Adjuster Licensing Class Exam with Complete Solutions

The amount the insured must pay in a loss before any payment is due is known as? - ANSWER-Deductible What is a partial legal defense that reduces the amount of damages that a person can recover based upon the amount that this person's own negligence contributed to the loss - ANSWER-Comparative Negligence What is a situation involving a person other than an insured? - ANSWER-Third Party Loss The part of the insurance policy that details the rights and duties of the insured and the insurance company in the policy? - ANSWER-Conditions An event that results in an insured loss and damages? - ANSWER-Occurrence What is the value of your property, based on the current cost to replace it minus depreciation? - ANSWER-Actual Cash Value Mary has a Homeowner's policy. Her Coverage A limit of liability is $250,000 and her Coverage B limit of liability is $125,000. Her policy has a 2% deductible. What is her deductible? - ANSWER-$5,000 What is the type of negotiation that is also sometimes called positional or hard-bargaining negotiation? - ANSWER-Distributive What is the responsibility to another for one's negligence? - ANSWER-Liability What is the failure to use that degree of care which an ordinary person of reasonable prudence would use under similar circumstances? - ANSWER-Negligence What is the intentional misrepresentation of a material fact that may void a contract? - ANSWER-Fraud What is the process when an insurer and an insured have a dispute regarding the amount of the damage? - ANSWER-Appraisal This type of Auto Coverage pays for your damages if you were involved in a hit and run: - ANSWER-Uninsured Motorist What is the cost associated with replacing property at current market prices? - ANSWER-Replacement Cost What is the period a policy is in force, from the beginning or effective date to the expiration date? - ANSWER-Policy Period What is making an oral or written statement that is false or maliciously critical of, or derogatory to, the financial condition of any insurer that is calculated to injure any person engaged in the insurance business? - ANSWER-Defamation If the insurer needs additional time to evaluate and investigate a claim, they can request how many additional days? - ANSWER-45 Calendar Days When deciding to issue or to decline a standard fire, homeowners or farm policy, an insurer may not consider a ____________________ as a basis for declination? - ANSWER-Customer Inquiry What time requirements does the policyholder have to complete the requirements that the insurer has requested? - ANSWER-No Time Requirements What must an insurer provide for the declination, cancellation, or nonrenewal of an insurance policy? - ANSWER-Written Statement Once the insurer receives all of the information that they have requested from the policyholder, the insurer must review the claim, and accept or reject it within how many days? - ANSWER-15 Business Days Once the insurer accepts or rejects the claim, they have how long to pay the claim or issue the full or partial denial of the claim? - ANSWER-5 Business Days An insurer may refuse to renew a policy if the insurer has mailed notice of nonrenewal to the insured at least _______ days before the policy's expiration date? - ANSWER-30 What was established in 1991 to ensure the prompt payment of insurance claims? - ANSWER-Article 21.55 The insurer must acknowledge the claim, begin the investigation, and request all of the information needed to evaluate the claim within what time frame? - ANSWER-15 Calendar Days The Special Limit of Liability for Bullion/Valuable Papers is? - ANSWER-$500 Under the Texas HO-B policy, you would choose the Deductible Clause 1 for losses caused by? - ANSWER-Windstorm, Hurricane, or Hail Trees, shrubs, plants, and lawns are not covered for losses caused by? - ANSWER-Windstorm Under the Texas HO-B policy, the most you can pay for any one tree is? - ANSWER-$250 Under the Texas HO-B, the structure is covered for what type of losses? - ANSWER-All risks of physical loss, unless excluded Under the Texas HO-B jewelry, watches, and furs are limited to? - ANSWER-$500 for losses caused by theft Under the Texas HO-B, if your policyholder has a percentage deductible, how do you determine what the deductible amount is? - ANSWER-Apply the percentage to the Coverage A limit of liability When handling a difficult policyholder, you should always remain? - ANSWER-Calm and Professional What should adjusters do to obtain a fair and equitable settlement? - ANSWER-Work in Good Faith What should you do to make sure your policyholder always stays informed? - ANSWER-Timely Follow Up The claims activity log (claim diary) must be clear, concise, factual, and always? - ANSWER-Up to Date What is a crucial element to the adjustment process? - ANSWER-Claim Investigation The adjuster must set appointments ____________ to meet both the needs of the adjuster and the policyholder? - ANSWER-At Reasonable Times When an adjuster receives a new claim, they should make initial contact with the policyholder within what time frame? - ANSWER-24 Hours An employee of the Office of Injured Employee Counsel is known as? - ANSWER-An Ombudsman What type of disability refers to a temporary disablement that allows the employee to continue in the same job, but with a reduced capability? - ANSWER-A temporary partial disability What are two examples of compensation provided by worker's compensation? - ANSWER-Paying for medical bills and replacing lost income What are the four categories of benefits that Workers' Compensation laws incorporate? - ANSWER-Disability, Medical, Survivor, Rehabilitation An employer must report the injuries to their insurance carrier within how many days that they were made aware of the injury? - ANSWER-8 What type of disability lasts for a short period, after which the employee is fully able to return to work? - ANSWER-A temporary total disability Workers' Compensation provides covered employees with income and medical benefits if they are? - ANSWER-Injured on the job, or have a work related injury or illness Under Workers' Compensation law, there are how many types of disability? - ANSWER-4 The employee has the responsibility to tell their employer if they have been injured at work within ___________ days - ANSWER-30 The grade unaffected by construction techniques such as fill, landscaping, or berming? - ANSWER-Natural Grade What are the four sections of the Flood Policy? - ANSWER-Dwelling, Contents, Debris Removal, ICC What is a location having special flood, mudflow, or erosion problems? - ANSWER-Special Flood Hazard Area Who determines the risk of flood in various locations across the United States? - ANSWER-FEMA In order to qualify for Replacement Cost, the policyholder must be insured for at least? - ANSWER-80% of the replacement cost The policy term for NFIP policies is? - ANSWER-One year What does substantially damaged mean? - ANSWER-51% or more of the dwelling is destroyed The waiting period after you've applied and paid the premium for a flood policy before the policy is effective? - ANSWER-30 days Under a Flood policy, contents are always settled at? - ANSWER-Actual Cash Value Under a Flood policy, the building/structure maximum limit of liability is? - ANSWER-$250,000 What is the state's insurer of last resort for wind and hail coverage in the 14 coastal counties and parts of Harris County? - ANSWER-Texas Windstorm Insurance Association