damaged property could be repaired, rebuilt, or replaced 2. date business resumes operations at new, permanent location (whichever comes first) the insured. The employees would have to file through Workers Comp.  Which of the following can be found in a Commercial General Liability Contract?  Declarations  Common Policy Conditions  Occurrence and Claims-Made Forms  All of the Above - correct answer D. All of the Above  There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions:  50%  10%  0%  A Percentage Ratio - correct answer C. 0%  Under a Commercial General Liability Policy, a basic limit of __________ per person applies to Medical Payments:  $1,000  $10,000  $2,500  $5,000 - correct answer D. $5,000  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.  Declarations  Contract  Policy  Up to $750,000 in Death Benefits  Reimbursement for Medical Expenses incurred  Reimbursement for lost wages on percentage basis  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:  Permanent Total  Temporary Total  Permanent Impairment  Temporary Full - correct answer D. Temporary Full  The measure to determine disability benefits is the __________ of the employee at the time of injury:  Average Monthly Wage  Average Weekly Wage  Average Daily Wage  Income Estimate - correct answer B. Average Weekly Wage  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:  The Experience Rating Plan  The Retrospective Rating Plan  The Risk Plan  None of the Above - correct answer A. The Experience Rating Plan  Under workers compensations, a rate is charged for every __________ of payroll to employees.  $100  $1,000  A products and completed operations form  A premises and operations form  An owners and contractors protective liability form  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.  Under Employer's Liability, the minimum limits of liability are:  100/100/500  100/500/1000  500/100/500  100/500 - correct answer A. 100/100/500  $100,000 for all claims in each accident  $100,000 per employee for disease  $500,000 for all disease claims  Under Crime Insurance, losses must be discovered within 1 year. This is defined as:  The Discovery Period  The Loss Sustained Period  The Open Period  All of the Above - correct answer A. The Discovery Period  Crime Insurance is _________ over any other Insurance coverage.  Primary  Secondary  Excess  Recess - correct answer C. Excess  Cover only losses that both occurred and were discovered during the policy period, or within one year of its expiration. This is defined as:  Discovery  Loss Sustained  Sustained Loss  None of the Above - correct answer B. Loss Sustained  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:  Extortion  Surrendered Property  Client's Property  None of the Above - correct answer A. Extortion  Also triggered by threats to damage the premises or property within the premises.  Which of the following are NOT a type of bond?  Contract  Fiduciary  Court  Apprentice - correct answer D. Apprentice  Which of the following are characteristics of a License Bond?  To guarantee the licensee will act according to laws  Protect public from unfair business practice  Proper collection and payment of taxes  All of the Above - correct answer D. All of the Above  Guarantees the performance between the principle and the obligee:  Principal  Obligee together in an effort to reduce medical costs.  HMO  Major Medical Insurance  Coinsurance  PPO - correct answer D. PPO  Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance:  Hospitilization  Hospital Indemnity  Hospital Services  All of the Above - correct answer B. Hospital Indemnity  This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force:  Waiver of Subrogation  Waiver of Premium  Waiver of Value  None of the Above - correct answer B. Waiver of Premium  'premiums are waived"  Provides coverage for expenses, including loss of income, arising from an accident. This is defined as?  Accident Insurance  Hospitilization  Hospital Pay  None of the Above - correct answer A. Accident Insurance  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?  Conditionally Renewable  Guaranteed Renewable  Optionally Renewable  None of the Above - correct answer A. Conditionally Renewable members for a prepaid fixed fee, equivalent to an insurance premium.  HMO  PPO  Major Medical Plan  All of the Above - correct answer A. HMO  Established in 1973, this association was created for applicants who are unable to obtain insurance in the private market:  FWCJUA  FWUA  Citizens  FRPCJUAE. 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:  FWCJUA  FWUA  Citizens  FRPCJUA  FAJUA - 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:  FWCJUA  FWUA  Citizens  FRPCJUA  FAJUA - 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  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:  Misrepresentation  Lack of Fitness  Deception  Sliding - correct answer D. Sliding  A licensed General Lines Claim Adjuster is required to complete how many hours of continuing education every two years?  6  12  18  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.  True  False - correct answer B. False  After pleading guilty or no contest to a felony, a licensed individual has _________ days to inform the Department?  10  20  30  40 - correct answer C. 30  Must be licensed, appointed by a General Lines Agent and can transact AUTO insurance only in the Office Only.  Customer Representative 4-40  Limited Customer Representative 4- 42  General Lines Claim Adjuster 6-20  One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as:  Insurance Agent  General Lines Agent  Claims Adjuster  All of the Above - correct answer C. Claims Adjuster  Establishing a dollar value on a claim is defined as:  Negotiation  Evaluation  Adjusting  None of the Above - correct answer B. Evaluation  Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as:  Junk  Salvage  Covered Property  Peril - correct answer B. Salvage  The voluntary or intentional relinquishment of a known right is defined as a(n):  Waiver  Estoppel  Avoidance of Performance  None of the Above - correct answer A. Waiver  The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to:  Conduct  Work Habits  Claim Handling Activites  All of the Above - correct answer D. All of the Above  The adjusters basic activities in claims handling are:  When investigating liability insurance claims, which of the following three major elements are determined:  Coverage  Liability  Damages  All of the Above - correct answer D. All of the Above  An adjuster who is self employed and not affiliated with either insurers or bureaus is defined as a(n):  Fee Adjuster  Public Adjuster  Bureau Adjuster  Independent Adjuster - correct answer D. Independent Adjuster  The adjuster's investigation may include all of the following except:  Verification of Bills and Estimates  Photographs  Witness Canvasses  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:  Adjustment  Summons  Claim  None of the Above - correct answer C. Claim  The process of disposing of an insurance claim is defined as:  Adjusting  Claims Management  Adjustment  None of the Above - correct answer A. Adjusting  All of the following are requirements for the "Code of Ethics," except:  Adjusters should not give legal advice department of insurers is defined as a(n):  Company or Staff Adjuster  Fee Adjuster  Public Adjuster  Bureau Adjuster - correct answer A. Company or Staff Adjuster  Which of the following are not considered to be an adjuster:  Employee or Staff Adjuster  Independent Adjuster  Public Adjuster  General Lines Adjuster - correct answer D. General Lines Adjuster  A motor vehicle or mobile home which is a total loss is defined as:  Lost Profit  Salvage  Salvageable  All of the Above - correct answer B. Salvage  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):  Third Party Claim  Two Party Claim  Derivative Claim  All of the Above - correct answer A. Third Party Claim  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:  Appointment  Express Authority  Registered  Soliciting  None of the Above - correct answer B. Sliding  Which of the following are reasons for refusal, suspension or revocation of a license or appointment?  Lack of Qualifications  Failure to Pass State Examinations  Fraudulent or Dishonest Practices  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?  60  30  15  90 - correct answer B. 30