Florida Claims Adjuster Exam 2024 Questions and Answers, Exams of Insurance Economics

Download Florida Claims Adjuster Exam 2024 Questions and Answers and more Exams Insurance Economics in PDF only on Docsity! Florida Claims Adjuster Exam 2024 Questions And Answers 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: A. The first mortgagee, ABC B. The Insured C. Jointly to ABC and XYZ D. All listed interests - correct answer D. All listed interests Remember that the insurer is not responsible to know the degrees of interest. In the event of a loss, one payment is made by the insurer and it is up to the additional interests on working out their share. Insurance applies separately to each insured as if other insureds did not exist. This is defined as: A. Severability B. Conditional C. Warranty D. None of the above - correct answer A. Severability Property insurance policies usually contain a(n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value: A. Pro Rata B. Abandonment Florida Claims Adjuster Exam 2024 Questions And Answers C. Liberalization D. All of the above - correct answer B. Abandonment A(n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject: A. Conditional Contract B. Personal Contract C. Economic Contract D. Insurable Interest - correct answer D. Insurable Interest 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. Cancellation Clause B. Policy Period C. Pro Rata D. Liberalization - correct answer D. Liberalization The time frame is typically 60 days. 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. Florida Claims Adjuster Exam 2024 Questions And Answers C. A permanent loss of a bodily function D. Permanent scarring on the face of the insured - correct answer B. Temporary Injury of the Insured Also included: permanent injury other than scarring and disfigurement Under Mechanical Breakdown Coverage, new cars are eligible for service up to: A. 36 Months/36,000 Miles B. 24 Months/36,000 Miles C. 12,000 Months/12,000 Miles D. 12 Months/36,000 Miles - correct answer A. 36 Months/36,000 Miles Used vehicles: 12 Months/12,000 Miles If financial responsibility doesn't exist at the time of an accident, which of the following things must happen to avoid penalties? A. The legally valid claims of others must be satisfied (up to 10/20/10) B. The owner and operator must provide certification of future responsibility for future accidents C. Both A & B D. None of the Above - correct answer C. Both A & B Florida Claims Adjuster Exam 2024 Questions And Answers 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: A. 1 B. 3 C. 4 D. 2 - correct answer B. 3 The Business Automobile Policy includes all of the following coverage forms except: A. The Garage Coverage Form B. The Trailer Interchange Coverage Form C. The Truckers Coverage Form D. 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. A. 10,000 B. 20,000 C. 1,000 D. Depends on the damaged property - correct answer A. 10,000 Florida Claims Adjuster Exam 2024 Questions And Answers Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles: A. Servicing Coverage Form B. Garage Coverage Form C. Truckers Coverage Form D. None of the Above - correct answer B. Garage Coverage Form The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10. A. Split B. Single C. Straight D. None of the Above - correct answer A. Split 10/20/10 = 10,000 per person injured 20,000 all injuries combined 10,000 property damage Example of straight liability limit = $30,000 Florida Claims Adjuster Exam 2024 Questions And Answers A. DP-1, or the Basic Form B. DP-2, or the Broad C. DP-3, or the Special Form D. None of the Above - correct answer C. DP-3, or the Special Form 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: A. Excess Liability B. Umbrella C. Both A & B D. None of the Above - correct answer C. Both A & B Which of the following is not covered under Coverage C, Personal Property? A. A fire breaks out in the residence and an overnight guest loses his clothes in the fire B. A fish dies because he has been left alone for a week without food C. The insureds daughters tennis racket is stolen from her locker D. The insureds suitcase and clothing, valued at $1,500, are stolen from his hotel - correct answer B. A fish dies because he has been left alone for a week without food Animals are listed as an "exclusion" under a Homeowner's policy. Florida Claims Adjuster Exam 2024 Questions And Answers All of the following are eligible for a Homeowner's Policy, except? A. An apartment tenant B. A condominium owner C. Four-family dwelling owner-occupant D. 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? A. Protects against economic loss to residences and household property and legal liabilities B. Owner-occupants of 1-4 family dwellings C. Renters who maintain residential occupancy in any type of building D. All of the Above - correct answer D. All of the Above Also included: personal, non-business risk, no more than 2 roomers/boarders, condominium unit owners and cooperative apartment occupants 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. Florida Claims Adjuster Exam 2024 Questions And Answers Under a Homeowner's Policy, what coverage will pay for the hotel room bill? A. Fair Rental Value B. Value Obligation C. Loss of Use D. 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: A. Preferred Risk Flood Policy B. Standard Flood Policy C. Universal Flood Insurance D. None of the Above - correct answer A. Preferred Risk Flood Policy Although Flood Insurance is provided by the Federal Government, those who are not in a "flood zone" may purchase a preferred risk policy to cover them for a flood claim. 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: A. Condominium Dwelling Form Florida Claims Adjuster Exam 2024 Questions And Answers 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. A. Value Reporting B. Replacement Cost C. Agreed Value D. None of the Above - correct answer A. Value Reporting Replacement Cost is incorrect b/c it calculates monetary value of one's personal property 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." A. 10 days B. 55 days C. 65 days D. 45 days - correct answer D. 45 days Used to cover buildings in the course of construction: A. Builders Risk Policy B. Builders Replacement Policy Florida Claims Adjuster Exam 2024 Questions And Answers C. Construction Replacement Policy D. 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. A. Commercial Inland Marine Coverage B. Personal Inland Marine Coverage C. Ocean Commercial Coverage D. 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. A. Business Income Insurance Coverage B. Business Income Replacement Coverage C. Business Income Actual Value Coverage Florida Claims Adjuster Exam 2024 Questions And Answers D. 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) What payment covers several areas of costs related to claims, and are payable in addition to the policy limits? A. Supplementary B. Liability C. Personal Injury D. All of the Above - correct answer A. Supplementary Generally, all costs of litigation are covered (court costs, prejudgment interest, judgement interest, cost of bonds to release attachments) 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. The Med Pay Section must pay Primary B. The General Liability Policy will pay up to $20,000 in medical payments Florida Claims Adjuster Exam 2024 Questions And Answers A. Includes B. Excludes C. Prohibits D. Summarizes - correct answer B. Excludes Firms involved in Nuclear activities receive protection from special insurer pools organized for that purpose. 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? A. Loss Known B. Known Loss C. Claims-Made D. None of the Above - correct answer B. Known Loss Insurer should have been notified and further investigation of the spill and effective clean-up would have been observed. Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made: A. Occurrence Form B. Claims-Made Form C. Premises and Operations Exposure Florida Claims Adjuster Exam 2024 Questions And Answers D. None of the Above - correct answer A. Occurrence Form vs. Claims-Made: applies only to BI or PD occurring on or after retroactive date for which claim is received/recorded during policy period 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: A. Occurrence B. Claims-Made C. Operations Completed D. None of the Above - correct answer B. Claims-Made Retroactive date is stated in Declarations and will normally be same date as issuing company's first claims-made effective date for insured. All of the following are components of Workers Compensation, except: A. Up to $750,000 in Death Benefits B. Reimbursement for Medical Expenses incurred C. Reimbursement for lost wages on percentage basis D. 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. Florida Claims Adjuster Exam 2024 Questions And Answers The following are classes of disability, except: A. Permanent Total B. Temporary Total C. Permanent Impairment D. Temporary Full - correct answer D. Temporary Full Also included: Temporary Partial The measure to determine disability benefits is the __________ of the employee at the time of injury: A. Average Monthly Wage B. Average Weekly Wage C. Average Daily Wage D. Income Estimate - correct answer B. Average Weekly Wage Disability - incapacity due to injury to earn same or any other employment wages that employee was receiving at time of injury. 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: A. The Experience Rating Plan Florida Claims Adjuster Exam 2024 Questions And Answers which is added the actual losses incurred by the insured. This is defined as: A. Cost-Plus Rating Plan B. Experience Rating Plan C. Retrospective Rating Plan D. None of the Above - correct answer C. Retrospective Rating Plan Often referred to as Cost-Plus Programs Under Employer's Liability, the minimum limits of liability are: A. 100/100/500 B. 100/500/1000 C. 500/100/500 D. 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 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: Florida Claims Adjuster Exam 2024 Questions And Answers A. $1,000 B. $2,000 C. $4,000 D. $5,000 - correct answer D. $5,000 Under Crime Insurance, losses must be discovered within 1 year. This is defined as: A. The Discovery Period B. The Loss Sustained Period C. The Open Period D. All of the Above - correct answer A. The Discovery Period Crime Insurance is _________ over any other Insurance coverage. A. Primary B. Secondary C. Excess D. Recess - correct answer C. Excess A situation may arise where another form of insurance will pay claim - that insurance would be primary. Cover only losses that both occurred and were discovered during the policy period, or within one year of its expiration. This is defined as: Florida Claims Adjuster Exam 2024 Questions And Answers A. Discovery B. Loss Sustained C. Sustained Loss D. None of the Above - correct answer B. Loss Sustained One exception to the rule is that Loss Sustained forms will also cover losses that occurred under previous (expired) crime policies and that were discovered during current policy year, as long as crime coverage had continued w/o interruption 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. This is defined as: A. Loss Sustained B. Valuation C. Discovery D. None of the Above - correct answer C. Discovery If XYZ restaurant discovers stolen goods taken over a year ago, this is within 2 years of inception date and found within policy period so it's covered. Under Crime Insurance, the insured is covered for loss by: A. Theft Florida Claims Adjuster Exam 2024 Questions And Answers Which of the following are NOT a type of bond? A. Contract B. Fiduciary C. Court D. Apprentice - correct answer D. Apprentice Contract - fulfill obligation Fiduciary - make good to court for any deficiencies found in performance Court - protect opposing party from loss Which of the following are characteristics of a License Bond? A. To guarantee the licensee will act according to laws B. Protect public from unfair business practice C. Proper collection and payment of taxes D. All of the Above - correct answer D. All of the Above Guarantees the performance between the principle and the obligee: A. Principal B. Obligee C. Surety D. All of the Above - correct answer C. Surety Florida Claims Adjuster Exam 2024 Questions And Answers aka Bonding Company; Surety is a "guarantee" 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: A. Performance B. Bid C. Court D. Maintenance - correct answer A. Performance Considered a contract bond One who undertakes to perform, to fulfill a contract or to meet an obligation is known as: A. Principal B. Obligee C. Surety D. All of the Above - correct answer A. Principal Obligee - needs guarantee principal will perform Surety - guarantees performance between principal and obligee Florida Claims Adjuster Exam 2024 Questions And Answers 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: A. Bid B. Performance C. Court D. Maintenance - correct answer A. Bid 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: A. Indemnitor B. Surety C. Obligee D. None of the Above - correct answer A. Indemnitor Known as "fourth party", may put up collateral Which of the following are parties to a Bond? A. Principal B. Obligee C. Surety D. All of the Above - correct answer D. All of the Above Principal - undertakes to perform/fulfill Florida Claims Adjuster Exam 2024 Questions And Answers D. 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? A. Accident Insurance B. Hospitilization C. Hospital Pay D. None of the Above - correct answer A. Accident Insurance Typical exclusions would be: hernia, war, disease and bacterial infections, suicide attempts, air travel injuries, accidents while committing felony, accidents while under the influence 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? A. Conditionally Renewable B. Guaranteed Renewable C. Optionally Renewable D. None of the Above - correct answer A. Conditionally Renewable vs. Optionally: company may not cancel during term but reserves right to non-renew upon expiration Florida Claims Adjuster Exam 2024 Questions And Answers vs. Guaranteed: insurer required to renew policy at stated age (typically 65); company reserves right to increase premium The coverage that is intended to afford protection against catastrophic losses is defined as? A. Major Medical B. HMO C. PPO D. None of the Above - correct answer A. Major Medical Some forms designed to supplement basic policies; others provide both basic and catastrophic coverage A policy may contain a provision which states a period of time between issuance and acceptance before sickness benefits begin. This is defined as: A. Waiting Period B. Elimination Period C. Both A & B D. None of the Above - correct answer C. Both A & B This helps keep premiums reasonable by eliminating chance of persons buying coverage only when they are sick Characteristics of an HMO plan usually include: Florida Claims Adjuster Exam 2024 Questions And Answers A. Small of non-existent Deductibles B. Fewer Exclusions C. Insurance services to members through employed physicians D. All of the Above - correct answer D. All of the Above Also included: broad coverage, coinsurance provisions 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? A. Hospitalization Expense B. Hospital Indemnity C. Accident Policy D. All of the Above - correct answer A. Hospitalization Expense Associated with a daily limit, not to exceed specified maximum A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. A. HMO B. PPO C. Major Medical Plan D. All of the Above - correct answer A. HMO Florida Claims Adjuster Exam 2024 Questions And Answers Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services. A. True B. False - correct answer B. False 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: A. Misrepresentation B. Lack of Fitness C. Deception D. Sliding - correct answer D. Sliding A licensed General Lines Claim Adjuster is required to complete how many hours of continuing education every two years? A. 6 B. 12 C. 18 D. 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. Florida Claims Adjuster Exam 2024 Questions And Answers A. True B. False - correct answer B. False After pleading guilty or no contest to a felony, a licensed individual has _________ days to inform the Department? A. 10 B. 20 C. 30 D. 40 - correct answer C. 30 Must be licensed, appointed by a General Lines Agent and can transact AUTO insurance only in the Office Only. A. Customer Representative 4-40 B. Limited Customer Representative 4-42 C. General Lines Claim Adjuster 6-20 D. General Lines Agent 2-20 - correct answer B. Limited Customer Representative 4-42 Defaming a competitor company or agent is not only unprofessional, it can also result in a license suspension. A. True B. False - correct answer A. True Florida Claims Adjuster Exam 2024 Questions And Answers A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative. A. True B. False - correct answer B. False An Insurance Company which is formed under the laws of the State of Illinois, and has its Home Office there, is considered a: A. US Domestic Company B. Foreign Company C. Alien Company D. Unadmitted Company - correct answer B. Foreign Company Domestic: this state (FL) Foreign: other state (still in US) Alien: elsewhere One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as: A. Insurance Agent B. General Lines Agent Florida Claims Adjuster Exam 2024 Questions And Answers Investigation - establish coverage, determine liability, verify damages qualify Evaluation - determine fair payment in accordance with contract and law Negotiation - settlement based on facts discovered during evaluation Under the Florida Unfair Insurance Trade Practices Act, penalties are provided for misrepresentation of business practices, which include all of the following except: A. Failing to act promptly B. Failure to explain claim denials in writing C. Denying claims with reasonable investigation D. Failure to maintain complaint handling procedures - correct answer C. Denying claims with reasonable investigation An adjuster who represents the financial interests of the insured named in the policy is defined as a(n): A. Public Adjuster B. Bureau Adjuster C. Fee Adjuster D. Independent Adjuster - correct answer A. Public Adjuster Florida Claims Adjuster Exam 2024 Questions And Answers When investigating liability insurance claims, which of the following three major elements are determined: A. Coverage B. Liability C. Damages D. All of the Above - correct answer D. All of the Above 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: A. Fiduciary B. Estoppel C. Public D. None of the Above - correct answer A. Fiduciary Should always be maintained whether or not the adjuster is a direct employee An adjuster who is self employed and not affiliated with either insurers or bureaus is defined as a(n): A. Fee Adjuster B. Public Adjuster C. Bureau Adjuster Florida Claims Adjuster Exam 2024 Questions And Answers D. Independent Adjuster - correct answer D. Independent Adjuster The adjuster's investigation may include all of the following except: A. Verification of Bills and Estimates B. Photographs C. Witness Canvasses D. 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: A. Adjustment B. Summons C. Claim D. None of the Above - correct answer C. Claim Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as: A. Advanced Payment B. Full Release Settlement C. Non-Advanced Payment D. Scheduled Payment - correct answer A. Advanced Payment Florida Claims Adjuster Exam 2024 Questions And Answers Which of the following are not considered to be an adjuster: A. Employee or Staff Adjuster B. Independent Adjuster C. Public Adjuster D. General Lines Adjuster - correct answer D. General Lines Adjuster Bureau Adjusters are also considered adjusters. An applicant for a license as an adjuster may qualify as an adjuster in the following fields (but not limited to): A. All lines of insurance except life and annuities B. Property and Casualty C. Workers Compensation Insurance D. All of the Above - correct answer D. All of the Above Also: motor vehicle physical damage and health insurance A motor vehicle or mobile home which is a total loss is defined as: A. Lost Profit B. Salvage C. Salvageable D. All of the Above - correct answer B. Salvage It cannot be restored to prior condition Florida Claims Adjuster Exam 2024 Questions And Answers 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. Third Party Claim B. Two Party Claim C. Derivative Claim D. All of the Above - correct answer A. Third Party Claim 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: A. Business Territory B. Home Territory C. Home State D. None of the Above - correct answer C. Home State Any material which is or may have been a motor vehicle or mobile home, 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 Florida Claims Adjuster Exam 2024 Questions And Answers or for its component parts, or a combination of the two. This is defined as: A. Junk B. Derelict C. Major Component Parts D. None of the Above - correct answer B. Derelict 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: A. Customer Representative B. General Lines Agent C. Adjuster D. None of the Above - correct answer A. Customer Representative (4-40 license) 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: A. Appointment B. Express Authority C. Registered Florida Claims Adjuster Exam 2024 Questions And Answers A. Churning B. Sliding C. Soliciting D. None of the Above - correct answer B. Sliding Which of the following are reasons for refusal, suspension or revocation of a license or appointment? A. Lack of Qualifications B. Failure to Pass State Examinations C. Fraudulent or Dishonest Practices D. 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? A. 60 B. 30 C. 15 D. 90 - correct answer B. 30 Florida Claims Adjuster Exam 2024 Questions And Answers 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): A. Customer Service Representative B. Adjuster C. Health Agent D. General Lines Agent - correct answer D. General Lines Agent An agent representing a health maintenance organization, or as to health insurance only, an insurer transacting health insurance is defined as a(n): A. Health Agent B. Health Representative C. HMO Agent D. None of the Above - correct answer A. Health Agent An applicant for a temporary license must be: A. A natural person at least 18 years of age B. A US citizen or legal alien who possesses work authorization C. Both A & B D. None of the Above - correct answer C. Both A & B Florida Claims Adjuster Exam 2024 Questions And Answers One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. This is defined as a(n): A. Unauthorized B. Certified C. Domiciled Insurer D. Authorized - correct answer D. Authorized Actual Cash Value - correct answer Replacement cost minus depreciation Subrogation - correct answer When an insured has a right to collect damages from another party but elects to claim damages under his/her insurance policy; rights transfer to the insurer Loss Payee Clause - correct answer Provides, in event of payment being made under the policy in relation to insured risk, that payment will be made to a third party rather than the beneficiary Mortgagee Clause - correct answer Protects a lender who has an insurable interest in a home Grants special protection for the interest of a mortgage named in the policy; setting up a separate content between insurer and mortgagee Florida Claims Adjuster Exam 2024 Questions And Answers Foreign - correct answer Insurer formed under laws of another state, district territory, or commonwealth of U.S. Alien - correct answer Insurer other than domestic or foreign (outside U.S.) Sliding - correct answer Selling an item and stating that it is required by law Waiver - correct answer Voluntary relinquishment or surrender of some right or privilege Fiduciary - correct answer 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 Evaluation - correct answer Establishing a dollar value on a claim. Determines the fair payment in accordance with the contract and applicable law Negotiation - correct answer A quality settlement based on facts discovered during the evaluation process Florida Claims Adjuster Exam 2024 Questions And Answers Estoppel - correct answer An equitable principle to the effect that if one intentionally or unintentionally creates the impression that a certain fact exists, an innocent party relies on that impression and is damaged as a result, the guilty party may be legally prohibited (estopped) from asserting that the fact does not exist. Junk - correct answer Any material which is or may have been a motor vehicle or mobile home, with or without all component parts, 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 Salvage - correct answer Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss. Motor vehicle or mobile home is a total loss Appointment - correct answer Authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf Derelict - correct answer Material which is or may have been a motor vehicle or mobile home, with or without all component parts, 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 component parts or both Florida Claims Adjuster Exam 2024 Questions And Answers Implied Waiver - correct answer May result from some act of neglect on part of the adjuster Express Waiver - correct answer Occurs when insurer or its representative knowingly gives up a known right under insurance contract Mechanical Breakdown Coverage - correct answer Covers repairs to mechanical parts of your vehicle that break; even covers in events not related to an accident Identify examples of peril. - correct answer Fire, windstorm, flood after hurricane, etc. (something that causes a loss) How long does one have to notify the Department of Financial Services for a name and/or address change? - correct answer 30 days What is the coinsurance clause and how might it apply to a given scenario? - correct answer A coinsurance clause on a property policy requires the policyholder to carry, at minimum, a specified percent of the dwelling's replacement cost. Failure results in monetary penalty. Florida Claims Adjuster Exam 2024 Questions And Answers What are the penalties for not complying with the No-Fault Law? - correct answer 1. Owner is denied immunities from legal liabilities that are granted to those who comply 2. Owner is personally liable for payment of PIP benefits to those entitled 3. Owner's driver's license and vehicle registration are subject to suspension What is the PIP Death Benefit amount? - correct answer Effective 1/1/13, the death benefit will be $5,000 IN ADDITION to the $10,000 in medical and disability benefits afforded by PIP. Example: Joe is seriously injured in an accident and incurs $50,000 in medical bills. He passes away a few days later. PIP would pay its maximum amount of $10,000 and, in addition, pay an extra $5,000 for death benefit. Who administers the Financial Responsibility Law? - correct answer The Department of Highway Safety and Motor Vehicles What are the characteristics of a Homeowner's policy? - correct answer -protects against economic loss to residence and household property and legal liabilities -owner/occupants of 1-4 family dwellings -renters who maintain residential occupancy in any type of building Florida Claims Adjuster Exam 2024 Questions And Answers -other structures (not permanently attached) What are the benefits under the Workers Compensation Law? - correct answer -Medical Expenses: needed medical treatment with no dollar limit -Disability Benefits: compensation for wage loss -Death Benefits: if death results within one year of accident or, if it follow continuous disability, within five years after the accident What are the requirements for continuing education for a 6-20 license? - correct answer A licensed General Lines Claims Adjuster is required to complete 24 hours of education every 2 years. Who might have an insurable interest in a property? - correct answer Anyone who would suffer an economic loss from an adverse happening to the property What do the Declarations of a policy outline? - correct answer The declarations 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 Which parties are associated with a bond? - correct answer -Principal: one who undertakes to perform, fulfill a contract, or meet an obligation Florida Claims Adjuster Exam 2024 Questions And Answers -Obligee: one who is guaranteed that the principal will perform -Surety (Bonding Company): guarantees performance -Indemnitor: may act as additional party at times; agrees to reimburse the surety for any loss it may suffer from having bonded the principal What are the features of Major Medical Insurance? - correct answer Major Medical Insurance is intended to afford protection against catastrophic losses. Some forms are designated to supplement basic hospital/surgical policies; others intend to provide both basic and catastrophic coverage These policies are characterized by a deductible, high maximum limit, and percentage participation or coinsurance. It may contain internal limits for hospital daily room charge and surgical services. What associations make up Citizens Property and Insurance? - correct answer Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and Florida Windstorm Joint Underwriting Association (FWUA) What are the characteristics of a Personal Automobile Policy Declaration page? - correct answer Liability (bodily injury), property damage, uninsured motorist, medical payments, PIP, collision deductible, comprehensive deductible, towing coverage, and rental coverage Florida Claims Adjuster Exam 2024 Questions And Answers 4. All Lines Claims Adjuster 6-20: investigates, Evaluates and Negotiates Claims What are some reasons for suspension, revocation, or termination of a license? - correct answer 1. Transacting insurance outside of scope of one's license ►For example, an individual cannot sell life insurance if he or she has a Customer Service license but has not obtained a life license. 2. Misrepresentation or Fraud. 3. Participating in unfair methods of competition. ►Using discriminatory practices, making false entries on an insurance application or defaming others. 4. Sliding: Selling an item and stating that it is required by law (when it is not). 5. Demonstration of unworthiness or lack of fitness. 6. Misappropriation of funds. 7. Failure to inform Department of Financial Services, within 30 days, after pleading guilty or no contest to a felony. Compare/contrast different types of adjusters. - correct answer 1. Independent Adjuster - self-employed and not affiliated with either insurers or bureaus 2. Company/Staff Adjuster - salaried employee under supervision of home, branch, regional claims department of insurers Florida Claims Adjuster Exam 2024 Questions And Answers 3. Public Adjuster - represents the financial interests of the insured named in the policy 4. Claims Adjuster - one who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies 5. Bureau Adjuster - agent of adjustment bureau which serves multiple company clients *Independent and Bureau are both "Fee Adjusters" What is an Insurance Contract? - correct answer Insurance is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies What are the components that make up the investigation process? - correct answer Inquiry, verification, comparison What are the Code of Ethics for adjusters? - correct answer Formal rules which impact on adjuster practices 1. Adjusters may not directly negotiate with a claimant who is represented by an attorney. 2. In interviewing witnesses, adjusters must avoid any actions tending to induce a suppression or deviation from the truth. A witness who requests a copy of a statement given must be provided with a copy. Florida Claims Adjuster Exam 2024 Questions And Answers 3. Adjusters shall not give legal advice. 4. Adjusters shall not draft special releases; they are permitted only to fill in blanks of forms provided by the insurer. 5. Adjusters will not take advantage of an incapacitated claimant which would be to the detriment of the claimant. 6. Adjusters will not knowingly fail to advise claimants of their rights under contracts and laws of the state. 7. Adjusters will approach all aspects of the process with an unprejudiced and open mind, make truthful and unbiased reports, handle all processes with integrity and accept no remuneration other than that to which there is legal entitlement, and act with diligence and due dispatch in achieving proper disposition of claims. 8. The adjuster must put the duty for fair and honest treatment of the claimant above the adjuster's own interests, in every instance.