SC Claims Adjuster Practice Questions and
Correct Answers
What is ACV equation?
Replacement cost-depreciation
What is the coinsurance formula?
Cov you did have / cov should've had x loss = claim payment - deductible
To serve in The Director's position they must ?
Appointed by governor, member of governors cabinet, serve at governors pleasure, bonded
by 50000 surety bond
Powers and duties of the director
Supervise and regulate rates and service of every insurer in state. Enforce insurance related
laws in state.. Reports to Atty General. Acts as circuit judge for insurance matters. License
individuals, agencies and companies
Qualifications to be licensed adjuster
At least 18; apply either on prescribed form or website, pass license exam, pay $80 license
fee; not committed any immoral act grounds for license denial, suspension, or revocation
Are nonresident applicants for nonresident license required to provide a SLED
Background check?
No
What is a resident adjuster
,Authorized by SC Dept of insurance to represent insurance companies and write insurance
policies to citizens of SC; resident of SC and consider it their home of record companies
What is a non resident adjuster
When director enters reciprocal agreement with director of another state and each state
accepts the other's process and accepts the requirements of that state. Adjuster's license must
meet min requirement for SC
Duty of adjuster
Dispose of claims
Staff Adjuster
Salaried employee of insurance company to handle the company's claims
Independent Adjuster
Licensed adjuster not directly employed by company but may be contracted to represent a
company or organization
Public Adjuster
represent the policyholder in the negotiation and settlement of a claim with the staff or
independent adjuster
Claim investigation process
DENS - Document claim file, Evaluate to determine if insured is liable, Negotiate to come to
agreement , Settle
Dwelling policy form structure
,Agreement; definitions, deductible, Coverages, Perils insured against, General exclusions,
conditions
Dwelling Policy Eligibility
Up to 5 roomers or boarders; no more than 4 residential units, properties under construction;
owner or tenant occupied, mobile homes on basic of its no more than 1 apartment, seasonal
dwellings unoccupied for 3 or more months in a 12 month period, Can't be designed as a farm
policy
When would a nonresident adjuster be able to adjust claims in SC without beinh
licensed in SC?
In a catastrophe when there arent enough licensed adjusters in SC to handle claims
How long does the adjuster have to notify the Dept of insurance of change of address?
30 days
What are the rules regarding hearing and notice of hearing?
Director can hold hearing for anything necessary, or can be requested by effected party.
Notice must be given 30 days before the hearing and must state the subject of the inquiry and
specific charges
What are applicable penalties for noncompliance with the SC insurance code?
License suspension, denial, revocation, monetary fines, imprisonment
Describe fraud in insurance
A willful oral or written statement intending to deceive or omit material facts EX : applicant
misstated their age or occupation applying for property insurance
Can a person who has been found guilty of fraud work in insurance?
, Yes with a 1033 waiver
What are the four elements of an insurance contract
Agreement(offer and acceptance) consideration, competent parties, legal purpose
What is a contract of adhesion?
Contract where insured must accept the entire contract with all of its terms and conditions;
insurer sets terms and conditions and insured can only "take it or leave it"
Definition of indemnify
Restore to same financial status before the loss and prevent financial gain
Definition of representation
Statements believed to be true but not guaranteed to be true
Definition of warranties
Absolutely true statement; if breached could make the policy invalid
What are the 3 types of hazards?
Physical, Moral, Morale
What is risk?
The uncertainty or chance of a loss occurring.
What type of behavior constitutes negligence?
failure to use reasonable care resulting in damage or injury to another
proximate cause
Correct Answers
What is ACV equation?
Replacement cost-depreciation
What is the coinsurance formula?
Cov you did have / cov should've had x loss = claim payment - deductible
To serve in The Director's position they must ?
Appointed by governor, member of governors cabinet, serve at governors pleasure, bonded
by 50000 surety bond
Powers and duties of the director
Supervise and regulate rates and service of every insurer in state. Enforce insurance related
laws in state.. Reports to Atty General. Acts as circuit judge for insurance matters. License
individuals, agencies and companies
Qualifications to be licensed adjuster
At least 18; apply either on prescribed form or website, pass license exam, pay $80 license
fee; not committed any immoral act grounds for license denial, suspension, or revocation
Are nonresident applicants for nonresident license required to provide a SLED
Background check?
No
What is a resident adjuster
,Authorized by SC Dept of insurance to represent insurance companies and write insurance
policies to citizens of SC; resident of SC and consider it their home of record companies
What is a non resident adjuster
When director enters reciprocal agreement with director of another state and each state
accepts the other's process and accepts the requirements of that state. Adjuster's license must
meet min requirement for SC
Duty of adjuster
Dispose of claims
Staff Adjuster
Salaried employee of insurance company to handle the company's claims
Independent Adjuster
Licensed adjuster not directly employed by company but may be contracted to represent a
company or organization
Public Adjuster
represent the policyholder in the negotiation and settlement of a claim with the staff or
independent adjuster
Claim investigation process
DENS - Document claim file, Evaluate to determine if insured is liable, Negotiate to come to
agreement , Settle
Dwelling policy form structure
,Agreement; definitions, deductible, Coverages, Perils insured against, General exclusions,
conditions
Dwelling Policy Eligibility
Up to 5 roomers or boarders; no more than 4 residential units, properties under construction;
owner or tenant occupied, mobile homes on basic of its no more than 1 apartment, seasonal
dwellings unoccupied for 3 or more months in a 12 month period, Can't be designed as a farm
policy
When would a nonresident adjuster be able to adjust claims in SC without beinh
licensed in SC?
In a catastrophe when there arent enough licensed adjusters in SC to handle claims
How long does the adjuster have to notify the Dept of insurance of change of address?
30 days
What are the rules regarding hearing and notice of hearing?
Director can hold hearing for anything necessary, or can be requested by effected party.
Notice must be given 30 days before the hearing and must state the subject of the inquiry and
specific charges
What are applicable penalties for noncompliance with the SC insurance code?
License suspension, denial, revocation, monetary fines, imprisonment
Describe fraud in insurance
A willful oral or written statement intending to deceive or omit material facts EX : applicant
misstated their age or occupation applying for property insurance
Can a person who has been found guilty of fraud work in insurance?
, Yes with a 1033 waiver
What are the four elements of an insurance contract
Agreement(offer and acceptance) consideration, competent parties, legal purpose
What is a contract of adhesion?
Contract where insured must accept the entire contract with all of its terms and conditions;
insurer sets terms and conditions and insured can only "take it or leave it"
Definition of indemnify
Restore to same financial status before the loss and prevent financial gain
Definition of representation
Statements believed to be true but not guaranteed to be true
Definition of warranties
Absolutely true statement; if breached could make the policy invalid
What are the 3 types of hazards?
Physical, Moral, Morale
What is risk?
The uncertainty or chance of a loss occurring.
What type of behavior constitutes negligence?
failure to use reasonable care resulting in damage or injury to another
proximate cause
