NC CLAIMS ADJUSTER LATEST 2026 CORE EXAM MANUAL
QUESTIONS AND SOLUTIONS RATED A+
✔✔Prepare Final Adjustment Reports - ✔✔● Provide final settlement documents to
claimant
● Explain settlement documents
● Inform claimant of repair deadlines
● Explain depreciation recovery (if applicable)
● Store related claim documentation
● Close the claim
✔✔Draft Authority - ✔✔● Adjuster can settle directly with claimants and write checks for
the insurer
● Often limited to a certain amount (e.g. $5,000)
● Without Draft Authority, adjuster must submit settlement for approval
• Most claims adjusters are given draft authority by the insurers to expedite the payment
of claims.
• The insurer will normally limit the draft authority in terms of the limit that can be paid
and the lines of insurance to which it applies.
• The larger more complicated claims would normally be handled by senior claims
management and payment made at that level.
✔✔Do not negotiate when - ✔✔● When dollar amount difference is too small
● When dollar amount difference is too great
● For punitive damages
note:
If the claimant's demands are much higher than the insurer's range and he is not willing
to lower it to an acceptable amount, the adjuster is wasting valuable time trying to
negotiate, and the case should proceed to dispute resolution or the court.
✔✔Declaratory Judgment Action - ✔✔● Court declares the legal rights of both parties
● Court does NOT decide how to resolve the case
● Disputing parties then use the court's decision to come to settlement
✔✔Full Release Settlement - ✔✔Results in immediate payment when the claimant
signs a release relinquishing his or her right to sue
✔✔Scheduled Release - ✔✔Called OPEN-ENDED Release
or Rehabilitation Settlement (because often used when body injuries require ongoing
rehabilitation)
Insurer pays all compensatory damages and agrees to pay certain future "incidentals"
, • Seller agrees to pay all compensatory damages (General & special) up to the point of
settlement
• Insurer also pays for "incidentals" for future claims related to the claim (Ex. Ongoing
physical therapy)
• Most often used in workers compensation claims
✔✔PARTIAL RELEASE - ✔✔● Payment of Property Damage; Bodily Injury Pending
● Involves claims that have property damage along with a bodily injury
● The insurer indemnifies all property damages while awaiting settlement for bodily
injury
● Claimant must be in a condition in which he can understand this settlement option
✔✔Advanced Payment Settlement - ✔✔• Used when the claimant's damages are
mostly bodily injury and the claimant is unable to work.
• Involves a series of partial payments that will be subtracted when the final settlement
amount is determined.
• Decreases chances of lawsuit.
✔✔No Release - ✔✔Walk-away settlement
• Insurer pays the bills
• special wording on check so that signing and cashing the check equates to signing a
release
✔✔Structure Settlement - ✔✔• Series of smaller payments over time
• reserved for larger claims
• insure often has to pay a portion upfront
✔✔Before negotiations Begin: 3 Things - ✔✔1. Is there coverage?
○ peril is covered
○ policy is active, etc.
2. What is the insured's liability?
(liability claims only)
3. What are the damages?
○ special damages
○ general damages
Remember: no negotiating punitive damages!
✔✔Preparing to negotiate... Do this: - ✔✔• Complete Investigation
• Complete Estimate
• Know the circumstances
• Be clear about objectives
• Understand possible obstacles
• Have an idea of the maximum the insurer will pay
• Have an idea of the minimum amount the claimant will accept
QUESTIONS AND SOLUTIONS RATED A+
✔✔Prepare Final Adjustment Reports - ✔✔● Provide final settlement documents to
claimant
● Explain settlement documents
● Inform claimant of repair deadlines
● Explain depreciation recovery (if applicable)
● Store related claim documentation
● Close the claim
✔✔Draft Authority - ✔✔● Adjuster can settle directly with claimants and write checks for
the insurer
● Often limited to a certain amount (e.g. $5,000)
● Without Draft Authority, adjuster must submit settlement for approval
• Most claims adjusters are given draft authority by the insurers to expedite the payment
of claims.
• The insurer will normally limit the draft authority in terms of the limit that can be paid
and the lines of insurance to which it applies.
• The larger more complicated claims would normally be handled by senior claims
management and payment made at that level.
✔✔Do not negotiate when - ✔✔● When dollar amount difference is too small
● When dollar amount difference is too great
● For punitive damages
note:
If the claimant's demands are much higher than the insurer's range and he is not willing
to lower it to an acceptable amount, the adjuster is wasting valuable time trying to
negotiate, and the case should proceed to dispute resolution or the court.
✔✔Declaratory Judgment Action - ✔✔● Court declares the legal rights of both parties
● Court does NOT decide how to resolve the case
● Disputing parties then use the court's decision to come to settlement
✔✔Full Release Settlement - ✔✔Results in immediate payment when the claimant
signs a release relinquishing his or her right to sue
✔✔Scheduled Release - ✔✔Called OPEN-ENDED Release
or Rehabilitation Settlement (because often used when body injuries require ongoing
rehabilitation)
Insurer pays all compensatory damages and agrees to pay certain future "incidentals"
, • Seller agrees to pay all compensatory damages (General & special) up to the point of
settlement
• Insurer also pays for "incidentals" for future claims related to the claim (Ex. Ongoing
physical therapy)
• Most often used in workers compensation claims
✔✔PARTIAL RELEASE - ✔✔● Payment of Property Damage; Bodily Injury Pending
● Involves claims that have property damage along with a bodily injury
● The insurer indemnifies all property damages while awaiting settlement for bodily
injury
● Claimant must be in a condition in which he can understand this settlement option
✔✔Advanced Payment Settlement - ✔✔• Used when the claimant's damages are
mostly bodily injury and the claimant is unable to work.
• Involves a series of partial payments that will be subtracted when the final settlement
amount is determined.
• Decreases chances of lawsuit.
✔✔No Release - ✔✔Walk-away settlement
• Insurer pays the bills
• special wording on check so that signing and cashing the check equates to signing a
release
✔✔Structure Settlement - ✔✔• Series of smaller payments over time
• reserved for larger claims
• insure often has to pay a portion upfront
✔✔Before negotiations Begin: 3 Things - ✔✔1. Is there coverage?
○ peril is covered
○ policy is active, etc.
2. What is the insured's liability?
(liability claims only)
3. What are the damages?
○ special damages
○ general damages
Remember: no negotiating punitive damages!
✔✔Preparing to negotiate... Do this: - ✔✔• Complete Investigation
• Complete Estimate
• Know the circumstances
• Be clear about objectives
• Understand possible obstacles
• Have an idea of the maximum the insurer will pay
• Have an idea of the minimum amount the claimant will accept
