Florida Claims Adjuster Exam 2024 Update: Key Concepts in Property Insurance, Exams of Nursing

Download Florida Claims Adjuster Exam 2024 Update: Key Concepts in Property Insurance and more Exams Nursing in PDF only on Docsity! Florida Claims Adjuster Exam with Certified Answer 2024 Update. Peril_Answer Somthing t√dhat causes a loss. Hazard_Answer Something that increases the probability that a loss will occur. Warranty_Answer A policy condition, either based on information in the insureds application or inserted by the insurer. It is a guarantee of a fact. Misrepresentation_Answer An untrue statement by the insured, made in an application for insurance but which does not become a part of the policy. Concealment_Answer The failure of the insured to reveal relevant facts known to the insured in applying for insurance. Abandonment_Answer Property insurance policies usually contain an abandonment clause, stating the insured cannot dump damaged property on the insurer and demand its full value. Severability_Answer The insurance applies separately to each insured as if other insureds did not exist. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Proximate Cause_Answer A fundamental doctrine in property insurance holds 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. Direct Loss_Answer Physical harm to tangible property. Indirect Loss_Answer Economic loss which flows as a result of direct loss. Actual Cash Value(ACV)_Answer Replacement Cost minus Depreciation Coinsurance_Answer Is a method of providing equity in premiums by granting lower rates to those indureds who accept the responsibility of insuring for amounts which reflect a high percentage of the value of the subject property. Personal Contract_Answer Policies cover people who own and operate things, such as automobiles. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Appraisal_Answer 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_Answer Is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Binder_Answer Acts as a temporary contract until the policy is issued. How many days should a insurer give for a prior notice of concellation of a binder ?_Answer 5 days. Property Insurance_Answer Any insurance wherein payment by the insurer will be paid directly to the insured or other specifically named interests. Liability Insurance_Answer 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". Florida Claims Adjuster Exam with Certified Answer 2024 Update. Loss Payee Clause_Answer 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_Answer 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. Other Structures_Answer Covers items that are not permanently attached to the main dwelling, such as a shed, fence, etc. Commercial Inland Marine_Answer Helps identify the kinds of risk which are eligible for either ocean or inland Marine insurance. Building Ordinance Coverage_Answer This endorsement covers the insured for enforcement of laws which require demolition of undamaged portions of buildings. Umbrella Policy_Answer 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. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Known Loss_Answer Prevents an insured from coverage if the insured knew the loss was probable at the time of the insurance contract. Value Reporting_Answer The limit of coverage is set at an amount somewhat higher than expected peak values. Commercial Property Insurance_Answer Covers direct and indirect losses related to properties other than one to four family dwellings and farm properties. Employee Theft_Answer 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_Answer Aggreement to fulfill a contractual obligation used frequently in construction and supplying goods. Health Maintenance Organization (HMO)_Answer Provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Sliding_Answer Selling an item and stating that it is required by law. What is the Death Benefit amount for PIP ?_Answer $5,000 What is the amount for medical and disability benefits afforded by PIP ? _Answer $10,000 Who is the Financial Responsibility Law administered by ?_Answer The Department of Highway Safety and Motor Vehicles. What are the Basic PIP Benefits ?_Answer -Medical-80% of responsible expenses are paid for necessary medical, surgical, X-Ray and dental. -Work Loss-60% of any loss of gross income and loss of earning capacity reimbursed. -Replacement Services-100% for the cost of having household services performed by others. -Death-Effective 01/01/2013 the death benefit will be $5,000 in addition to the $10,000 in medical and disability benefits afforded by PIP. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Company or Staff Adjuster_Answer Are salaried employees under the supervision of the home, branch or regional claims department of insurers. Fee Adjusters_Answer Offer their services on a fee-for-service basis. They represent many insurers. Bureau Adjuster_Answer Employee or agent of an adjustment bureau which serves multiple company clients such as the GAB Business Services, Inc and Underwriters Adjusting Company both national firms. Independent Adjuster_Answer Are Self-Employed and are not affiliated with either insurers or bureaus. They serve as adjuster representatives of insurers, and their services are compensated on a fee-plus-expenses basis for each loss handled. Public Adjuster_Answer Is a claims adjuster who is an advocate for the policyholder in appraising and negotiating an insurance claim. What are the Characteristics of a Personal Auto Policy Declaration Page ?_Answer -Liability(Bodily Injury) -Property Damage -Uninsured Motorist Florida Claims Adjuster Exam with Certified Answer 2024 Update. -Medical Payments -Personal Injury Protection -Collision Deductible -Comprehensive Deductible -Towing Coverage -Rental Coverage What are examples of Transacting Insurance?_Answer -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 ?_Answer -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 ?_Answer A simple verification of bills and estimates or it may be expanded to include Florida Claims Adjuster Exam with Certified Answer 2024 Update. Claim_Answer Is the assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief. Claims Adjuster_Answer One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies. Adjusting_Answer Process of disposing of an insurance claim. Loan Receipt_Answer 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_Answer 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 ?_Answer 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. Florida Claims Adjuster Exam with Certified Answer 2024 Update. What are the violations of the Unfair Trade Practices Act ?_Answer - 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. Section 624.155 of the Florida Statues provides ?_Answer 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_Answer 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 ?_Answer 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. Florida Claims Adjuster Exam with Certified Answer 2024 Update. 10=10,000 Property Damage-the most paid out for damage caused to property of others. What is SR-22 ?_Answer 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 ?_Answer -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 ?_Answer -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 ?_Answer 90 days. Florida Claims Adjuster Exam with Certified Answer 2024 Update. -Common policy conditions -One of the two coverage forms, Occurrence, or Claims-Made -A Nuclear Energy Liability Exclusion endorsement -Various other endorsements may be attached to broaden or restrict the coverage provided by these basic forms. Declarations_Answer Identifies the named insured and address, states the policy period and premium and miscellaneous information about the insured, and specifies the limits of coverage that apply. The policy states that if a company wishes to cancel, How many days must it give prior notice ?_Answer 30 days. Nuclear Endorsement_Answer Excludes all hazards related to nuclear energy. What is Coverage A ?_Answer Bodily Injury and Property Damage Insuring Agreement. Bodily Injury(BI)_Answer Physical harm and includes sickness or disease or death resulting there from. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Property Damage(PD)_Answer Physical injury to tangible property, including loss of use of that property. Occurrence_Answer An accident, including. continues or repeated exposure to substantially the same general harmful conditions. Accident_Answer A sudden, unexpected event. Coverage Territory_Answer Is the U.S. and its territories or possessions , Puerto Rico and Canada, including international waters and airspace between these places. The Coverage Trigger_Answer Determines how policy will respond. The Occurrence form_Answer Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made. The Claims-Made form_Answer 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. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Retroactive Date_Answer Establishes the original policy date for a serious of claims made policies. Intentionally Injury_Answer Coverage excludes injury or damage which is expected or intended by the insured. liquor Liability_Answer 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_Answer Coverage excludes liabilities under a workers compensation or similar law or arising from injuries to employees of the insured. Pollution_Answer There a basically no coverage for injury, damage or clean up costs caused by pullutants, subject to minor exceptions. What is Coverage B ?_Answer Personal and Advertising Injury. What is Coverage C ?_Answer Medical Payments. Florida Claims Adjuster Exam with Certified Answer 2024 Update. All Lines Claims Adjuster 6-20_Answer Investigates, Evaluates, and Negotiates Claims. A General Lines Adjuster is required to do what ?_Answer 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 ?_Answer 30 days. Loss Sustained_Answer Cover only losses that both occurred and were discovered during the policy period, or within one year of it's expiration. Discovery_Answer Any loss discovered during the policy period or within 60 days after it's expiration is called regardless of when it occurred. Property Covered_Answer 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_Answer Covers the named insureds legal liability if it is the safe depository for customers property. Perils covered include burglary, robbery, destruction on damage. Florida Claims Adjuster Exam with Certified Answer 2024 Update. Valuation_Answer 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_Answer A slightly different set of basic Crime Coverage Forms is tailored for insuring governmental entities. Guests' Property_Answer 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_Answer 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_Answer 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_Answer Will pay for the loss of or damage to money, securities and other property resulting from using a computer to Florida Claims Adjuster Exam with Certified Answer 2024 Update. fraudulently transport from inside the insureds promises to a person or place outside the premises, which encompasses anywhere in the world. Extortion_Answer 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_Answer 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_Answer 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_Answer 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_Answer Covers theft, disappearance, or destruction of securities, which have been deposited with a custodian, such as a bank or stockbroker.