Insurance Adjuster Questions And
Answers
AcCGLccancprovidecliabilitycinsuranceccoveragecforcallcofcthecfollowingcpersons,cEXCEPT:c-
cCORRECTccANSWER-
Customers,cGenerallycspeaking,cCGLcpoliciescwillccovercthecliabilitycofcexecutives,cpartner
s,cemployees,cmanagers,cvolunteers,cagents,cstockholderscandcrepresentativescofcancinsu
redcbusiness,cbutconlycwhencsuchcindividualscarecperformingcundercthecscopecofcthecinsure
d'scbusinesscactivities.
AcfarmcinsurancecpolicycmaycincludecallcofcthecfollowingcEXCEPT:c-cCORRECTccANSWER-
Accommercialcpackagecpolicy,cAcFarmcpolicycdoescincludecsomeccommercialccoverages,cb
utcitcdoescnotcincludecancentireccommercialcpackagecpolicy.
Acstandcalonecexcesscliabilitycpolicy:c-cCORRECTccANSWER-
Followscacbasecpolicy,cbutcmaychavecdifferentcexclusionscandclimitations,cAcstandcalonecex
cesscliabilitycpolicycfollowscacbasecpolicy,cbutcmaychavecdifferentcexclusionscandclimitations
.
AdjustercAlicecisctryingctocdeterminecthecfinalcsettlementcamountcforcTed'scclaim.cTed'schou
secwascdamagedcincaccoveredcloss,candcAlicechascestimatedcthatcitcwillccostc$25,000ctocma
kecthecnecessarycrepairs.cTed'schomeownerscpolicychascac$100,000climitcandcac$2,000cde
ductible.cTypically,chowcmuchcwouldcAdjustercAliceccalculatecTed'scfinalcsettlementcamoun
tctocbe?c-cCORRECTccANSWER-
$23,000,cBecausecthectotalclosscisclesscthancthecpolicyclimit,cthecdeductiblecisctypicallycsubtr
actedcfromcthectotalclosscamount.cIncthisccase:c$25,000c-c$2,000c=c$23,000.
AllcofcthecfollowingccausescofclosscarecexcludedcfromccoveragecincancEquipmentcBreakdow
ncProtectioncCoveragecForm,cEXCEPT:c-cCORRECTccANSWER-MechanicalcFailure
Amycneedscmorecfloorcspacecinchercantiquecfurniturecstore,csocshecbuyscacstoragecbuildingc
3cmilescaway.cSheciscworriedcaboutckeepingcthecfurniturecincthecstoragecbuildingcsafe,csocsh
ecputscincancalarmcsystemcandcsmokecdetectors.cBycpurchasingcthecalarmcsystemcandcsmo
kecdetectors,cAmyciscpracticing:c-cCORRECTccANSWER-
RiskcReduction,cBycpurchasingcthecalarmcsystemcandcsmokecdetectors,cAmyciscreducingcth
eclikelihoodcthatchercstoragecbuildingcorcitsccontentscarecdamagedcorclost.cSo,cincthiscinstanc
e,cAmyciscpracticingcriskcreduction.
, Ancadjusterchascacdutyctocprovidecwhichcofcthecfollowingctocthecclaimant?c-
cCORRECTccANSWER-
Ancopenclinecofccommunication,cThecadjustercmustcworkctocmaintaincopenccommunicationc
withcthecclaimantcthroughoutcthecentirecclaimcprocess.
BothcStevecandchiscwife,cArlene,ccarrycDP-
2cpoliciesconctheirc$135,000chome.cSteve'scpolicychascaclimitcofc$108,000candcArlene'schasc
ac$27,000climit,candcbothcpoliciescpayconcacprocratacbasis.cAftercachailstormccausesc$13,00
0cincdamagectoctheircroof,chowcmuchcofcthecdamagecwillcbeccoveredcbycSteve'scpolicyc(ignor
ingcanycdeductible)?c-cCORRECTccANSWER-$10,400,cHailcisccoveredcundercthecDP-
2cpolicycandcthecdwellingciscfullycinsured.cWhencpoliciescpayconcacprocratacbasis,ceachcpolic
ycpayscitscsharecofctheclosscaccordingctocitscsharecofcallcpolicyclimits.cSteve'scpolicyclimitcam
ountsctoc80%cofcthectotalccoverage,csochiscpolicycwillccoverc80%cofcthecloss.c($108,000c+c$2
7,000c=c$135,000ctotal)c($108,000c/c$135,000c=c80%cofctotal)c($13,000cxc80%c=c$10,400)
Dr.cSmithchascacclaims-
madecmalpracticecinsurancecpolicycwithcacpolicycperiodcfromcJunec30,c2006ctocJunec30,c20
07.cWhichcclaimcwouldctriggercthiscpolicy?c-cCORRECTccANSWER-
AcclaimcfiledconcJanuaryc13,c2007cforcsurgerycperformedconcJunec28,c2005,cAcclaims-
madecpolicyccoverscclaimscinitiatedcduringcthecpolicycperiod.cIncthiscsituation,cthatcwouldcinc
ludecclaimscfiledcbetweencJunec30,c2006candcJunec30,c2007.
Duringccatastrophes,cwhichcofcthecfollowingciscTRUE?c-cCORRECTccANSWER-
AdjustersclicensedcincothercstatesccancactcascemergencycadjusterscincFlorida.
FarmercJanechadcancMPCIcpolicycincplacecwhenchercwheatcfieldcwascruinedcbycachailcstorm.c
Janecpromptlycplowedcupcthecwheatcandcplantedcaccoverccrop.cTwocdaysclatercshecfiledcaccl
aimcwithchercinsurer.cThecclaimcwascdenied.cWhatcmightcbecthecreasoncforcthecdenial?c-
cCORRECTccANSWER-
Janecdidcnotcleavecsamplescofcthecdestroyedccropcforcthecadjusterctocexamine,cInccropcinsur
ance,conecofcthecinsured'scdutiescaftercaclosscisctocleavecsamplescofcthecdamagedccropcforct
hecadjusterctocinspect.cIfcJanecdidcnotcdocthis,cthencthecinsurerccouldcdenychercclaim.
Frankcpurchasedcac$150,000cinsurancecpolicycforchischome,cwhichciscvaluedcatc$125,000,c
withcthechopescofcmakingcac$25,000cprofitcinctheceventchischomeciscdestroyed.cAftercFrankcb
urnschischousecdown,checfilescacclaimcagainstchischomeownerscpolicy.cAssumingcthatcFrank
'scpolicycincludescancoverinsurancecprovision,chowcmuchcwillchiscinsurercindemnifycFrankcfo
rchiscloss?c-cCORRECTccANSWER-
$0,cBycpurchasingcextracinsurancecwithcintentionsctocdefraudcthecinsurer,cFrankcvoidedchisci
nsurancecpolicycandchecwillcreceivecnothing.
Honey'scBakeryciscaclocalccoffeecshopcruncbyctwocsisters.cIncacrushctocleaveconecafternoon,ct
heircnewcemployeecforgetsctocturncoffcthecgascstove.cThecleakingcgasccausescancexplosion,c
destroyingctheckitchen.cWhichcconditioncinctheirccommercialcpropertycpolicyccouldchelpcthec
sistersccoverctheccostcofcthecdamage?c-cCORRECTccANSWER-
Answers
AcCGLccancprovidecliabilitycinsuranceccoveragecforcallcofcthecfollowingcpersons,cEXCEPT:c-
cCORRECTccANSWER-
Customers,cGenerallycspeaking,cCGLcpoliciescwillccovercthecliabilitycofcexecutives,cpartner
s,cemployees,cmanagers,cvolunteers,cagents,cstockholderscandcrepresentativescofcancinsu
redcbusiness,cbutconlycwhencsuchcindividualscarecperformingcundercthecscopecofcthecinsure
d'scbusinesscactivities.
AcfarmcinsurancecpolicycmaycincludecallcofcthecfollowingcEXCEPT:c-cCORRECTccANSWER-
Accommercialcpackagecpolicy,cAcFarmcpolicycdoescincludecsomeccommercialccoverages,cb
utcitcdoescnotcincludecancentireccommercialcpackagecpolicy.
Acstandcalonecexcesscliabilitycpolicy:c-cCORRECTccANSWER-
Followscacbasecpolicy,cbutcmaychavecdifferentcexclusionscandclimitations,cAcstandcalonecex
cesscliabilitycpolicycfollowscacbasecpolicy,cbutcmaychavecdifferentcexclusionscandclimitations
.
AdjustercAlicecisctryingctocdeterminecthecfinalcsettlementcamountcforcTed'scclaim.cTed'schou
secwascdamagedcincaccoveredcloss,candcAlicechascestimatedcthatcitcwillccostc$25,000ctocma
kecthecnecessarycrepairs.cTed'schomeownerscpolicychascac$100,000climitcandcac$2,000cde
ductible.cTypically,chowcmuchcwouldcAdjustercAliceccalculatecTed'scfinalcsettlementcamoun
tctocbe?c-cCORRECTccANSWER-
$23,000,cBecausecthectotalclosscisclesscthancthecpolicyclimit,cthecdeductiblecisctypicallycsubtr
actedcfromcthectotalclosscamount.cIncthisccase:c$25,000c-c$2,000c=c$23,000.
AllcofcthecfollowingccausescofclosscarecexcludedcfromccoveragecincancEquipmentcBreakdow
ncProtectioncCoveragecForm,cEXCEPT:c-cCORRECTccANSWER-MechanicalcFailure
Amycneedscmorecfloorcspacecinchercantiquecfurniturecstore,csocshecbuyscacstoragecbuildingc
3cmilescaway.cSheciscworriedcaboutckeepingcthecfurniturecincthecstoragecbuildingcsafe,csocsh
ecputscincancalarmcsystemcandcsmokecdetectors.cBycpurchasingcthecalarmcsystemcandcsmo
kecdetectors,cAmyciscpracticing:c-cCORRECTccANSWER-
RiskcReduction,cBycpurchasingcthecalarmcsystemcandcsmokecdetectors,cAmyciscreducingcth
eclikelihoodcthatchercstoragecbuildingcorcitsccontentscarecdamagedcorclost.cSo,cincthiscinstanc
e,cAmyciscpracticingcriskcreduction.
, Ancadjusterchascacdutyctocprovidecwhichcofcthecfollowingctocthecclaimant?c-
cCORRECTccANSWER-
Ancopenclinecofccommunication,cThecadjustercmustcworkctocmaintaincopenccommunicationc
withcthecclaimantcthroughoutcthecentirecclaimcprocess.
BothcStevecandchiscwife,cArlene,ccarrycDP-
2cpoliciesconctheirc$135,000chome.cSteve'scpolicychascaclimitcofc$108,000candcArlene'schasc
ac$27,000climit,candcbothcpoliciescpayconcacprocratacbasis.cAftercachailstormccausesc$13,00
0cincdamagectoctheircroof,chowcmuchcofcthecdamagecwillcbeccoveredcbycSteve'scpolicyc(ignor
ingcanycdeductible)?c-cCORRECTccANSWER-$10,400,cHailcisccoveredcundercthecDP-
2cpolicycandcthecdwellingciscfullycinsured.cWhencpoliciescpayconcacprocratacbasis,ceachcpolic
ycpayscitscsharecofctheclosscaccordingctocitscsharecofcallcpolicyclimits.cSteve'scpolicyclimitcam
ountsctoc80%cofcthectotalccoverage,csochiscpolicycwillccoverc80%cofcthecloss.c($108,000c+c$2
7,000c=c$135,000ctotal)c($108,000c/c$135,000c=c80%cofctotal)c($13,000cxc80%c=c$10,400)
Dr.cSmithchascacclaims-
madecmalpracticecinsurancecpolicycwithcacpolicycperiodcfromcJunec30,c2006ctocJunec30,c20
07.cWhichcclaimcwouldctriggercthiscpolicy?c-cCORRECTccANSWER-
AcclaimcfiledconcJanuaryc13,c2007cforcsurgerycperformedconcJunec28,c2005,cAcclaims-
madecpolicyccoverscclaimscinitiatedcduringcthecpolicycperiod.cIncthiscsituation,cthatcwouldcinc
ludecclaimscfiledcbetweencJunec30,c2006candcJunec30,c2007.
Duringccatastrophes,cwhichcofcthecfollowingciscTRUE?c-cCORRECTccANSWER-
AdjustersclicensedcincothercstatesccancactcascemergencycadjusterscincFlorida.
FarmercJanechadcancMPCIcpolicycincplacecwhenchercwheatcfieldcwascruinedcbycachailcstorm.c
Janecpromptlycplowedcupcthecwheatcandcplantedcaccoverccrop.cTwocdaysclatercshecfiledcaccl
aimcwithchercinsurer.cThecclaimcwascdenied.cWhatcmightcbecthecreasoncforcthecdenial?c-
cCORRECTccANSWER-
Janecdidcnotcleavecsamplescofcthecdestroyedccropcforcthecadjusterctocexamine,cInccropcinsur
ance,conecofcthecinsured'scdutiescaftercaclosscisctocleavecsamplescofcthecdamagedccropcforct
hecadjusterctocinspect.cIfcJanecdidcnotcdocthis,cthencthecinsurerccouldcdenychercclaim.
Frankcpurchasedcac$150,000cinsurancecpolicycforchischome,cwhichciscvaluedcatc$125,000,c
withcthechopescofcmakingcac$25,000cprofitcinctheceventchischomeciscdestroyed.cAftercFrankcb
urnschischousecdown,checfilescacclaimcagainstchischomeownerscpolicy.cAssumingcthatcFrank
'scpolicycincludescancoverinsurancecprovision,chowcmuchcwillchiscinsurercindemnifycFrankcfo
rchiscloss?c-cCORRECTccANSWER-
$0,cBycpurchasingcextracinsurancecwithcintentionsctocdefraudcthecinsurer,cFrankcvoidedchisci
nsurancecpolicycandchecwillcreceivecnothing.
Honey'scBakeryciscaclocalccoffeecshopcruncbyctwocsisters.cIncacrushctocleaveconecafternoon,ct
heircnewcemployeecforgetsctocturncoffcthecgascstove.cThecleakingcgasccausescancexplosion,c
destroyingctheckitchen.cWhichcconditioncinctheirccommercialcpropertycpolicyccouldchelpcthec
sistersccoverctheccostcofcthecdamage?c-cCORRECTccANSWER-
