Claims Adjuster Questions And
Answers - Updated
Subrogation - ANSWER -the transfer of rights that allows the insurer to recover its
losses after it indemnified a policyholder
-when a policyholder is indemnified for a loss, she may no longer collect payment for
that loss form anyone else. She has transferred this right to the insurer.
-only applies to the amount the insurer pays
-the policyholder still has the right to demand payment from the guilty party for any
damages that exceed the indemnity.
Cancellation and Non-Renewal of Policies - ANSWER -insurers must give policy
holders 30 days’ notice of cancellation or non-renewal
-in case of non-payment of premiums, 10 days’ notice
-policies in effect for less than 60 days, 10 days’ notice
-notification must be delivered in person or at least by first class mail
-if sent by mail, insurer must keep the receipt
Unearned Premium Refunds - ANSWER Insurers must refund unearned
premiums to the policyholder in case of cancellation:
-- on or before the cancellation date
--to the insured or to his agent
If the insurer fails to return unearned premiums on time:
--a penalty of 25% is added
--along with 18% interest
Cancellation by the Insured - ANSWER -policyholder returns policy to insurer of
sends written notice requesting future date of cancellation.
-insurer sends receipt confirming date for cancellation
-insurer informs any third party
-policy automatically cancelled upon replacement policy's effective date
- ANSWER
Insurance - ANSWER -an economic device used to protect against extreme
unforeseen loss
- the transfer of risk from one party to another
Premium - ANSWER -the fee paid by the insured in exchange for insurance
, Principle of Indemnity - ANSWER -the insurer should be restored to where they
were before the incident
-no profit can be made
Idemnification - ANSWER -to compensate for loss or damage; to provide security
for financial reimbursement to an individual in case of a specified loss incurred by the
person
4 Elements of a Legal Contract - ANSWER -Agreement- signature or handshake
-Consideration- money exchange
-Competent Parties-18 yrs. old, sober, sane
-Legal Purpose-no contracts for money laundering
Insured - ANSWER individual who pays premiums in exchange for protection
-can be a person, person's or an organization
- "You," "Your," or "Yours’s"
(if the insured is a group it is important to list the "first named insured,"- because that is
the only one that can authorize changes to the policy)
Insurer - ANSWER -company or group offering insurance
-can be a government organization
-terms- "We," "Us," and "Our
6 Characteristics of a Contract:
Personal - ANSWER -protects the person (insured) from loss
-does not protect property from becoming damaged
-coverage follows the person not the property
6 Characteristics of a Contract:
Adhesion - ANSWER -one party dictates terms
-the insured has no power to write the contract
-courses will favor the insured in a case of ambiguity
6 Characteristics of a Contract:
Utmost Good Faith - ANSWER -applicants are expected not to withhold any
information or the contract can be voided
6 Characteristics of a Contract:
Aleatory - ANSWER -depending on a unknown future event
-Insurer only has to pay in and when covered losses occur
6 Characteristics of a Contract:
Answers - Updated
Subrogation - ANSWER -the transfer of rights that allows the insurer to recover its
losses after it indemnified a policyholder
-when a policyholder is indemnified for a loss, she may no longer collect payment for
that loss form anyone else. She has transferred this right to the insurer.
-only applies to the amount the insurer pays
-the policyholder still has the right to demand payment from the guilty party for any
damages that exceed the indemnity.
Cancellation and Non-Renewal of Policies - ANSWER -insurers must give policy
holders 30 days’ notice of cancellation or non-renewal
-in case of non-payment of premiums, 10 days’ notice
-policies in effect for less than 60 days, 10 days’ notice
-notification must be delivered in person or at least by first class mail
-if sent by mail, insurer must keep the receipt
Unearned Premium Refunds - ANSWER Insurers must refund unearned
premiums to the policyholder in case of cancellation:
-- on or before the cancellation date
--to the insured or to his agent
If the insurer fails to return unearned premiums on time:
--a penalty of 25% is added
--along with 18% interest
Cancellation by the Insured - ANSWER -policyholder returns policy to insurer of
sends written notice requesting future date of cancellation.
-insurer sends receipt confirming date for cancellation
-insurer informs any third party
-policy automatically cancelled upon replacement policy's effective date
- ANSWER
Insurance - ANSWER -an economic device used to protect against extreme
unforeseen loss
- the transfer of risk from one party to another
Premium - ANSWER -the fee paid by the insured in exchange for insurance
, Principle of Indemnity - ANSWER -the insurer should be restored to where they
were before the incident
-no profit can be made
Idemnification - ANSWER -to compensate for loss or damage; to provide security
for financial reimbursement to an individual in case of a specified loss incurred by the
person
4 Elements of a Legal Contract - ANSWER -Agreement- signature or handshake
-Consideration- money exchange
-Competent Parties-18 yrs. old, sober, sane
-Legal Purpose-no contracts for money laundering
Insured - ANSWER individual who pays premiums in exchange for protection
-can be a person, person's or an organization
- "You," "Your," or "Yours’s"
(if the insured is a group it is important to list the "first named insured,"- because that is
the only one that can authorize changes to the policy)
Insurer - ANSWER -company or group offering insurance
-can be a government organization
-terms- "We," "Us," and "Our
6 Characteristics of a Contract:
Personal - ANSWER -protects the person (insured) from loss
-does not protect property from becoming damaged
-coverage follows the person not the property
6 Characteristics of a Contract:
Adhesion - ANSWER -one party dictates terms
-the insured has no power to write the contract
-courses will favor the insured in a case of ambiguity
6 Characteristics of a Contract:
Utmost Good Faith - ANSWER -applicants are expected not to withhold any
information or the contract can be voided
6 Characteristics of a Contract:
Aleatory - ANSWER -depending on a unknown future event
-Insurer only has to pay in and when covered losses occur
6 Characteristics of a Contract:
