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Insurance Claims Adjusting | Complete Study Guide, Practice Questions & Verified Answers

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This document provides a comprehensive study guide for Insurance Claims Adjusting, featuring exam-style practice questions, verified answers, and detailed explanations to support licensing and professional certification preparation. It covers key topics including the claims process, policy interpretation, claims investigation, liability assessment, property and casualty insurance, documentation, negotiation techniques, insurance ethics, regulatory compliance, and claims settlement procedures.

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INSURANCE CLAIMS ADJUSTING | COMPLETE STUDY GUIDE WITH PRACTICE QUESTIONS AND
VERIFIED ANSWERS FOR INSURANCE LICENSING EXAMS

1. :
2. Insurance claim: a formal request to an insurance company requesting a payment, based on the terms of
an insurance policy (contract)
3. First-party claim: is made by a policyholder, insured, or beneficiary, directly against the insurance company.
First-party claims are filed under policies such as Dwelling or Automobile Physical Damage
4. Third-party claim: is made against an insured who is covered by a liability policy, such as Commercial
General Liability or Malpractice insurance policies. It's important to remember that policies such as Homeowners,
Personal Auto, and Business Owners contain both first and third-party coverage
5. What do claims adjusters do?: Insurance claims adjusters inspect and investigate property damage
or personal injury claims to determine the amount an insurance company is liable to pay for a loss
6. Types of insurance claims adjusters: 1. Independent adjusters - they worк on behalf of the
insurance company
2. Public adjusters - they worк on behalf of the policyholders.
Both types must be licensed according to the laws of the state in which they are worкing
7. Are independent adjusters permitted to adjust claims on behalf of the indi-
vidual policyholder?: No
8. How may independent adjusters be hired by an insurance company?: 1. "Statt
or company" adjuster worкing in the home oflce of the insurance company.
2. "Field" adjuster who adjusts claims for an insurer in a particular location.
9. What else can "Staff" adjuster also include and what does that include?: Statt
adjusters can also include "specialty" adjusters such as worкers compensation adjusters, accident & health adjusters,
automobile claims adjusters, and other specialties as licensed per state law.
10. What other companies may independent adjusters worк for? And what are
these adjusters referred as?: Adjusting companies that deploy teams of adjusters to worк on behalf
of an insurer in the case of a catastrophe such as a hurricane, flood, or tornado. These adjusters are referred to as
"catastrophe" or "CAT" adjusters
11. What do many states title their adjuster licenses as? And what type of
adjusters have these licenses?: 1. Property & Casualty Adjuster
2. General Lines Adjuster, or
3. All Lines Adjuster
12. What is a Public adjuster?: an independent contractor representing solely the financial interests of
the insured named in the policy.
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