A relatively simple auto bodily injury claim is assigned to Bill because he has been
trained in the handling of third-party bodily injury claims. In investigating the claim, Bill
learns that the vehicle damaged in the accident is an expensive hybrid to which
ordinary repair techniques may not apply. When Bill reports this development to his
supervisor, the supervisor is likely to take any of the following actions, except:
a. Instruct Bill to deny the collision claim due to the vehicle's specialized nature.
b. Instruct Bill to work with another adjuster who has a complementary skill set.
c. Keep Bill involved with the claim in order to broaden Bill's skills.
d. Reassign the claim to an adjuster who is more experienced in handling auto
physical damage claims.
Give this one a try later!
Instruct Bill to deny the collision claim due to the vehicle's specialized
nature.
That's correct! A third-party bodily injury liability claim could be valid if it
occurs in an unconventional vehicle. The claim would not automatically be
denied simply because the loss occurs in an unconventional vehicle.
However, the physical damage portion of this claim might require
specialized handling by or in conjunction with an adjuster who specializes
, in that area. Alternatively, it might provide a learning experience for the
bodily injury adjuster who has already been assigned to the claim.
If the adjuster assigned to Jane Grant's Stylish Lady slip-and-fall claim is to make a
best practice meaningful contact with Molly McClure, who was injured on the
insured's premises, the adjuster will
a. call Ms. McClure within 24 hours of receiving the assignment and speak directly to
her.
b. within 2 hours of receiving the assignment, send Ms. McClure a letter asking her to
call the adjuster.
c. Call Ms. McClure the next day after receiving the assignment and leave a message
in her voicemail to call the adjuster at her convenience.
d. Email Ms. McClure within 24 hours of receiving the assignment forms to complete
and telling her that once the forms are received the adjuster will set up an
appointment.
Give this one a try later!
call Ms. McClure within 24 hours of receiving the assignment and speak
directly to her.
That's correct! Best practice is to speak directly with the party (not send a
letter or email, or leave a voicemail) within 24 hours of the assignment.
Adjuster Donna writes the following coverage denial letter to the insured: "Dear Ms.
Jones, Our investigation into the above captioned loss is complete. Due to exclusion
B 6, on page 17 of your auto policy, we are unable to make any payment to you. Thank
you for selecting ABC Insurance to insure your home and auto. Sincerely, Donna,
Adjuster, ABC Insurance." This was not a proper coverage denial letter. A proper
coverage denial letter will do all the following, except:
a. Give a summary of the coverage facts.
b. Quote the specific policy provisions.
c. Connect the facts to the policy provisions quoted.
d. Avoid specifically saying that the claim is not covered.
Give this one a try later!
, Avoid specifically saying that the claim is not covered.
That's correct! The insured deserves a full and understandable explanation
of the decision, and the regulations require it.
What information is found on the declarations page of a policy?
a. Insured's name, address, phone number, and email address
b. Policy number, application date, inception date, and expiration date
c. Policy number, policy period, insured name and address, and coverages purchased
d. Coverages purchased, coverage limits, coverage deductibles, and coverage
exclusions
Give this one a try later!
Policy number, policy period, insured name and address, and coverages
purchased
That's correct! The declarations page does not include (A) the insured's
phone number and email, (B) the application date, or (D) the coverage
exclusions.
Felicia cannot understand some of the phrasing in her homeowners policy. She
therefore presents her insurance agent with her request for a series of suggested
modifications that would, in her opinion, make the policy clearer. The agent informs
her that the wording of this standard policy cannot be changed. Felicia's policy is a(n)
a. ambivalent contract.
b. contract of adhesion.
c. manuscript policy.
d. uniform policy.
Give this one a try later!
contract of adhesion. --
A contract of adhesion is a standard-form contract prepared by one party
trained in the handling of third-party bodily injury claims. In investigating the claim, Bill
learns that the vehicle damaged in the accident is an expensive hybrid to which
ordinary repair techniques may not apply. When Bill reports this development to his
supervisor, the supervisor is likely to take any of the following actions, except:
a. Instruct Bill to deny the collision claim due to the vehicle's specialized nature.
b. Instruct Bill to work with another adjuster who has a complementary skill set.
c. Keep Bill involved with the claim in order to broaden Bill's skills.
d. Reassign the claim to an adjuster who is more experienced in handling auto
physical damage claims.
Give this one a try later!
Instruct Bill to deny the collision claim due to the vehicle's specialized
nature.
That's correct! A third-party bodily injury liability claim could be valid if it
occurs in an unconventional vehicle. The claim would not automatically be
denied simply because the loss occurs in an unconventional vehicle.
However, the physical damage portion of this claim might require
specialized handling by or in conjunction with an adjuster who specializes
, in that area. Alternatively, it might provide a learning experience for the
bodily injury adjuster who has already been assigned to the claim.
If the adjuster assigned to Jane Grant's Stylish Lady slip-and-fall claim is to make a
best practice meaningful contact with Molly McClure, who was injured on the
insured's premises, the adjuster will
a. call Ms. McClure within 24 hours of receiving the assignment and speak directly to
her.
b. within 2 hours of receiving the assignment, send Ms. McClure a letter asking her to
call the adjuster.
c. Call Ms. McClure the next day after receiving the assignment and leave a message
in her voicemail to call the adjuster at her convenience.
d. Email Ms. McClure within 24 hours of receiving the assignment forms to complete
and telling her that once the forms are received the adjuster will set up an
appointment.
Give this one a try later!
call Ms. McClure within 24 hours of receiving the assignment and speak
directly to her.
That's correct! Best practice is to speak directly with the party (not send a
letter or email, or leave a voicemail) within 24 hours of the assignment.
Adjuster Donna writes the following coverage denial letter to the insured: "Dear Ms.
Jones, Our investigation into the above captioned loss is complete. Due to exclusion
B 6, on page 17 of your auto policy, we are unable to make any payment to you. Thank
you for selecting ABC Insurance to insure your home and auto. Sincerely, Donna,
Adjuster, ABC Insurance." This was not a proper coverage denial letter. A proper
coverage denial letter will do all the following, except:
a. Give a summary of the coverage facts.
b. Quote the specific policy provisions.
c. Connect the facts to the policy provisions quoted.
d. Avoid specifically saying that the claim is not covered.
Give this one a try later!
, Avoid specifically saying that the claim is not covered.
That's correct! The insured deserves a full and understandable explanation
of the decision, and the regulations require it.
What information is found on the declarations page of a policy?
a. Insured's name, address, phone number, and email address
b. Policy number, application date, inception date, and expiration date
c. Policy number, policy period, insured name and address, and coverages purchased
d. Coverages purchased, coverage limits, coverage deductibles, and coverage
exclusions
Give this one a try later!
Policy number, policy period, insured name and address, and coverages
purchased
That's correct! The declarations page does not include (A) the insured's
phone number and email, (B) the application date, or (D) the coverage
exclusions.
Felicia cannot understand some of the phrasing in her homeowners policy. She
therefore presents her insurance agent with her request for a series of suggested
modifications that would, in her opinion, make the policy clearer. The agent informs
her that the wording of this standard policy cannot be changed. Felicia's policy is a(n)
a. ambivalent contract.
b. contract of adhesion.
c. manuscript policy.
d. uniform policy.
Give this one a try later!
contract of adhesion. --
A contract of adhesion is a standard-form contract prepared by one party
