FLORIDA CLAIM ADJUSTER FINAL PRACTICE EXAMS

FLORIDA CLAIM ADJUSTER FINAL PRACTICE EXAMS A claim in the property/casualty industry Is defined as: - CORRECT ANSWER-an assertion of an alleged legal right against a person, entity, company or insurer that carries with it a demand for money as compensation for injuries or damages when you purchase insurance, you are buying: - CORRECT ANSWER-peace of mind that if an insured event does occur, that the insurance company will keep its promise and provide the financial protection that you purchased in today's society, the most important factor in the purchase of insurance is: - CORRECT ANSWER-trust One of the most important claim handling goals of an insurance company is: - CORRECT ANSWER-to help those who have been injured or who have suffered loss for which the insured is responsible, while at the same time minimizing loss for the insured party and carrier what is the primary difference between a company employee adjuster and an independent adjuster - CORRECT ANSWER-a company employee adjuster works for an insurance company and an independent adjuster works independently for themselves or for adjusting firms who represent many clients an adjuster's responsibility as a fiduciary means: - CORRECT ANSWER-the adjuster represents, and controls, the property and financial interests of the client to whom he/she owes a high degree of loyalty and good faith the basic and primary functions of an adjuster are: - CORRECT ANSWER-investigating, evaluating, reporting, negotiating and disposing of claims once an adjuster is licensed, he or she must maintain a continuing education requirement. What is that adjuster's compliance requirement in order to retain a license? - CORRECT ANSWER-an adjuster must complete 24 hours of continuing education in every 2 year compliance period, of which 5 hours must be taken in a properly certified 5 hour law and ethics update course the adjuster's code of ethics starts with a basic premise which states: - CORRECT ANSWER-the work of adjusting engages the public trust Which of the following would NOT be a preferred claims practice or behavior under FL Unfair Insurance Trade Practices Act? - CORRECT ANSWER-Not responding to an insured calls because you haven't made up your mind what are the four critical elements of a contract? - CORRECT ANSWER-1. agreement to terms (must understand what is given and received) 2. adequate consideration for the promises made 3. legal capacity of the parties to contract 4. contract must have legal purpose an insurance policy is often referred to as a contract of adhesion which means: - CORRECT ANSWER-if any of the wording or language in the policy is vague or ambiguous, making it difficult to understand or interpret, the law is well settled that the interpretation shall be in favor of the party who did not control its terms (the policyholder) breach of contract by a carrier or its adjuster through non-payment or on-compliance with policy requirements, could have the following consequences for a carrier - CORRECT ANSWER-if found guilty of a breach of contract, the carrier could be punished with a "bad faith" verdict that would cost it millions of dollars what are the fundamental parts of an insurance policy? - CORRECT ANSWER-1. Declarations Page 2. Insuring Agreement 3. Exclusions 4. Conditions What is one of the duties of an insured following a loss? - CORRECT ANSWER-giving prompt notice of loss to the insurer describe the difference between a peril and a hazard - CORRECT ANSWER-a peril is a cause of loss, like fire. A hazard is a condition that exists beforehand that increases the likelihood of such a loss, like a messy storeroom or garage the doctrine of proximate cause is defined as - CORRECT ANSWER-if there is an unbroken chain of events, or series of consequences, flowing from the initial loss caused by the insured peril to a subsequent loss, the insured peril causing the initial loss will be considered the "proximate cause" of the subsequent loss A couple had Coverage A limits of $250K on their home located in FL. A tornado spawned by Hurricane Ernesto damaged their roof resulting in estimated repair costs of $11,500. The adjuster deducted the FL hurricane deductible of $5,000 from the estimate and paid them $6,500 in settlement of their property claim. This is known as the application of: - CORRECT ANSWER-a percentage deductible (hurricane deductible)