Insurance Policy Analysis: Understanding Coverages, Exclusions, and Claims, Exams of Nursing

Download Insurance Policy Analysis: Understanding Coverages, Exclusions, and Claims and more Exams Nursing in PDF only on Docsity! 1 FLORIDA CLAIMS ADJUSTER EXAM AND PRACTICE EXAM WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS 2024(NEWEST) ALREADY GRADED A+ Judith's engagement ring is stolen soon after she and her fiancé cancelled their wedding plans. Instead of paying Judith in cash, her homeowners insurance policy gives the insurer the right to: A. assign recovery rights to her ex-fiancé. B. replace the missing ring. C. annul the engagement in writing. D. deny coverage. B. replace the missing ring. Which is NOT a bodily injury for purposes of coverage by the business auto policy (BAP)? A. disease. B. death. C. mental trauma. D. illness. C. mental trauma. A businessowners property coverage applies to: A. Business personal property. B. Real estate and improvements. C. Buildings alone. D. Buildings, business personal property, or both. D. Buildings, business personal property, or both. The purpose of uninsured motorists coverage is to: A. protect insureds from drivers who have no auto liability insurance B. protect uninsured divers from claims for bodily injury C. protect uninsured drivers from claims for damage to their own autos D. protect insureds from drivers with inadequate limits of auto liability insurance 2 A. protect insureds from drivers who have no auto liability insurance.....? Which is NOT considered equipment under the equipment breakdown coverage form? A. electric motors B. vacuum tank C. computers D. laboratory beakers D. laboratory beakers...? A contractor hires 15-year-old Kevin as a part-time employee to cut lumber, knowing the law does not permit Kevin to work near power tools because of his age. Kevin accidentally cuts his finger off while using a power saw. The liability coverage of the contractor's workers compensation and employers liability insurance policy: A. covers the claim for injuries and any resulting punitive damages. B. does not cover this claim because it involves intentional injury. C. covers this claim, because Kevin was an employee injured on the job. D. does not cover this claim because the contractor knew it employed Kevin in violation of the law. D. does not cover this claim because the contractor knew it employed Kevin in violation of the law. What kind of insurance is the coverage in an ocean marine insurance policy that protects a shipowner against a covered loss to the vessel but not to its cargo? A. hull insurance B. collision insurance C. protection and indemnity insurance D. physical damage insurance A. hull insurance.....? Why is a homeowners insurance policy considered a package policy? A. It combines two or more separate coverages in a single policy B. It is associated with home ownership C. It is usually sold with other policies D. It comes in a policy binder A. It combines two or more separate coverages in a single policy Speedy Trucking Company owns a fleet of trucks. Other companies hire Speedy to transport their cargo. What kind of company is Speedy? A. for-hire carrier B. livery service 5 In what way does a public adjuster differ from a staff or independent adjuster? A. Public adjusters represent insureds, while other adjusters represent insurers. B. Public adjusters are government employees. C. Public adjusters work only with claims below a certain value. D. Public adjusters specialize in certain claims. A. Public adjusters represent insureds, while other adjusters represent insurers. The business auto policy (BAP) may include all of the following EXCEPT: A. business auto declarations B. business auto coverage form C. personal auto insurance D. common policy conditions form C. personal auto insurance........? A claims adjuster ls NOT required to keep a complete and accurate claim file to: A. help the insurer deny the c1aim B. facilitate examination by insurance regulators C. document the activities related to the adjustment of the claim D. enable others to service the claim 1f the adjuster 1s unavailable A. help the insurer deny the c1aim Everette's ski shop does most of its business in the winter. He replenishes his stock during the fall, when he is often underinsured, and keeps a minimal inventory during the spring and summer, when he is actually overinsured. What property endorsement would suit his needs for coverage? A. weather guard. B. peak season. C. inflation guard. D. foliage. B. peak season. Many inland marine insurance policies accompany covered property whether it remains in a single location or moves from one location to another. Because of this, what are inland marine policies often called? A. drifters B. floaters C. sliders D. gliders B. floaters 6 Marty drives to Ritzy Restaurant. After parking in a nearby lot he slips on the icy pavement and breaks his ankle. Two months later, he submits his $1,000 medical bill to Ritzy Restaurant for payment. Why might Ritzy's commercial general 1iability insurer refuse to pay this claim under Coverage C-medical payments? A. The injury involved a member of the public B. The injury occurred off the insured premises C. Ritzy's negligence caused the accident D. The injury was caused by Marty's negligence B. The injury occurred off the insured premises....? When adding business income coverage to an equipment breakdown policy, the insurer requires the insured to complete an annual report of values form. Among other things what is this this form used to determine? A. The insured's loss experience as regards past equipment breakdowns B. Whether the insured qualifies for business income coverage C. The amount to be paid to the insured in the event an equipment breakdown causes a loss of income D. the depreciation of covered equipment C. The amount to be paid to the insured in the event an equipment breakdown causes a loss of income........? Which health insurance policy pays a benefit if the insured dies or is dismembered because of an accident? A. accidental death and dismemberment (AD&D) po1icy B. Medicare supplement policy C. medical expense policy D. disability income policy A. accidental death and dismemberment (AD&D) po1icy Jordan converts her home's attached garage into an apartment that students rent year-round for $300 each month. A tenant accidentally starts a fire in the apartment making it uninhabitable for three months while the damage is repaired. Which coverage in Jordan's homeowners insurance policy covers her rental income loss? A. civil authority prohibits use B. reasonable repairs C. additional living expense D. fair rental value D. fair rental value....? 7 Nigel and Collette form N&C Company, a partnership that is the named insured in a businessowners policy. For purposes of liability coverage, who Is NOT an insured? A. a customer who sues N&C B. Collette's husband C. the bookkeeper D. N&C Company A. a customer who sues N&C Pierre's homeowners policy often refers to "we." He correctly determines that "'we" means: A. the insurance agent who sold the po1icy B. thee insurance company C. the insurance industry D. Pierre and his family B. thee insurance company........? Who of the following would be able to buy insurance to cover their potential losses from the activity described? A. Judith, who has just purchased an automob1le B. Jimmy, who places bets on horse races C. Darryl, who buys land as a speculative investment D. Suzanne, who trades stocks online A. Judith, who has just purchased an automob1le......? Justin is employed by Quarry Works Inc. After ten years of working in various positions, he learns that he has silicosis. To ensure his condition will qualify as an occupational disease under most workers compensation laws. What must Justin demonstrate? A. The condition arose out of and m the course of his employment B. The condition was caused by the negligence of his employer C. The condition specifically relates to his most recent job tasks D. The condition was caused by the negligence of another employee A. The condition arose out of and m the course of his employment......? A retired artist Amber gives free evening lessons in her home to promising young artists. According to hers homeowners insurance policy, why is her giving lessons not considered a business? A. Because she is retired B. Because she receives no money or other compensation C. Because she only does it part time D. Because art is a talent 10 Earl's businessowners policy has a liability and medical expenses limit of $300,000. Five customers are injured in an explosion. Each is awarded $150,000 in damages. How much will Earl's insurer pay in response to this claim? A. $300,000. B. $150,000. C. $750,000. D. $1,500,000. A. $300,000. Salvador's business does not own any vehicles, but Salvador sometimes rents a van to make deliveries. Most deliveries are made by employees who use their own cars. How should Salvador's businessowners policy be modified to address his auto liability exposures? A. A hired auto and nonowned auto liability endorsement should be added. B. A nonowned auto liability endorsement alone should be added. C. A hired auto liability endorsement alone should be added. D. The BOP automatically includes nonowned auto liability coverage, so no modification is needed. A. A hired auto and nonowned auto liability endorsement should be added. The business auto policy (BAP) provides the broadest possible liability coverage when what symbol is used for liability? A. symbol 10. B. symbol 7. C. symbol 2. D. symbol 1. D. symbol 1.....? Genevieve wants to renew her Florida Insurance Adjusters license. Which of the following is not a condition for renewal? A. fulfillment of continuing education B. payment of the renewal fee C. submission of a renewal form D. report of insurance sales made in the last two years D. report of insurance sales made in the last two years Despite having its liquor license revoked, a restaurant fails to inform its insurer and continues to serve alcoholic beverages. A customer is involved in a serious auto accident and sues the restaurant under the applicable dram shop act. How will the insurer respond? After several violations, Napoleon Bar and Grill's liquor license was revoked. Napoleon did not inform its insurer of this fact and continued to serve alcohol to its regular customers including Brett. After a long night at the bar, Brett was involved in a serious auto accident and sued Napoleon under the applicable dram shop act. Napoleon's liquor liability 11 insurance: A. provides coverage because Napoleon was selling alcoho1ic beverages B. provides no coverages because the accident occurred away from Napoleon's premises C. provides no coverage because Napoleon's required license was not in effect D. It will provide coverage if serving alcohol was incidental to the restaurant's primary business as a restaurant C. provides no coverage because Napoleon's required license was not in effect........? Public officials in Robyn's community adopt a new building code. Although existing bui1dings are grandfathered, the new code specifies that any noncomplying building that is more than 50 percent damaged must be demolished and rebuilt to comply with the code. Which endorsement does Robyn need in her commercial property policy to cover this risk? A. ordinance or law B. builder's risk C. value reporting D. building materials A. ordinance or law Kathie is the only person named in the declarations of her homeowners insurance policy. When her policy refers to an "insured" it does NOT include: A. Kathie's husband B. Kathie's father-in-law who lives in her house C. Kathie's next-door neighbor D. Kathie C. Kathie's next-door neighbor To operate as an insurance agency in Florida an agency is required to: A. appoint at least two agents to manage the agency B. appoint the Office as its agent for service or process C. obtain a license or reg1strabon from the state D. have transacted insurance in Florida for at least two years before apply for a license C. obtain a license or registration from the state Owen's house is damaged when Latrice's car crashes into it. After Owen's insurer pays to repair the house, the insurer tries to recover its costs from Latrice. What provision in Owen's policy gives the insurer this right? A. subrogation B. recovered property 12 C. assignment C. loss settlement B. recovered property? Which activity would fall outside the definition of "farming" in the standard farm liability coverage form? A. Selling farm produce from a roadside stand B. Selling tee shirts at a farmer's market in the city C. Crop dusting D. Field Irrigation B. Selling tee shirts at a farmer's market in the city? Holly routinely charges her clients an extra amount in addition to the premium stated In the insurance policy to cover her own personal administrative expenses. What is true about Holly's actions? A. They are lawful B. They are lawful if the client agrees in writing C. They are unlawful D. They are lawful in most cases C. They are unlawful....? Which of the following is NOT one of the duties of the Department of Financial Services? b. Dept does NOT set rates nor write policies Set rates and write policies for various company products The adjuster has a particular relationship to his principal, the insurer. Which of the following best describes this relationship? It is a fiduciary relationship. The Claims Adjuster's role in the insurance industry includes all the following EXCEPT: Gives appropriate legal advice and writes binding contracts All of the following activities are illegal for an adjuster, EXCEPT: Use only company forms to prepare releases All of the following are part of the conditions imposed upon the insured in the event of a loss, EXCEPT: Insured should negotiate on behalf of the company for 3rd party claimants. A claimant was given a settlement, which stipulated, that if the claimant did not contact the company within a certain period of time, the claim would automatically close. No release was signed. Which of the following best describes this method of settlement? No release or walk-away 15 Employee injuries-covered under worker compensation Liability for pollution, except from the normal operating fluids of the vehicle. Liability arising from mobile equipment. Which of the following is covered under the Garage Policy? Garage location If an insured has $100,000 of "unstacked" UM, and 2 cars on the policy, how much is available under a UM claim? $100,000 An insured has $100 deductible Other Than Collision, and $250 deductible Collision. If a rock breaks his windshield and repairs total $675, how much will be paid? $675, under Other Than Collision, with no deductible When searching for insurance solutions to pay for personal injuries from an auto accident, the order of payment in Florida in most cases, would be: PIP, Med Pay, Liability, Uninsured Motorist An insured and his spouse have two cars insured under a Personal Auto Policy. What coverage is available for a car that the wife borrows from a friend to use for the weekend? The borrowed car would have the broadest coverage available on the policy. Jack is involved in an accident - he is driving his car when hit by an at-fault driver, Sam. (Florida residents). Jack has two more cars at home. Both Jack and Sam have Basic PIP with no deductible, Med Pay coverage of $5,000, Liability of 50/100/50, and Stacked Uninsured Motorist of $50,000 on each car that they own. Jack has a medical claim of $215,000. How much will Jack's Uninsured Motorist pay for this claim? $150,000 An insured buys an ISO Mechanical Breakdown Coverage Policy on his used car. For what length of time and mileage will he have coverage? 12 Months / 12,000 Miles If Jack has an accident that is his fault, Jack has liability insurance with 10/20/10 limits, Extended PIP with no deductible, & Med Pay of $2,000 ... what is the maximum potential payment from Jack's Personal Auto Policy to a guest passenger, who suffers injury and does not own an auto, has no auto insurance and has $42,000 in medical expenses? $22,000 (PIP $10,000; Med Pay $2,000; BI $10,000) UM (Uninsured Motorist) coverage under the PAP (Personal Auto Policy) pays for: bodily injury to the insured caused by hit and run driver Lender's interests in REAL property are protected with a Mortgage clause, how are lender's interests protected in personal property - such as automobiles? 16 Loss payable clause While driving on the Pennsylvania Turnpike, William's auto has a collision with a deer that jumps in front of his car. In order for coverage to be afforded, William's Personal Auto Policy must have: Other than Collision coverage An insured took his TV to a shop for repairs, on the way, he stopped suddenly and the TV fell off the seat, breaking the TV. How will his PAP (Personal Auto Policy) respond? The PAP will not respond. An insured has "Stacked" Uninsured Motorist with 25/50 limits on each of 2 vehicles that he owns. How much Uninsured Motorist coverage is available to the insured in the event of an accident with a hit & run driver? 50/100 The "trigger" of the financial responsibility law is: An accident involving bodily injury or property damage rendering the vehicle inoperable or a serious violation such as DUI. Which of the following is the lowest single limit automobile liability that meets the requirements of the Florida Financial Responsibility Law? $30,000 An insured had an accident in another state that required liability limits of 25/50/25. Our insured had 10/20/10 limits. What happens if the liability he incurs exceeds 10/20/10? Our insured's policy will respond to the higher limit of the other state Joe has 10/20/10 liability limits, and he borrows Sue's car. Sue has 15/30/15 limits of liability. Joe injures a pedestrian while driving Sue's car and the pedestrian's medical bills due from liability total $22,000 (PIP & Med Pay are paid out in full). How much is paid from Liability? Sue's policy pays $15,000 & Joe's policy pays $7,000 Your insured has purchased the minimum split limit policy that meets Financial Responsibility Law in Florida. He causes the following bodily injuries to passengers: Carl $12,000 Jeanne $10,000 Charlie $10,000 How much will his policy pay? $20,000 for the total BI portion of accident An insured has 25/50/25 limits and injured another person. The injured person won a tort claim for $30,000 against the insured and the insured's attorney charged $7,500 to defend the insured. How much is paid by the insured's insurance company? 17 $32,500, the policy limit and the attorney's fees for defense. Which of the following is NOT one of the "thresholds" in the "No-Fault" law? The temporary injury of the insured Which of the following is a "defined motor vehicle" under Florida No-Fault law? 9,500 pound SUV If an insured is injured by an at-fault driver, and has injuries of $5,000, what amount will PIP pay if he has Florida No-Fault Basic PIP with a $1,000 deductible? $3,200 Which of the following could NOT be considered an "owner" of a motor vehicle? A long term lease of 3 months Which of the following is true concerning the extended PIP endorsement? Medical expense reimbursement is raised from 80% to 100% When an Additional PIP Endorsement is added to the Personal Auto Policy, we know that the policy already has Extended PIP Endorsement Nonresidents must comply with the Florida No Fault law: If their auto is in Florida over 90 of the last 365 days When is the named insured NOT entitled to PIP benefits? Injured outside of Florida while a pedestrian struck by a defined motor vehicle Which of the following statements is false concerning No-Fault Auto Insurance? Negligence must be established. An insured has Basic PIP with no deductible, in an accident he incurs medical bills of $8,000, $1,000 in lost wages, and $500 in replacement services - how much will PIP portion of policy pay? $7,500 Jane is a Florida resident with an auto. She has PIP coverage of $10,000 with no deductible. If she is in an auto accident and has medical bills of $10,000, how much will her PIP pay? $8,000 If Jane also has work loss of $1000 due to the auto accident, how much will her PIP pay for work loss? $600 20 Sam will be paid for all 22 days, since the 7 day waiting period is not imposed if the disability lasts more than 21 days All the following are components of the Workers Compensation EXCEPT: Unlimited death benefits What is the limit on medical benefits under Workers Compensation? All medical costs with no limit The following are employees who must have workers compensation EXCEPT: Pro athletes A claimant ate some undercooked fish and got violently ill at the restaurant. Which of the following would pay for this occurrence? A premises and operations form Which of the following are covered exposures for bodily injury and property damage under the CGL (Commercial General Liability) Policy: Products and completed operations Contractual Liability Contingent Liability Who is covered for their exposure under the CGL - Commercial General Liability Policy? Employees of the business Volunteers, legal representative, trustee Real estate manager Under a CGL Occurrence liability form, which policy would cover an accident that occurred June 1, 1998, and was discovered and reported July 15, 2008: A policy dated 1/1/98 to 12/31/98 Under CGL, the Occurrence form - bodily injury or property damage must occur during the policy period - reporting of the claim may be: within policy period or thereafter with no limit on time Under CGL Claims-made form, the Supplemental extended reporting period: May extend the reporting period from one year to an indefinite time. A furniture manufacturing business wanted to serve free beer at its company picnic. What is required for this business to have liability coverage for liquor consumption at the picnic? The business CGL policy will cover this exposure Insurance agents and adjusters may have their professional activities covered under a type of liability insurance called: Errors and Omissions Liability Which of the following is true concerning the definition of "accident" under the CGL (Commercial General Liability) ? 21 An accident may include continuous and repeated exposure to the same condition. The coverage for damage to an aircraft under the care, custody, or control of the insured while the plane is in for storage or service is: Hangarkeepers liability Under the commercial property form, what length of time must expire before a building is considered "vacant", thus suspending some coverages, while reducing payment on others? 60 Days A florist wanted coverage on business contents that vary in amount over the course of a year. Which form best covers this situation? The value reporting endorsement Both commercial property and liability were combined into one policy, thus saving money on underwriting expense. What is this combination called? A package policy A ship loaded with lumber encountered a terrible storm, and some of the lumber was thrown overboard to save the ship - this action is called: Jettison A contractor was concerned some of his tools, such as a welder, could be stolen from the job site. What inland marine form is best suited for this exposure? The contractors equipment floater In Commercial Policies - Vacancy of more than 60 days suspends coverage on all the following EXCEPT : Windstorm Condominiums may be covered by both an Association (Commercial Condo) Policy and a Unit Owners' (Homeowners) Policy, which of the following is true? The Association Policy is primary and the Unit Owners' Policy is excess There are advantages of an agent recommending a commercial package policy over several monoline policies. Which of the following is an advantage? The package policy is easier to rate and sell - more efficient .In the package policy, coverage gaps are less likely to occur. Premium savings may result from a package policy. A shipper contemplates 10 or 11 loads of produce to be shipped to Pennsylvania over the course of the next 12 months. What inland marine coverage best fits this exposure? An annual transit policy Commercial leases have special coverages in the Leasehold Coverage Form due to the fact that 22 they are long-term often with investment in the real estate. A home oxygen service must continue to supply its customers even if the facility is destroyed by a fire. Consequently, the service may make purchases from one of its competitors to keep their own customers supplied with medically necessary equipment in order to have the opportunity to stay in business. Where is this type of insurance coverage found ? Extra Expense Coverage form A community applied to be part of the National Flood Insurance Program. Until they are approved, what is the status of the community? They are in the emergency program Which of the following would be excluded (NOT covered) under a personal articles floater on an "all risks" basis? Insects destroy a valuable postage stamp worth $500 Which of the following is false concerning flood insurance? To be insured for flood, a new building only must have the walls up. All of the following are EXCLUSIONS under a personal articles floater (Personal Inland Marine Policy) EXCEPT: Theft An Umbrella Policy may be broader than the underlying policies and respond as primary coverage. When the Umbrella is PRIMARY, there is an amount to be paid by the insured before the Umbrella will pay. What is this amount called? The self-insured retention All of the following may qualify for a dwelling policy EXCEPT: A 6 - family dwelling All of the following are eligible for a Homeowners Policy EXCEPT: A beach house owned by Acme Corporation The principle of "insurable interest" is important in the dwelling policy as well as other kinds of insurance. Which of the following does not have " insurable interest" in the described property? One who attends a Mary Kay party at a friend's property Aunt Mary lives with the insured Homeowner. A thief steals her hearing aid. The HO-3 will: Cover within the limits of the H/O policy Which of the following is eligible for a Homeowners policy? I. Susie, who has purchased a condo unit for her residence. 25 Jack and Connie - both 50 years old and of sound mind - agree to have Jack burn down Connie's house for $10,000. What element of a valid contract is missing? Legal purpose Risks that are insurable are: Pure risk Insurance that covers the responsibility for loss arising out of policy holder's negligence - that results in payment to a party other than the insured is: Liability The goal of insurance is to restore the insured to the same economic position as before the covered loss occurred, this is the principle of: Indemnity At the end of this course, you must do which of the following? Pass the final course exam with a scored of 70% or higher Print your certificate from this website Apply for your Insurance Adjuster license at the Florida Department of Financial Services website at www.myfloridacfo.com/division/agents 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 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 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 C. Liberalization D. All of the above 26 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 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 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. A. Doctrine of Proximate Cause B. Doctrine of Perils & Hazards C. Insurance Policy Handbook D. Doctrine of Property Insurance A. Doctrine of Proximate Cause For example, if a property insurance policy covers the peril of fire but further damage is caused by smoke, water used to extinguish, and the process of moving property away - fire is considered to be the proximate cause of all of the damage. The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as? A. Actual Cash Value B. Replacement Cost C. "Old for New" D. None of the Above A. Actual Cash Value A policy condition, either based on information in the insured's application or inserted by the insurer, is defined as: A. Warranty B. Misrepresentation C. Concealment D. None of the Above 27 A. Warranty The following are basic characteristics of a property or liability insurance contract, except: A. Personal Contract B. Conditional Contract C. Loss of Settlement Contract D. Contract of Adhesion 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, to protect the property against further loss, and to give the insurer proof of the loss is defined as? A. Conditional Contract B. Adhesion Contract C. Indemnity Contract D. All of the Above A. Conditional Contract "may be conditioned" Which of the following is not one of the "Thresholds" in the "No-Fault" law? A. Death of the Insured B. Temporary Injury of the Insured C. A permanent loss of a bodily function D. Permanent scarring on the face of the insured 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 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 C. Both A & B 30 B. DP-2, or the Broad C. DP-3, or the Special Form D. None of the Above 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 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 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. 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 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 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. Under a Homeowner's Policy, what coverage will pay for the hotel room bill? A. Fair Rental Value B. Value Obligation 31 C. Loss of Use D. Insurers Duties 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 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 B. Personal Condominium Unit Owners Form C. Condominium Unit Owners Form D. None of the Above C. Condominium Unit Owners Form Does not cover buildings since coverage would typically be provided under the Condo Association coverage form issued. The Commercial Property Contract includes all of the following, except: A. Common Policy Conditions B. Commercial Property Conditions C. Coverage Form D. Commercial Loss Schedule 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: A. Condominium Association Form B. Condominium Unit Owners Form C. Condominium Insured Owner Form D. None of the Above A. Condominium Association Form This, along with Condo Unit Owners Form, is located under Condo Coverage. 32 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: A. Business Property Insurance B. Building Property Insurance C. Commercial Property Insurance D. None of the Above 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. A. 25 B. 90 C. 45 D. None of the Above C. 45 Also, notice must state reasons the policy is not to be renewed. 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 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 D. 45 days Used to cover buildings in the course of construction: A. Builders Risk Policy B. Builders Replacement Policy C. Construction Replacement Policy D. None of the Above A. Builders Risk Policy Includes: structure being built (including foundations), fixtures and machinery, equipment to service 35 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 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 D. None of the Above 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 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 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. 36 The following are classes of disability, except: A. Permanent Total B. Temporary Total C. Permanent Impairment D. Temporary Full 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 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 B. The Retrospective Rating Plan C. The Risk Plan D. None of the Above A. The Experience Rating Plan This, along with Retrospective Rating Plan, is a manual rating process until premiums reach a certain level. Under workers compensations, a rate is charged for every __________ of payroll to employees. A. $100 B. $1,000 C. $10 D. $500 A. $100 The National Council on Compensation Insurance enforces this rating. Under Workers Compensation, Part Four Your Duties if Injuries Occur, an employer is required to: A. Provide the names/addresses of injured persons and witnesses B. Promptly provide any legal papers C. Cooperate and assist as insurer requests D. All of the Above D. All of the Above Also included: immediate contact with insurer, providing immediate medical or other services, do 37 nothing to interfere with insured's right of recovery, make no voluntary payments or assume any obligation except at employer's own cost. Under Workers Compensation, Employers Liability includes: A. Claims by others for the liabilities to insureds employees B. Claims by relatives of injured employees for consequential damages C. Claims made by employees that are not subject to Workers Comp Laws D. All of the Above D. All of the Above 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? A. A products and completed operations form B. A premises and operations form C. An owners and contractors protective liability form D. None of the Above D. None of the Above Samantha is not an employee of the barbecue joint; Workers Comp does not apply. 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: A. Cost-Plus Rating Plan B. Experience Rating Plan C. Retrospective Rating Plan D. None of the Above 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 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: A. $1,000 B. $2,000 40 Which of the following are NOT a type of bond? A. Contract B. Fiduciary C. Court D. Apprentice 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 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 C. Surety 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 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 A. Principal Obligee - needs guarantee principal will perform Surety - guarantees performance between principal and obligee 41 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 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 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 D. All of the Above Principal - undertakes to perform/fulfill Obligee - guaranteed principal will perform Surety - guarantees performance *Indemnitor - may act as additional party; agrees to reimburse surety for any loss This type of bond covers streets, sidealks, sewers, etc.: A. Sidewalk B. Subdivision C. Supply D. None of the Above B. Subdivision Falls under Maintenance Bond 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: A. Public Official Bond B. Lost Instrument Bond C. Public Instrument Bond D. None of the Above 42 B. Lost Instrument Bond Also guarantees to save issuer from any loss growing out of lost instrument 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. A. HMO B. Major Medical Insurance C. Coinsurance D. PPO D. PPO Most plans provide that emergency treatment will be paid even if treated party does not go to service provider on approved list. Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance: A. Hospitilization B. Hospital Indemnity C. Hospital Services D. All of the Above B. Hospital Indemnity This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force: A. Waiver of Subrogation B. Waiver of Premium C. Waiver of Value D. None of the Above 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 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 45 Representative's license D. This practice is only acceptable if the product training was certified by the Life Insurance Company C. This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services. A. True B. False 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 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 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. A. True B. False 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 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 46 B. Limited Customer Representative 4-42 C. General Lines Claim Adjuster 6-20 D. General Lines Agent 2-20 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 A. True 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 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 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 C. Claims Adjuster D. All of the Above C. Claims Adjuster Commonly referred to as claims auditor Establishing a dollar value on a claim is defined as: A. Negotiation B. Evaluation C. Adjusting D. None of the Above 47 B. Evaluation For bodily injury and uninsured motorist claims, a settlement range will be set rather than a single dollar amount Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as: A. Junk B. Salvage C. Covered Property D. Peril B. Salvage Efficient disposal of salvage reduces amount of loss to either insured or insurer The voluntary or intentional relinquishment of a known right is defined as a(n): A. Waiver B. Estoppel C. Avoidance of Performance D. None of the Above A. Waiver The law recognizes two types: express and implied. The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to: A. Conduct B. Work Habits C. Claim Handling Activites D. All of the Above D. All of the Above The adjusters basic activities in claims handling are: A. Investigation B. Evaluation C. Negotiation D. All of the Above D. All of the Above 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 50 B. Rating and underwriting rules 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): A. Company or Staff Adjuster B. Fee Adjuster C. Public Adjuster D. Bureau Adjuster A. Company or Staff Adjuster 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 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 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 B. Salvage It cannot be restored to prior condition 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 A. Third Party Claim 51 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 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 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 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 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 D. Certificate of Authority A. Appointment Licensees are given authority through the appointment process 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: A. 1 Year B. 6 Weeks C. 1 Month D. 6 Months D. 6 Months 52 How many continuing education hours must an insurance adjuster complete every 2 years? A. 12 B. 20 C. 24 D. 14 C. 24 Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices: A. False Statements B. Unfair Discrimination C. Unlawful Rebates D. All of the Above D. All of the Above 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: A. Automobile Agent B. Automobile Representative C. Limited Customer Service Representative D. Limited Customer Service Agent C. Limited Customer Service Representative 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. Life Agent B. Life Representative C. General Lines Agent D. None of the Above A. Life Agent 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: A. Churning B. Sliding C. Soliciting D. None of the Above 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 55 Bid Form of bond required to accompany a bid for a contract which will require that successful bidder furnish further bond if awarded job. Agreement to fulfill a contractual obligation used frequently in construction and supplying goods PPO (Preferred Provider Organization) Selected group of hospitals and medical practitioners in given area who have joined together in an effort to reduce medical costs HMO (pre-paid fixed fee) (Health Maintenance Organization) Provides comprehensive health services to its members for a prepaid fixed fee equivalent to an insurance premium Domestic Insurer formed under laws of this state Foreign Insurer formed under laws of another state, district territory, or commonwealth of U.S. Alien Insurer other than domestic or foreign (outside U.S.) Sliding Selling an item and stating that it is required by law Waiver Voluntary relinquishment or surrender of some right or privilege Fiduciary 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 Establishing a dollar value on a claim. Determines the fair payment in accordance with the contract and applicable law Negotiation A quality settlement based on facts discovered during the evaluation process Estoppel 56 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 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 Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss. Motor vehicle or mobile home is a total loss Appointment Authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf Derelict 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 Implied Waiver May result from some act of neglect on part of the adjuster Express Waiver Occurs when insurer or its representative knowingly gives up a known right under insurance contract Mechanical Breakdown Coverage Covers repairs to mechanical parts of your vehicle that break; even covers in events not related to an accident Identify examples of peril. 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? 30 days What is the coinsurance clause and how might it apply to a given scenario? 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. 57 Almost without exception, the percentage is 80% in coinsurance clauses of homeowner policies - this means the insured should carry 80% of replacement cost if they don't want to be penalized at the time of loss. What are the minimum requirements for the Financial Responsibility Law? (there are two) 1. legal valid claims of others must be satisfied up to the 10/20/10 requirements 2. owner/operator must provide certification of financial responsibility for future accidents What is PIP and how may it apply to a given scenario? Personal Injury Protection with limit of $10,000 per person, per accident If Jeremy has a not-at-fault accident and he has PIP with a $1000 deductible, he can expect PIP to pay $1,600 of his $3,000 medical bill. (3,000 - 1,000 = 2,000 x .80 = 1,600) What is the difference between PIP and Workers Compensation? Which one is excess? PIP is primary against all other forms of medical and disability insurance coverage. Florida courts have held PIP is excess over Workers Comp. To eliminate duplicate recoveries, the law prohibits persons who have received PIP from recovering same amounts from others in legal liability actions. What are the basic PIP benefits? 1. Medical; 80% of reasonable expenses are paid for necessary medical, surgical, x-ray, dental, and rehab services 2. Work Loss; 60% of any loss of gross income and loss of earning capacity is reimbursed 3. Replacement Services; 100% for cost of having household services performed by others which the injured person would have normally performed 4. Death; $5,000 IN ADDITION to the $10,000 in medical/disability benefits afforded by PIP How does PIP apply to pedestrians (in and out of state)? PIP applies to Florida residents if struck by insured's motor vehicle while not occupying a self-propelled vehicle (a pedestrian). In situations wherein PIP does not apply, named insured and relatives occupying or struck by others vehicles out-of-state; nonresident passengers out-of-state; and nonresidents as pedestrians in Florida - The No-Fault Law has no applicability and usual legal remedies and other insurance coverage's are to be relied upon. When can Other-Than-Collision (Comprehensive Coverage) be used? When there is damage to your vehicle not caused by a collision (hail storm damages hood, animal runs into car, windshield replacement) What are the penalties for not complying with the No-Fault Law? 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 60 1. General Lines Agent 2-20: licensed to write property/casualty, surety or health insurance. 2. Customer Representative 4-40: must be licensed, appointed by a General Lines Agent and may assist in transactions in the OFFICE ONLY 3. Limited Customer Representative 4-42: must be licensed, appointed by a General Lines Agent and transact AUTO insurance in the OFFICE ONLY. 4. All Lines Claims Adjuster 6-20: investigates, Evaluates and Negotiates Claims What are some reasons for suspension, revocation, or termination of a license? 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. 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 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? 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? Inquiry, verification, comparison What are the Code of Ethics for adjusters? 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 61 copy. 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. Peril Something that causes a loss. Hazard Something that increases the probability that a loss will occur. Warranty A policy condition, either based on information in the insureds application or inserted by the insurer. It is a guarantee of a fact. Misrepresentation 62 An untrue statement by the insured, made in an application for insurance but which does not become a part of the policy. Concealment The failure of the insured to reveal relevant facts known to the insured in applying for insurance. Abandonment Property insurance policies usually contain an abandonment clause, stating the insured cannot dump damaged property on the insurer and demand its full value. Severability The insurance applies separately to each insured as if other insureds did not exist. Proximate Cause The cause having the most significant impact in bringing about the loss under a first-party property insurance policy, when two or more independent perils operate at the same time (i.e., concurrently) to produce a loss. Courts employ a set of rules to resolve causation disputes when a property policy states that it covers or excludes losses "caused by" a peril and there is more than one peril at work in a fact pattern. Under common law, whether the policy provides coverage depends on which peril is chosen as the proximate cause. 65 1.) Implied voluntary relinquishment, abandoning a legal advantage, need, claim or right. 2.) Agreement or added clause of a policy that excludes some losses or limits the sum of a claim, or extends coverage to add items not in a normal policy. Express Waiver Occurs when the insurer or its representative knowingly gives up a known right under the insurance contract. Implied Waiver A waiver that is assumed to be in effect from a person's behavior and shows he is waiving a right. Damages Monetary compensation that is awarded by a court in a civil action to an individual who has been injured through the wrongful conduct of another party. Subrogation When an insured has a right to collect damages from another party, but instead elects to claim the damages under his insurance policy, his rights against the other party are transferred to the insurer. Changes All policies provide that any changes to the policy be made by the insurer, in writing. Policy Period The condition states that coverage applies only to losses or occurrences that take place during the policy period. (Prior to the stated date and time of termination). Policy Territory Condition limiting coverage to occurrences or losses that take place only within a stated geographical region. Other Insurance The principle of indemnity dictates against duplicate recovery for the same loss. Cancellation The insured may cancel at any time, for any reason, without advance notice. If the conpany wishes to cancel, it must provide some degree of advance notice so the insured will have time to replace the coverage. 66 Appraisal A written contract of or written agreement for or effecting insurance, or the certificate thereof, by whatever name called, and includes all clauses, riders, endorsements and papers which are a part thereof. Insurance Is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Binder Acts as a temporary contract until the policy is issued. How many days should an insurer give for prior notice of cancellation of a binder? 5 days. Property Insurance Any insurance wherein payment by the insurer will be paid directly to the insured or other specifically named interests. Liability Insurance Payment will be on behalf of the insured to another, based upon the insureds liability to the recipient. Simply stated, Liability is "Negligence of the Insured". Loss Payee Clause A Clause in a contract of insurance that provides, in the event of payment being made under the policy in relation to the insured risk, that payment will be made to a 3rd party rather than to the insured beneficiary of the policy. Mortgage Clause A property insurance provision granting special protection for the interest of a mortgagee named in the policy, in effect setting up a separate content between the insurer and the mortgagee. 67 Other Structures Covers items that are not permanently attached to the main dwelling, such as a shed, fence, etc. Commercial Inland Marine Helps identify the kinds of risk which are eligible for either ocean or inland Marine insurance. Building Ordinance Coverage This endorsement covers the insured for enforcement of laws which require demolition of undamaged portions of buildings. Umbrella Policy Covers a much higher limit and goes above and beyond claims directly relating to your home and auto, it provides your assets from an unforeseen event, such as a tragic accident in which you are held responsible for damages or bodily injuries. Known Loss Prevents an insured from coverage if the insured knew the loss was probable at the time of the insurance contract. Value Reporting The limit of coverage is set at an amount somewhat higher than expected peak values. Commercial Property Insurance Covers direct and indirect losses related to properties other than one to four family dwellings and farm properties. Employee Theft Provides coverage for loss of or damage to money, securities, and other property resulting from theft committed by an employee. Theft is defined as the unlawful taking of money, securities or other property to the deprivation of the insured. Bid Aggreement to fulfill a contractual obligation used frequently in construction and supplying goods. Health Maintenance Organization (HMO) Provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. Preferred Provider Organization (PPO) A selected group of hospital's and medical practitioners in a given area who have joined together in an effort to reduce medical costs. 70 -Comprehensive Deductible -Towing Coverage -Rental Coverage What are examples of Transacting Insurance? -Solictitation of Insurance -Negotiation of Insurance -Effecting Coverage (Binding insurance coverage) -Transacting Insurance Matters(during and after insurance is bound). What are thresholds of the No-Fault Law ? -Significant and permanent loss of a bodily function or -Permanent injury other than scarring and disfigurement or -Significant and permanent scarring or disfigurement or -Death What is the adjusters investigation limited too ? A simple verification of bills and estimates or it may be expanded to include photographs, witness canvasses, or recorded statements as the circumstances require. What are the componets of a investigation process ? -Inquiry -Verification -Comparison What are some reasons for suspension, revocation or termination of a license ? -Transacting Insurance outside of scope of one's license -Misrepresentation or fraud -Sliding -Demonstration of unworthiness or lack of fitness -Misappropriation of funds -Failure to inform Department of financial services, within 30 days, after pleading guilty or no contest to a felony. Florida Unfair Insurance Trade Practices Act Describes certain practices, penalties are provided for misrepresentation to insureds and claimants and business practices such as -Failing to act promptly -Failure to affirm or deny a claim when an insured is entitled there to -Failure to explain claim denials in writing -Failure to maintain complaint-handling procedures such as keeping accurate records of complaints. Comprehensive Coverage 71 Covers all loss except collision or overturn. Standard deductible is $100 per car, $500 per occurrence applies to losses from theft, mischief, and vandalism. What is the minimum requirements for the Financial Responsibility Law ? -The legally valid claims of others must be satisfied(up to the 10/20/10 requirements) -The owner and operator must provide certification of financial responsibility for future accidents. If not satisfied operator's driver's license and the registrations of all owned vehicle's are suspended. What are the basic activities in claims handling ? -Investigation to establish coverage, determine legal liability, and verify if the alleged damages qualify the loss for payment. -Evaluation to determine the fair payment in accordance with the contract and applicable law. -Negotiation of a quality settlement based on facts discovered during the evaluation process. Claim Is the assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief. Claims Adjuster One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies. Adjusting Process of disposing of an insurance claim. Loan Receipt 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 advanced pending the outcome of a claim against the person responsible for the damage. Apportionment Is a provision for computing and assigning to each of two or more contracts covering a claim its proportion of the amount of the loss. How to settle a claim for an Injured Minor ? Under Fl Law, the adjuster should settle a third-party liability claim of an injured minor child with both parents of the injured child, presuming the settlement is for an amount not in excess of $15,000. If it is more than that it must be consummated through the Circuit or County Courts. What are the violations of the Unfair Trade Practices Act ? -Failing to act promptly. -Failure to affirm or deny a claim when an insured is entitled thereto. 72 -Failure to explain claim denials in writing. -Failure to maintain complaint-handling procedures, such as keeping accurate records of complaints. Section 624.155 of the Florida Statues provides ? That any person who is damaged by certain insurer practices is granted a right to sue the insurer for damages. The Principle Of Utmost Good Faith An insurance contract is based, places serious responsibilities on the claim adjuster with regard to conduct, work habits, and specific claims handling activities. What does 10/20/10 mean ? 10=10,000 Livability per person injured-amount that will be paid out for injuries to one person. 20=20,000 Combined Total Liability for all injuries-this is the most paid out for injuries for an accident. 10=10,000 Property Damage-the most paid out for damage caused to property of others. What is SR-22 ? A form of coverage known as a NAMED NOOWNER policy is required, this form offers insurance coverage only while the insured is operating automobiles owned by others. What are the two things that need to happen for financial responsibility that did not exist at the time of the accident ? -The legally valid claims of others must be satisfied(up to the 10/20/10 requirements). -The owner and operator must provide certification of financial responsibility for future accidents. What are the main elements of the FL Law ? -Those who comply with the law have limited immunity from tort suits. -As one may not be able to seek legal liability damages against another for bodily injuries, the law substitutes, under one's own insurance, the coverage defined as Personal Injury Protection(PIP) How many days does a Non-Resident's vehicle physically present in FL have subject to the No-fault law ? 90 days. What are the three penalties for non-compliance with the compulsory insurance requirements ? -The owner is denied the immunities from legal liabilities that are granted to those who comply. -The owner is personalltly liable for payment of PIP benefits to those entitled to such benefits. -The owner's driver's license and vehicle registration are subject to suspension, as under the Financial Responsibility Law. What does Extended PIP do ? 75 If the insured is in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages, liability associated with serving liquor to intoxicated or underage persons or in violation of a law is excluded. Employee Injuries Coverage excludes liabilities under a workers compensation or similar law or arising from injuries to employees of the insured. Pollution There a basically no coverage for injury, damage or clean up costs caused by pullutants, subject to minor exceptions. What is Coverage B ? Personal and Advertising Injury. What is Coverage C ? Medical Payments. What are the General Liability Insurance Forms ? -Owners and Contractors Protective Liability(OCP)Form. -Liquor Liability Coverage Form. -Products/Completed Operations Liability Coverage Form -Pollution Liability Coverage and Pollution Limited Form. Professional Liability Insurance Coverage Covers liability arising from rendering of or failure to render professional services. Farm Liability Coverage Form Provides coverage for BI or PD arising out of farming operations of personal activities. The Custom Farming Endorsement Provides coverage for liability arising from the insureds performance of farming operations for another, for a charge under any contract or agreement. The Farm Employers Liability/Medical Payments Endorsement Applies the basic Liability and Medical Payments coverages to injuries to farm employees, but not to employees eligible to receive workers compensation benefits. Employment Related Practices Liability This Form provides employers witg claims- made coverage for liability arising out of claims for injury to an employee because of an employment-related offense. Unauthorized Entity 76 An entity that is required to be licensed or registered with the Florida Office of Insurance Regulation but is operating without the proper authorization is identified as an unauthorized insurer. To be Authorized and transact business in FL what must you have ? Certificate of Authority. General Lines Agent 2-20 Licensed to write property/casualty, surety, or health insurance. Customer Representative 4-40 Must be licensed, appointed by a General Lines Agent and may assist in transactions in the OFFICE ONLY. Limited Customer Representative 4-42 Must be licensed, appointed by a General Lines Agent and transact AUTO insurance in the OFFICE ONLY. All Lines Claims Adjuster 6-20 Investigates, Evaluates, and Negotiates Claims. A General Lines Adjuster is required to do what ? Participate in 24 hrs of continuing education every 2 years. A licensee must notify the Department in writing in how many days for change of name, address, phone number or email ? 30 days. Loss Sustained Cover only losses that both occurred and were discovered during the policy period, or within one year of it's expiration. Discovery Any loss discovered during the policy period or within 60 days after it's expiration is called regardless of when it occurred. Property Covered The policy covers only property the named insured owns or holds or for which the insured is legally liable, and for the benefit of the insured. Safe Depository Covers the named insureds legal liability if it is the safe depository for customers property. Perils covered include burglary, robbery, destruction on damage. Valuation 77 Money is valued at its face value; securities at their value on the day loss is discovered; and other property at actual replacement cost or, if less, cost to repair. Government Crime A slightly different set of basic Crime Coverage Forms is tailored for insuring governmental entities. Guests' Property Covers the named insureds legal liability for guest's property while in a safe deposit box or while the property is inside the premises or in the named insureds possession. Commercial Crime Forms Crime Insurance may be written as a separate policy, with it's own Declaration and Conditions, or as a package policy, bundled together with Employee Dishonesty. Forgery Or Alteration Provides coverage for loss by forgery or alteration of negotiable instruments, such as checks, drafts, promissory notes or similar instruments calling for payment of a sum certain in money. Computer Fraud Will pay for the loss of or damage to money, securities and other property resulting from using a computer to fraudulently transport from inside the insureds promises to a person or place outside the premises, which encompasses anywhere in the world. Extortion 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 being held captive. Clients Property Offers coverage for non-owned property for which the insured is legally liable while the property is on the premises of the insureds client. Lesses of Safe Deposit Boxes Covers theft, disappearance, or destruction of securities; and burglary or robbery of property other than money or securities, all from within designated places of safe depository. Funds Transfer Fraud Is designed to cover loss due to the fraudulent transfer of funds through the use of a telephone or fax machine. Securities Deposited with Others Covers theft, disappearance, or destruction of securities, which have been deposited with a custodian, such as a bank or stockbroker. 80 Written The term ethics refers to? service to others, personal respect and proper mode of conduct When an adjuster deals with a claimant who is not a policyholder, this claim is known as an? third party claim The successful adjuster/negotiator should understand that communication includes all of the following EXCEPT? Select one: A. Verbal and non-verbal messages B. Questioning C. Listening D. Decision-making Decision-making Which of the following is not a duty of the claims adjuster? Select one: A. Investigating B. Evaluating C. Negotiating D. Counseling Counseling The adjuster's duty to the insurer is best described as? Select one: A. Friendly B. Factual C. Fun D. Fiduciary Fiduciary Errors and Omissions claims are a result of? Select one: A. unethical behavior B. lack of knowledge or information C. Both unethical behavior and lack of knowledge or information are correct D. Neither unethical behavior and lack of knowledge or information are correct Both unethical behavior and lack of knowledge or information are correct Unethical behavior affects? Select one: A. The claimant 81 B. The adjuster C. All of the above D. The entire company All of the above All of the following are components of negotiating EXCEPT? Select one: A. The issue should be negotiable B. There must be an exchange of value for value C. The parties should trust each other D. The claimant must be satisfied The claimant must be satisfied The Civil Remedies Provision of the Insurance Code states that adjusters should not? Select one: A. Handle claims in a prompt manner B. Accompany claims payments with statements explaining coverage C. Settle claims in good faith D. Try to influence settlements Try to influence settlements The insured, a resident of Florida, was in an accident in Georgia. The Florida car was insured with liability limits of 10/20/10. Georgia's minimum liability limits are 20/40/10. How will the Florida policy respond? Select one: A. 10/20/10 B. 20/40/10 C. No coverage D. 20/40/20 20/40/10 Under a PAP, when does the insurance company cease to defend the insured? Select one: A. The insurance company is not obligated to defend the insured B. After the case has been resolved C. When the policy limit is exhausted D. At the policy's expiration When the policy limit is exhausted The Florida Financial Responsibility Law is triggered by? Select one: A. Registration of the vehicle B. Purchase of the vehicle C. An accident involving bodily injury or property damage D. Purchase of an auto policy 82 An accident involving bodily injury or property damage The insured is an owner and is insured for PIP. She is injured in an accident and has the following damages? medicals-$12,000, lost wages-$6,000. How much will PIP pay if there is a $1,000 deductible? Select one: A. $11,200 B. $12,400 C. $9,600 D. $10,000 $10,000 Trucker insurance premiums are based on all EXCEPT? Select one: A. Radius B. Age of the driver C. Type of business D. Territory garaged Age of the driver Joe works for Sinks-R-Us, Inc. As part of his compensation package, he is supplied with a company car, which he gets to take home every night. Joe wants to make sure the Liability coverage under his PAP covers him while driving his company car. What coverage would you add to Joe's PAP? Select one: A. Named Non-owned coverage B. Extended Non-owned Liability coverage C. Drive Away Liability coverage D. False Pretense coverage Extended Non-owned Liability coverage Dan has a Personal Auto Policy with Liability of 10/20/10 and basic PIP with a $1,000 deductible. He is running one day when a car strikes him. A week later he dies. Medical bills are $7,500 and lost wages are $1,000. How much, if any, will PIP pay in this claim? 10,800.00 Joe is an owner insured for PIP. In which of the following situations does Joe have his PIP benefits available to him? Select one: A. In a slip and fall accident in the mall in Florida B. In an accident while riding his motorcycle C. Struck as a pedestrian in Georgia D. In an accident while riding as a passenger in a friend's car in Florida In an accident while riding as a passenger in a friend's car in Florida 85 B. May purchase UM coverage more than liability limits C. May reject UM coverage in writing D. May elect non-stacked UM coverage in writing May purchase UM coverage more than liability limits The Truckers form that provides liability coverage for damage to non-owned trailers is called? Select one: A. Interchange coverage B. Commercial Trailer coverage C. Trailer Interchange coverage D. Trailer coverage Trailer Interchange coverage Hail damage to an auto is an example of? Select one: A. An exclusion to Part A\-Liability B. An exclusion to Part D-Physical Damage C. Other than collision D. Collision Other than collision Tom is injured in a not at-fault auto accident and has temporary injuries. What can be recovered in a tort claim if he has $16,000 in medical bills with a $1,000 PIP deductible? Select one: A. $6,000 B. $5,000 C. $15,000 D. $10,000 $6,000 The coverage that provides Liability, Medical Payments and Uninsured Motorist for a named individual who does not own an automobile is? Select one: A. Extended Non Owned B. Driver Other Car C. Named Non Owned D. Extended PIP Named Non Owned Uninsured Motorists coverage is used to cover the insured for? Select one: A. Bodily injury only B. Bodily injury and property damage 86 C. Medical payments D. Liability Bodily injury only Sam is an owner and not insured for PIP. Sam borrows Fred's car, which is insured for PIP. Sam has an at- fault accident when he strikes Betty's car. Betty is insured for PIP. As a result of Sam's negligence, Betty is injured and has $5,000 in medical bills. Which of the following is true? Select one: A. Sam does not have Tort Exemption B. Betty may sue Sam and Fred for $5,000 C. Betty must use her own PIP to pay her medical bills D. Sam may recover any damages from Fred's PIP Betty must use her own PIP to pay her medical bills Susie is driving down the street when a dog runs in front of her car. She swerves to avoid the dog and hits a tree. This is an example of? Select one: A. Collision B. Both A and B C. Other than collision D. Neither A or B Collision Which of the following is not eligible for a homeowners policy? Select one: A. Tom who owns the house he rents to his neighbor B. Joe who lives is a garage apartment C. A husband and wife who own a vacation home in Georgia D. Betty who rent a condominium unit Tom who owns the house he rents to his neighbor Homeowner policies are rated on all of the following, EXCEPT: Select one: A. Location of the dwelling B. Age of the homeowner C. Fire protection available D. Construction of the dwelling Age of the homeowner The insured lives in his principal residence 80% of the year. A flood loss would be paid at which of the following? Select one: A. At 80% coinsurance B. Replacement Cost 87 C. ACV D. Valued Policy Replacement Cost Under a Dwelling Policy, all of the following are eligible, EXCEPT: Select one: A. A rental apartment in a commercial building B. A 1-6 family dwelling C. A two-family dwelling owned by a corporation D. A mobile home A 1-6 family dwelling When a community applies for flood coverage, until they are approved they are under: Select one: A. The Regular Program B. The Special Program C. The Emergency Program D. The Flood Program The Emergency Program If an insured sells his house to another person, the buyer is prohibited from receiving the seller's insurance policy because insurance is a contract of: Select one: A. Conditions B. Adhesion C. Indemnity D. A personal nature A personal nature All of the following are eligible for a Homeowner Policy, EXCEPT: Select one: A. Renters who maintain resident in any type of building B. Dwellings owned by a corporation C. Owner-occupants of 1-4 family dwellings D. Condominium unit owners Dwellings owned by a corporation Outdoor equipment used to service the premises is covered under: Select one: A. Coverage C B. Coverage A C. Coverage B D. Coverage D 90 B. $100 C. $500 D. $0 $0 An insured has $200,000 Coverage A dwelling coverage, under his HO-3 Policy. He incurs the following damage from a covered peril: fence - $5,000; gazebo - $7,500; tool shed -$15,000. What will his HO Policy will pay? Select one: A. $10,000 B. No coverage C. $25,000 D. $20,000 $20,000 Which situation is not covered for liability under an HO3 policy? Select one: A. Mike used a 4-wheel ATV to haul yard clippings to his compost pile. A neighbor is on Mike's property and Mike accidentally runs into him with the ATV. B. Mike rents the community center for his son's wedding reception. A guest falls and the guest sues Mike for injuries. C. Mike owns a 16 foot. 100 H.P. outboard motor boat and he has an at-fault accident in which he totally destroys another boat. The owner of the boat sues Mike. D. Someone falls at the house Mike is planning to live in after it is built Mike owns a 16 foot. 100 H.P. outboard motor boat and he has an at-fault accident in which he totally destroys another boat. The owner of the boat sues Mike. Which of the following are available as HO hurricane deductibles? Select one: A. All of the above B. 2% C. 5% D. $500 All of the above If flooding is confined to one area, the flood water must cover: Select one: A. The building B. Over three acres of land C. Over two acres of land D. Over an acre of land Over two acres of land 91 A house under construction is eligible for a Homeowner Policy if: Select one: A. None of these answers are correct B. The builder doesn?t qualify for a Commercial Property Policy C. The builder is licensed D. The insured will be the owner-occupant D. The insured will be the owner-occupant If an Umbrella Policy serves as primary coverage, what part of the policy allows the insurer to apply a deductible? Select one: A. The Stand Alone Form B. The Follow Form C. The Self-insured Retention D. None of these answers are correct The Self-insured Retention The provision in the Builders Risk Coverage Form that penalizes the insured for underinsurance is called: Select one: A. Coinsurance B. Full Reporting C. Agreed Value D. Adequate Insurance Clause Adequate Insurance Clause The insured has a building that has been vacant for 75 days. Which of the following are covered? Select one: A. Theft B. Glass breakage C. Weight of ice and snow D. Vandalism Weight of ice and snow The insured owns a fireworks factory, which is especially busy during the months of June and July. Which endorsement should he purchase to cover his inventory during these months? Select one: A. Building Ordinance B. Value Reporting C. Peak Season D. Inflation Guard Peak Season The Builders Risk coverage form covers: Select one: 92 A. Contractors B. Buildings under construction C. Investors D. Builders Buildings under construction The Builders Risk Coverage Form assumes which coinsurance provision: Select one: A. 90% B. 100% C. 80% D. 70% . 100% In the event that the Condominium Association Coverage form and the Condominium Unit Owners Coverage form both cover a loss, which of the following is true? Select one: A. Both forms pay equally B. The Unit Owner form is primary and the Association form is excess. C. The two forms are prorated D. The Association form is primary and the Unit Owner form is excess The Association form is primary and the Unit Owner form is excess Both commercial property and liability were combined into one policy, thus saving money on underwriting expense. What is this combination called? Select one: A. A monocline policy B. A valid policy C. A combination policy D. A package policy A package policy Under the Business and Personal Property Coverage Form the provision for suspension for certain perils applies after: Select one: A. 60 days vacancy B. 30 days vacancy C. 90 days vacancy D. 120 days vacancy 60 days vacancy Under Business Income Coverage, the period of restoration begins: Select one: A. 72 hours after reporting the loss 95 C. 180 days D. 60 days 60 days The retroactive date under the CGL established the earliest date a claim will be paid by the insurance company under the: Select one: A. Claims-Made form B. Occurrence form C. Both the Occurrence and Claims-Made form D. Products and Completed Operations form Claims-Made form hysicians, Surgeons and Dentists Insurance will cover: Select one: A. Blood Banks B. Veterinarians C. All of these D. Optometrists All of these The basic amount of Medical Payment coverage under a CGL policy is: Select one: A. $2,000 B. $3,000 C. $1,000 D. $5,000 $5,000 Tom purchases a CGL - Occurrence form with an effective date of 1-1-03. He purchases a claims-made CGL with an effective date of 1-1-04. An injury from 8-1-03 is filed in 2005 when a claim is made. Which policy covers the injury? Select one: A. 1-1-03 policy B. 1-1-04 policy C. No coverage D. 1-1-05 policy 1-1-03 policy All of the following are covered under Supplemental Payments in a CGL EXCEPT: Select one: A. Expenses incurred at the company's request B. Lost wages up to $100/day 96 C. Bails bonds up to $250 D. Interest on judgments Lost wages up to $100/day Which of the following is not a covered territory for a CGL policy? Select one: A. Canada B. United States C. Puerto Rico D. Mexico Mexico Mr. Smith buys a CGL claims-made policy on 1-1-04 with a retroactive date of the policy's inception of 1- 1-04. He buys another CGL claims-made policy on 1-1-05 with a retroactive date of 1-1-05. An accident occurs on 7-1-04 and the claimant files this injury on 9-1-05. Which policy covers? Select one: A. 1-1-04 claims-made policy B. 1-1-05 claims made policy C. 1-1-04 is primary and 1-1-05 policy is excess D. Neither policy covers Neither policy covers What is unique about lawyer's professional liability insurance? Select one: A. It covers claims that existed before the policy was effective. B. It deducts claims expenses first and the balance is payable for the claim. C. It covers lawyers for fraudulent activities. D. It covers only lawyers in group practice. It deducts claims expenses first and the balance is payable for the claim. The three parties to a bond are: Select one: A. Surety, principal and cosigner B. Surety, insured and insurer C. Surety, obligee and indemnitor D. Surety, obligee and principal Surety, obligee and principal Safe Burglary is defined as: Select one: A. The taking of property by someone who has caused bodily harm B. The taking of property by someone who has entered the premises unlawfully as evidenced by visible signs of forced entry C. The taking of property by someone who has entered the premises unlawfully as evidenced by visible 97 signs of forced entry and caused bodily harm D. Any act of stealing The taking of property by someone who has entered the premises unlawfully as evidenced by visible signs of forced entry All of the following are penalties for non-compliance with Workers Compensation laws, EXCEPT: Select one: A. The employer may be charged a $1000 fine, plus $100 for each day of non-compliance B. The employer may be charged with a second-degree misdemeanor C. The employer's business property may be seized D. The employer's business may be closed The employer's business property may be seized Under Workers Compensation, what is the waiting period for disability benefits to begin? Select one: A. 30 days B. 7 days C. 14 days D. 21 days 7 days A fourth party to a bond is called a: Select one: A. Surety B. Principal C. Indemnitor D. Obligee Indemnitor Bill sent a cashier's check through the mail, but it never arrived at the destination of the recipient. Under which bond can the cashier's check be replaced? Select one: A. Fiduciary bond B. Blue Sky bond C. Lost Instrument bond D. Payment bond Lost Instrument bond A Florida employee was sent Boston to work for one week. While in Boston, they were injured on the job. How is the injury covered under WC benefits? Select one: A. The injury is covered under Florida's WC law B. There is no coverage under either state law