Florida Claims Adjuster Exam, Exams of Nursing

Download Florida Claims Adjuster Exam and more Exams Nursing in PDF only on Docsity! Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Severability - CORRECT ANSWERS Insurance applies separately to each insured as if other insureds did not exist. Abandonment - CORRECT ANSWERS Property insurance policies usually contain a(n) __________ clause, *stating the insured cannot dump damaged property on the insurer and demand its full value.* Insurable Interest - CORRECT ANSWERS One wherein economic loss would be suffered from an adverse happening to the subject. Liberalization - CORRECT ANSWERS 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.. Doctrine of Proximate Cause - CORRECT ANSWERS States that when there is an unbroken connection between an occurrence and damage that grows out of the occurrence, then the resultant damage is all a part of the occurrence. Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Actual Cash Value - CORRECT ANSWERS The Loss Settlement Valuation that subtracts an allowance for depreciation Warranty - CORRECT ANSWERS A policy condition, either based on information in the insured's application or inserted by the insurer Conditional Contract - CORRECT ANSWERS 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? Under Mechanical Breakdown Coverage, *new cars are eligible for service up to:* - CORRECT ANSWERS 36 Months/36,000 Miles Used vehicles: 12 Months/12,000 Miles If financial responsibility doesn't exist at the time of an accident, what happens? - CORRECT ANSWERS The legally valid claims of others must be satisfied (10/20/10) Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Which of the following is not one of the rating factors for a Homeowner's Policy? - CORRECT ANSWERS Age & Gender of Insured On a Homeowner's Policy, covers items that are not permanently attached to the dwelling. This is defined as: - CORRECT ANSWERS Other Structures Examples include sheds, fences, pool houses, detached car ports, etc. A lender has an insurable interest in a home and finds protection in the: - CORRECT ANSWERS Mortgagee Clause Mortgagee - Homeowner's policy Loss Payee - Automobile policy Which of the following forms is "all-risk" on the dwelling policy? - CORRECT ANSWERS DP-3, or the Special Form Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ When the basic liability limits provided by the policy are insufficient for an insureds needs, two coverage forms are used to provide the additional amounts of coverage: A. Excess Liability B. Umbrella C. Both A & B D. None of the Above - CORRECT ANSWERS Both A & B Which of the following is not covered under Coverage C, Personal Property? A. A fire breaks out in the residence and an overnight guest loses his clothes in the fire B. A fish dies because he has been left alone for a week without food C. The insureds daughters tennis racket is stolen from her locker D. The insureds suitcase and clothing, valued at $1,500, are stolen from his hotel - CORRECT ANSWERS B. A fish dies because he has been left alone for a week without food Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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 - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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: - CORRECT ANSWERS Condominium Association Form This, along with Condo Unit Owners Form, is located under Condo Coverage. Sometimes referred to as commercial fire and allied lines, this is the form of insurance that covers direct and indirect losses related to properties other than one-to-four family dwellings and farm properties: - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ B. 90 C. 45 D. None of the Above - CORRECT ANSWERS 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. - CORRECT ANSWERS 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." - CORRECT ANSWERS 45 days Used to cover buildings in the course of construction - CORRECT ANSWERS Builders Risk Policy Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Includes: structure being built (including foundations), fixtures and machinery, equipment to service building, owned materials and supplies used for construction. Temporary structures built or assembled on site are also included if not covered by insurance. First developed as an extension of Ocean Marine coverage, to provide coverage for cargo traveling over land, instead of by sea. - CORRECT ANSWERS Commercial Inland Marine Coverage Definition: to help identify kinds of risks which are eligible for either Ocean or Inland Marine insurance. Protects against *loss of business income* that results from damage to covered property from a covered cause of loss. (BIIC) - CORRECT ANSWERS Business Income Insurance Coverage Period of restoration begins 72 hours after date of direct damage. In effect, coverage has a 72 hour deductible. Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ specifies the limits of coverage that apply. - CORRECT ANSWERS Declarations The Nuclear Energy Liability Exclusion endorsement, in general, __________ all hazards related to nuclear energy. - CORRECT ANSWERS 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? - CORRECT ANSWERS 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: - CORRECT ANSWERS Occurrence Form Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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: - CORRECT ANSWERS Claims-Made Retroactive date is stated in Declarations and will normally be same date as issuing company's first claims-made effective date for insured. All of the following are components of Workers Compensation, except: A. Up to $750,000 in Death Benefits B. Reimbursement for Medical Expenses incurred C. Reimbursement for lost wages on percentage basis D. Funeral costs up to $7,500 - CORRECT ANSWERS Up to $750,000 in Death Benefits Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Compensation for death is payable if death results within one year of an accident or if it follows disability within five years of accident. The following are classes of disability, except: - CORRECT ANSWERS Temporary Full Also included: Temporary Partial The measure to determine disability benefits is the __________ of the employee at the time of injury: - CORRECT ANSWERS 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: - CORRECT ANSWERS The Experience Rating Plan Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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: - CORRECT ANSWERS Retrospective Rating Plan Under Employer's Liability, the minimum limits of liability are: - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ physical or intrinsic value of manuscripts, drawings or records: - CORRECT ANSWERS $5,000 Under Crime Insurance, losses must be discovered within 1 year. This is defined as: - CORRECT ANSWERS The Discovery Period Crime Insurance is _________ over any other Insurance coverage. - CORRECT ANSWERS Excess A situation may arise where another form of insurance will pay claim - that insurance would be primary. Cover only losses that both occurred and were discovered during the policy period, or within one year of its expiration. This is defined as: - CORRECT ANSWERS Loss Sustained One exception to the rule is that Loss Sustained forms will also cover losses that occurred under previous (expired) crime policies and that were discovered during current policy year, as long as crime coverage had continued w/o interruption Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Any loss discovered during the policy period or within 60 days after its expiration (one year after expiration for losses connected with employee benefit plans) is covered regardless of when it occurred. This is defined as: - CORRECT ANSWERS Discovery If XYZ restaurant discovers stolen goods taken over a year ago, this is within 2 years of inception date and found within policy period so it's covered. Under Crime Insurance, the insured is covered for loss by: A. Theft B. Burglary C. Robbery D. All of the Above - CORRECT ANSWERS D. All of the Above Unless the loss is specifically excluded or limited Provides for loss of money and securities outside the premises in the care, custody and control of a messenger or armored car Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Which of the following are characteristics of a License Bond? A. To guarantee the licensee will act according to laws B. Protect public from unfair business practice C. Proper collection and payment of taxes D. All of the Above - CORRECT ANSWERS D. All of the Above Guarantees the performance between the principle and the obligee: - CORRECT ANSWERS 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: - CORRECT ANSWERS Performance Considered a contract bond Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ One who undertakes to perform, to fulfill a contract or to meet an obligation is known as: - CORRECT ANSWERS Principal Obligee - needs guarantee principal will perform Surety - guarantees performance between principal and obligee 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: - CORRECT ANSWERS 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: - CORRECT ANSWERS Indemnitor Which of the following are parties to a Bond? A. Principal B. Obligee C. Surety D. All of the Above - CORRECT ANSWERS D. All of the Above Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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.: - CORRECT ANSWERS 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: - CORRECT ANSWERS Lost Instrument Bond Also guarantees to save issuer from any loss growing out of lost instrument Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ B. Elimination Period C. Both A & B D. None of the Above - CORRECT ANSWERS C. Both A & B This helps keep premiums reasonable by eliminating chance of persons buying coverage only when they are sick Characteristics of an *HMO plan* usually include: (HINT: S F P B C) - CORRECT ANSWERS S - Small of non-existent Deductibles F- Fewer Exclusions P - Insurance services to members through employed physicians B - Broad coverage C - Coinsurance provisions Provides indemnification to the insured for basic hospitalization of room and board in the hospital, nursing care, laboratory fees, operating room, medical supplies, etc. This is defined as? - CORRECT ANSWERS Hospitalization Expense Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Associated with a daily limit, not to exceed specified maximum A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. - CORRECT ANSWERS HMO Referred to as an emerging and increasingly important non- insurance alternative to dealing with risk of health care costs Established in 1973, this association was created for applicants who are unable to obtain insurance in the private market: - CORRECT ANSWERS FAJUA In 2002, the Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and the Florida Windstorm Joint Underwriting Association (FWUA), were combined to create: - CORRECT ANSWERS Citizens Passed during a legislative session in 1993, this association was created for employers who cannot obtain workers Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ compensation insurance in the private market: - CORRECT ANSWERS FWCJUA A General Lines Agent instructs a licensed Customer Representative 4-40 to thoroughly cover the details of a new life insurance product with every Homeowner customer who calls or visits the office. The agent provides training on the new product. Although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested. Which of the following is true? A. This practice is acceptable if done in the office under supervision of General Lines Agent B. This practice is acceptable because adequate training and product knowledge was provided C. This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative. A. True B. False - CORRECT ANSWERS 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: - CORRECT ANSWERS 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: - CORRECT ANSWERS Claims Adjuster Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Establishing a dollar value on a claim is defined as: - CORRECT ANSWERS 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: - CORRECT ANSWERS 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): - CORRECT ANSWERS 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: Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ A. Conduct B. Work Habits C. Claim Handling Activites D. All of the Above - CORRECT ANSWERS D. All of the Above The adjusters basic activities in claims handling are: A. Investigation B. Evaluation C. Negotiation D. All of the Above - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as: - CORRECT ANSWERS Claim Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as: - CORRECT ANSWERS Advanced Payment The process of disposing of an insurance claim is defined as: - CORRECT ANSWERS Adjusting Also "the negotiation period that results in an agreement" All of the following are requirements for the "Code of Ethics," except: A. Adjusters should not give legal advice B. Adjusters may negotiate with a claimant who is represented by an attorney C. A witness who requests a copy of a statement given must be provided with one Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ D. Adjusters will keep an unprejudiced and open mind - CORRECT ANSWERS B. Adjusters may negotiate with a claimant who is represented by an attorney Adjusters MAY NOT. Bad, adjuster, bad! A written statement given by the insured to the insurer acknowledging that money received in the settlement of damages is received, not as a final payment, but as an advance pending an outcome of a claim against the person responsible for the damage. This is defined as a(n): - CORRECT ANSWERS Loan Receipt Enables insurer to bring an action for recovery against a third party Duties and functions of the Department of Financial Services include all of the following except: A. Approve the issuance of licenses B. Rating and underwriting rules C. Claims Supervision Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ D. Investigate charges of unethical behavior - CORRECT ANSWERS 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): - CORRECT ANSWERS 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 - CORRECT ANSWERS 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): Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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: - CORRECT ANSWERS 6 Months How many continuing education hours must an insurance adjuster complete every 2 years? - CORRECT ANSWERS 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 - CORRECT ANSWERS 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: - CORRECT ANSWERS Limited Customer Service Representative Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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: - CORRECT ANSWERS 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: - CORRECT ANSWERS Sliding Which of the following are reasons for refusal, suspension or revocation of a license or appointment? A. Lack of Qualifications B. Failure to Pass State Examinations C. Fraudulent or Dishonest Practices D. All of the Above - CORRECT ANSWERS All of the Above Every licensee shall notify the department, in writing, after a change of name, residence address, principal business street address and/or mailing address within how many days? - CORRECT ANSWERS 30 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ An agent who transacts any one or more of the following types of insurance: Property, Casualty, Surety, Marine, and Health is defined as a(n): - CORRECT ANSWERS General Lines Agent An agent representing a health maintenance organization, or as to health insurance only, an insurer transacting health insurance is defined as a(n): - CORRECT ANSWERS Health Agent An applicant for a temporary license must be: - CORRECT ANSWERS 1. A natural person at least 18 years of age 2. A US citizen or legal alien One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. This is defined as a(n): - CORRECT ANSWERS Authorized Actual Cash Value - CORRECT ANSWERS Replacement cost minus depreciation Subrogation - CORRECT ANSWERS When an insured has a right to collect damages from another party but elects to claim Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Bid - CORRECT ANSWERS 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 - CORRECT ANSWERS (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) - CORRECT ANSWERS (Health Maintenance Organization) Provides comprehensive health services to its members for a prepaid fixed fee equivalent to an insurance premium Domestic - CORRECT ANSWERS Insurer formed under laws of this state Foreign - CORRECT ANSWERS Insurer formed under laws of another state, district territory, or commonwealth of U.S. Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Alien - CORRECT ANSWERS Insurer other than domestic or foreign (outside U.S.) Sliding - CORRECT ANSWERS Selling an item and stating that it is required by law Waiver - CORRECT ANSWERS Voluntary relinquishment or surrender of some right or privilege Fiduciary - CORRECT ANSWERS A relationship that requires maintenance of a high degree of fidelity and loyalty to the interests of the principal, whether or not the adjuster is a direct employee Evaluation - CORRECT ANSWERS Establishing a dollar value on a claim. Determines the fair payment in accordance with the contract and applicable law Negotiation - CORRECT ANSWERS A quality settlement based on facts discovered during the evaluation process Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Estoppel - CORRECT ANSWERS An equitable principle to the effect that if one intentionally or unintentionally creates the impression that a certain fact exists, an innocent party relies on that impression and is damaged as a result, the guilty party may be legally prohibited (estopped) from asserting that the fact does not exist. Junk - CORRECT ANSWERS Any material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal Salvage - CORRECT ANSWERS Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss. Motor vehicle or mobile home is a total loss Appointment - CORRECT ANSWERS Authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf Derelict - CORRECT ANSWERS Material which is or may have been a motor vehicle or mobile home, with or without all component Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ How does PIP apply to pedestrians (in and out of state)? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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*? (3) (Hint: I L S) - CORRECT ANSWERS 1. Owner is *denied immunities* from legal liabilities that are granted to those who comply Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 2. Owner is *personally liable* for payment of PIP benefits to those entitled 3. Owner's driver's license and vehicle registration are subject to *suspension* What is the PIP Death Benefit amount? - CORRECT ANSWERS Effective 1/1/13, the death benefit will be $5,000 IN ADDITION to the $10,000 in medical and disability benefits afforded by PIP. Example: Joe is seriously injured in an accident and incurs $50,000 in medical bills. He passes away a few days later. PIP would pay its maximum amount of $10,000 and, in addition, pay an extra $5,000 for death benefit. Who administers the Financial Responsibility Law? - CORRECT ANSWERS The Department of Highway Safety and Motor Vehicles What are the characteristics of a Homeowner's policy? - CORRECT ANSWERS -protects against economic loss to residence and household property and legal liabilities -owner/occupants of 1-4 family dwellings -renters who maintain residential occupancy in any type of building Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ What associations make up Citizens Property and Insurance? - CORRECT ANSWERS Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and Florida Windstorm Joint Underwriting Association (FWUA) What are the characteristics of a Personal Automobile Policy Declaration page? - CORRECT ANSWERS Liability (bodily injury), property damage, uninsured motorist, medical payments, PIP, collision deductible, comprehensive deductible, towing coverage, and rental coverage What are some examples of transacting insurance? - CORRECT ANSWERS 1. solicitation and inducement 2. preliminary negotiations 3. effectuation of a contract of insurance 4. transaction of matters subsequent to effectuation of contract of insurance 5. mailing or otherwise delivering written solicitation to any person in this state by an insurer or any person acting on their behalf for fee or compensation Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ What is the website for the Florida Department of Financial Services? - CORRECT ANSWERS www.myfloridacfo.com What are the thresholds of the No-Fault Law? - CORRECT ANSWERS (1) Significant and permanent loss of a bodily function, or (2) Permanent injury other than scarring and disfigurement, or (3) Significant and permanent scarring or disfigurement, or (4) Death. What is the Florida Unfair Insurance Trade Practices Act? - CORRECT ANSWERS Under this Act, penalties are provided for misrepresentation of business practices including: -Failing to act promptly -Failure to affirm or deny a claim when an insured is entitled thereto -Failure to explain claim denials in writing -Failure to maintain complaint-handling procedures, such as keeping accurate records of complaints What perils are covered by Comprehensive Coverage? Does the deductible apply to them all? - CORRECT ANSWERS Comprehensive Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Coverage applies to damage not caused by collision (an animal runs into your vehicle, hail damages your hood, glass claims, etc.) In Florida, windshields are replaced for free and you ARE NOT responsible for paying a deductible. What is the time frame for a Non-Renewable Temporary License? - CORRECT ANSWERS A period not to exceed 6 months What types of insurance licenses are offered by the Department and how do they differ? - CORRECT ANSWERS 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 Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ What are the Code of Ethics for adjusters? - CORRECT ANSWERS Formal rules which impact on adjuster practices 1. Adjusters may not directly negotiate with a claimant who is represented by an attorney. 2. In interviewing witnesses, adjusters must avoid any actions tending to induce a suppression or deviation from the truth. A witness who requests a copy of a statement given must be provided with a copy. 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. Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+ 8. The adjuster must put the duty for fair and honest treatment of the claimant above the adjuster's own interests, in every instance. Florida Claims Adjuster Exam WITH 203QUESTIONS WELL VERIFIED ANSWERS 2023/2024 GRADED A+