ADJUSTER PRO 2 EXAM 2023/2024

ADJUSTER PRO 2 EXAM 2023/2024 Agent - CORRECT ANSWER-one who recieves the authority to act on behalf of someone else Sales Agent - CORRECT ANSWER-receives authority to sell -authority given by written contract Insurance Adjuster - CORRECT ANSWER-receives authority to settle claims brought against the insurer - authority given by written contract Three major responsibilities of contracted agents - CORRECT ANSWER-1. follow the contract 2. always use reasonable judgement & care 3. provide all necessary information and documentation to the insurer Express Authority - CORRECT ANSWER-authority that is directly granted to the agent in writing via the agent's contract authority to: sell policies, collect premiums, issue binders, offer discounts, & cancel insurance Implied Authority - CORRECT ANSWER-the authority that the public reasonably believes the agent to have, based on the agent's representations: portraying oneself as a representative, wearing a name tag with a company logo, handing out company business cards Apparent Authority - CORRECT ANSWER-indirect authority that is granted when the insurer does NOT correct its agent, even though the agent may be acting in error What is an Independent Insurance Sales Agent? - CORRECT ANSWER-a self employed agent that is able to represent and offer insurance products from more than one company at a time. -able to compare and give rate quotes from diff companies - able to find a policy that bear fits the customer Exclusive (Captive) Agent - CORRECT ANSWER-paid on commission basis, represents one insurer at a time General Agent - CORRECT ANSWER-works for one company and supervises/trains the exclusive agents Direct Writer - CORRECT ANSWER-same as exclusive agent but works for salary day-to-day activities of a sale's agent - CORRECT ANSWER-sell insurance policies, service policyholders' contracts, collect premiums, represent the insurer Claim Function - CORRECT ANSWER-the process of handling claims for coverage under an insurance policy -primary role of an adjuster Two main goals in the Claims Function - CORRECT ANSWER-- comply with the terms of the contract - support the insurer's financial stability What is Adjusting? - CORRECT ANSWER-the process of comparing a claimant's losses to the promises made in an insurance policy What is an Insurance Adjuster? - CORRECT ANSWER-an agent who processes insurance claims for a salary, fee, or commission Who can an Adjuster work for? - CORRECT ANSWER-an insurer, a private company, an adjusting company, or the claimant (insured) Staff (Company) Adjuster - CORRECT ANSWER-employed by one insurer, salaried, can work locally, regionally, nationally ex. State farm Independent Adjuster - CORRECT ANSWER--can be called a fee adjuster or bureau adjuster - not contracted by any one insurer - self employed - processes claims for multiple insurers at the same time - paid by fee schedule, daily rate, or time + expense - sometimes paid on a commission basis Public Adjuster - CORRECT ANSWER-- hired by claimant - charges on commission (usually 10% of settlement) - hired when the insured knows the insurer will be making a payment for the claim - helps determine the proper identification and valuation of a loss - specializes in appraising and negotiating claims Emergency Adjuster - CORRECT ANSWER-temporarily licensed individuals who handle claims after natural disasters or catastrophes - only allowed to work on claims related to disaster Responsibilities of an Insurance Adjuster - CORRECT ANSWER-1. acts as the Fiduciary Agent 2. has the Power to Bind 3. must Report to the Principal Fiduciary Agent - CORRECT ANSWER-an adjuster must: - have authority granted by insurer via a contract - act for, and on behalf of, the principal(the insurer) - protect the principal's financial and property interests - adjuster must always act in the principal's best interest with utmost good faith The Power to Bind - CORRECT ANSWER-the principal is bound by the adjuster's decisions and actions. this authority: - is granted to adjuster in writing - means the adjuster may act on behalf of the employer - binds the employer Non-Waiver Agreement - CORRECT ANSWER-claimant agrees that adjuster's words and actions do not bind the insurer -typically used in catastrophe situations Reporting to the Principal - CORRECT ANSWER--the adjuster must give the principal frequent and regular updates on her progress on a claim Things contained in an adjuster's loss report - CORRECT ANSWER-date of loss, names of everyone involved, detailed description of loss, tort & tortfeasors if any, also details about the policy Initial or Preliminary Report - CORRECT ANSWER-- required within 15 days of receiving the claim - time lines and deadlines - apparent losses - liability issues - applicable coverages -initial claim reserve ( money that the insurer sets aside in prep for paying the claim) Interim (Status) Report - CORRECT ANSWER--update on claim progress - due at set intervals (15 or 30 days) as long as a claim is open - new evidence - medical information - repair estimates Final ( Full) Report - CORRECT ANSWER-all facts and evidence of the claim, policy coverage applied, adjusted losses, & final claim disposition