LOUISIANA INSURANCE ADJUSTER EXAMINATION SCRIPT
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔Third Party Claim - ✔✔A claim filed against an insurance policy by anyone other
than the person named on that policy.
✔✔First Party Claim - ✔✔A claim filed by the policyholder against his or her own
insurance policy.
✔✔Claimant - ✔✔Someone who has filed a claim.
✔✔Claim - ✔✔A demand for payment in accordance with the terms of an insurance
policy.
✔✔Indirect Loss - ✔✔An economic loss that results from a direct loss. i.e. renting a
hotel room until home is repaired
✔✔Direct Loss - ✔✔Loss incurred due to direct damage to property.
✔✔Proximate Cause - ✔✔Active, direct, and efficient cause of loss that sets in motion
an unbroken chain of events which bring about damage, destruction, or injury without
the intervention of a new and independent force.
✔✔Original Occurrence - ✔✔Causes damage that then leads to more damage.
✔✔Occurrence - ✔✔An event, incident, or condition that causes damage.
✔✔Soft Fraud - ✔✔Exaggerating a claim to inflate the indemnity. AKA Opportunistic
Fraud
✔✔Hard Fraud - ✔✔Deliberately planning or faking a loss.
✔✔Fraud - ✔✔The act of deliberately perverting, altering or misrepresenting the truth or
willfully deceiving an insurer in order to realize financial gain. Considered a Moral
Hazard. Can be "Hard" or "Soft"
✔✔Physical Hazard - ✔✔A physical condition that increases the chance of loss.
✔✔Types of Physical Hazards - ✔✔Environmental, Material, Operational, Occupational
✔✔Moral Hazard - ✔✔A subjective hazard that tends to increase the probable
frequency or severity of loss due to an insured peril. Results from a policyholder's
conscious decision. Involves reckless behavior because of the financial security offered
by insurance. Is a type of behavioral hazard.
, ✔✔Morale Hazard - ✔✔Implies a certain indifference to loss simply because of the
existence of insurance. Results from a policyholder's unconscious changes in behavior.
✔✔Hazard - ✔✔A condition increasing the likelihood or severity of a loss. Hazards can
be physical, moral or morale
✔✔3 types of Hazards - ✔✔Physical, Moral, Morale
✔✔Peril - ✔✔The actual cause of loss or damage. i.e. lightning, fire, flood, vandalism
✔✔Named Peril Policy - ✔✔List each Peril that is covered.
✔✔All Peril or Open Peril Policy - ✔✔Covers all perils except those specifically
excluded.
✔✔Loss - ✔✔Occurs when the value of an insured item is reduced by a covered peril or
when expenses have to be paid because of the incident. Also the amount paid out after
a claim is settled.
✔✔Risk - ✔✔The potential for financial loss; being exposed or open to damage. Also
refers to an insured item. There are two types of Risk - Speculative (not insurable) &
Pure (Insurable)
✔✔Speculative Risk - ✔✔Any risk in which gain is possible (not insurable) i.e. buying a
lottery ticket, investing in the stock market
✔✔Pure Risk - ✔✔Any risk which no gain is possible (insurable)
✔✔Key Concepts of a Policy - ✔✔1.) First Named Insured 2.) Binder 3.) Representation
& Misrepresentation 4.) Concealment 5.) Warranty 6.) Waiver 7.) Estoppel
✔✔Representation - ✔✔A statement of fact.
✔✔Binder - ✔✔Temporary coverage for an insurance applicant until the policy is issued.
✔✔Policy Period - ✔✔Dates in which the policy is in effect. Runs from the inception
date to the expiration date.
✔✔First Name Insured - ✔✔The person or entity listed first on the policy declarations
page as an insured. Only person allowed to authorize changes to the policy.
✔✔Insured - ✔✔The person or organization that pays the premiums for financial
protection
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔Third Party Claim - ✔✔A claim filed against an insurance policy by anyone other
than the person named on that policy.
✔✔First Party Claim - ✔✔A claim filed by the policyholder against his or her own
insurance policy.
✔✔Claimant - ✔✔Someone who has filed a claim.
✔✔Claim - ✔✔A demand for payment in accordance with the terms of an insurance
policy.
✔✔Indirect Loss - ✔✔An economic loss that results from a direct loss. i.e. renting a
hotel room until home is repaired
✔✔Direct Loss - ✔✔Loss incurred due to direct damage to property.
✔✔Proximate Cause - ✔✔Active, direct, and efficient cause of loss that sets in motion
an unbroken chain of events which bring about damage, destruction, or injury without
the intervention of a new and independent force.
✔✔Original Occurrence - ✔✔Causes damage that then leads to more damage.
✔✔Occurrence - ✔✔An event, incident, or condition that causes damage.
✔✔Soft Fraud - ✔✔Exaggerating a claim to inflate the indemnity. AKA Opportunistic
Fraud
✔✔Hard Fraud - ✔✔Deliberately planning or faking a loss.
✔✔Fraud - ✔✔The act of deliberately perverting, altering or misrepresenting the truth or
willfully deceiving an insurer in order to realize financial gain. Considered a Moral
Hazard. Can be "Hard" or "Soft"
✔✔Physical Hazard - ✔✔A physical condition that increases the chance of loss.
✔✔Types of Physical Hazards - ✔✔Environmental, Material, Operational, Occupational
✔✔Moral Hazard - ✔✔A subjective hazard that tends to increase the probable
frequency or severity of loss due to an insured peril. Results from a policyholder's
conscious decision. Involves reckless behavior because of the financial security offered
by insurance. Is a type of behavioral hazard.
, ✔✔Morale Hazard - ✔✔Implies a certain indifference to loss simply because of the
existence of insurance. Results from a policyholder's unconscious changes in behavior.
✔✔Hazard - ✔✔A condition increasing the likelihood or severity of a loss. Hazards can
be physical, moral or morale
✔✔3 types of Hazards - ✔✔Physical, Moral, Morale
✔✔Peril - ✔✔The actual cause of loss or damage. i.e. lightning, fire, flood, vandalism
✔✔Named Peril Policy - ✔✔List each Peril that is covered.
✔✔All Peril or Open Peril Policy - ✔✔Covers all perils except those specifically
excluded.
✔✔Loss - ✔✔Occurs when the value of an insured item is reduced by a covered peril or
when expenses have to be paid because of the incident. Also the amount paid out after
a claim is settled.
✔✔Risk - ✔✔The potential for financial loss; being exposed or open to damage. Also
refers to an insured item. There are two types of Risk - Speculative (not insurable) &
Pure (Insurable)
✔✔Speculative Risk - ✔✔Any risk in which gain is possible (not insurable) i.e. buying a
lottery ticket, investing in the stock market
✔✔Pure Risk - ✔✔Any risk which no gain is possible (insurable)
✔✔Key Concepts of a Policy - ✔✔1.) First Named Insured 2.) Binder 3.) Representation
& Misrepresentation 4.) Concealment 5.) Warranty 6.) Waiver 7.) Estoppel
✔✔Representation - ✔✔A statement of fact.
✔✔Binder - ✔✔Temporary coverage for an insurance applicant until the policy is issued.
✔✔Policy Period - ✔✔Dates in which the policy is in effect. Runs from the inception
date to the expiration date.
✔✔First Name Insured - ✔✔The person or entity listed first on the policy declarations
page as an insured. Only person allowed to authorize changes to the policy.
✔✔Insured - ✔✔The person or organization that pays the premiums for financial
protection
