Insurance Claims Adjusting Exam With
100% Correct And Verified Answers
- Correct Answer-
Insurance claim - Correct Answer-a formal request to an insurance company requesting
a payment, based on the terms of an insurance policy (contract)
First-party claim - Correct Answer-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
Third-party claim - Correct Answer-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
What do claims adjusters do? - Correct Answer-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
Types of insurance claims adjusters - Correct Answer-1. Independent adjusters - they
work on behalf of the insurance company
2. Public adjusters - they work on behalf of the policyholders.
Both types must be licensed according to the laws of the state in which they are working
Are independent adjusters permitted to adjust claims on behalf of the individual
policyholder? - Correct Answer-No
How may independent adjusters be hired by an insurance company? - Correct Answer-
1. "Staff or company" adjuster working in the home office of the insurance company.
2. "Field" adjuster who adjusts claims for an insurer in a particular location.
What else can "Staff" adjuster also include and what does that include? - Correct
Answer-Staff adjusters can also include "specialty" adjusters such as workers
compensation adjusters, accident & health adjusters, automobile claims adjusters, and
other specialties as licensed per state law.
What other companies may independent adjusters work for? And what are these
adjusters referred as? - Correct Answer-Adjusting companies that deploy teams of
adjusters to work 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
, What do many states title their adjuster licenses as? And what type of adjusters have
these licenses? - Correct Answer-1. Property & Casualty Adjuster
2. General Lines Adjuster, or
3. All Lines Adjuster
What is a Public adjuster? - Correct Answer-an independent contractor representing
solely the financial interests of the insured named in the policy.
Does the insured or the insurance company pay the public adjuster for his or her
services? - Correct Answer-Insured
What do state laws prohibit public adjusters from? - Correct Answer-Adjusting liability
type claims and restrict their authority to the adjustment of property insurance claims.
In some states, what can individuals hold licenses for concurrently, but not with respect
to the same claim? - Correct Answer-Individuals can hold an independent/staff adjuster
license and a public adjuster license concurrently.
What do other states prohibit? - Correct Answer-Other states prohibit an individual form
holding both an independent/staff adjuster license and a public adjuster license at the
same time, citing a conflict of interest
What does it mean if you are a fiduciary agent adjuster? - Correct Answer-A fiduciary
agent adjuster must represent the interest of "the principle".
Does an independent adjuster act as a fiduciary agent to the insurer? - Correct Answer-
Yes
If an independent adjuster acts as a fiduciary agent to the insurer, who is the principle? -
Correct Answer-The insurance company
What happens when the principle is the policyholder? - Correct Answer-The public
adjuster acts as a fiduciary agent with respect to the policyholder
What should the adjuster as a fiduciary agent of the principle not do? - Correct Answer-
1. Not represent interests that are averse to those of the principle
2. The adjuster should not profit, or seek to profit, from any outside source as a
consequence of actions for, or on behalf of, the principle
What are the six ways an adjuster must carefully act on behalf of his or her principle to
avoid engaging in the unauthorized practice of law? - Correct Answer-1. An adjuster
cannot legally advise the principle as to how the claim should be settled.
2. The adjuster may express an opinion on the extent of damage or injury, but only as
part of a factual analysis.
3. The adjuster must manage claims in compliance with all state laws and regulations.
100% Correct And Verified Answers
- Correct Answer-
Insurance claim - Correct Answer-a formal request to an insurance company requesting
a payment, based on the terms of an insurance policy (contract)
First-party claim - Correct Answer-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
Third-party claim - Correct Answer-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
What do claims adjusters do? - Correct Answer-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
Types of insurance claims adjusters - Correct Answer-1. Independent adjusters - they
work on behalf of the insurance company
2. Public adjusters - they work on behalf of the policyholders.
Both types must be licensed according to the laws of the state in which they are working
Are independent adjusters permitted to adjust claims on behalf of the individual
policyholder? - Correct Answer-No
How may independent adjusters be hired by an insurance company? - Correct Answer-
1. "Staff or company" adjuster working in the home office of the insurance company.
2. "Field" adjuster who adjusts claims for an insurer in a particular location.
What else can "Staff" adjuster also include and what does that include? - Correct
Answer-Staff adjusters can also include "specialty" adjusters such as workers
compensation adjusters, accident & health adjusters, automobile claims adjusters, and
other specialties as licensed per state law.
What other companies may independent adjusters work for? And what are these
adjusters referred as? - Correct Answer-Adjusting companies that deploy teams of
adjusters to work 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
, What do many states title their adjuster licenses as? And what type of adjusters have
these licenses? - Correct Answer-1. Property & Casualty Adjuster
2. General Lines Adjuster, or
3. All Lines Adjuster
What is a Public adjuster? - Correct Answer-an independent contractor representing
solely the financial interests of the insured named in the policy.
Does the insured or the insurance company pay the public adjuster for his or her
services? - Correct Answer-Insured
What do state laws prohibit public adjusters from? - Correct Answer-Adjusting liability
type claims and restrict their authority to the adjustment of property insurance claims.
In some states, what can individuals hold licenses for concurrently, but not with respect
to the same claim? - Correct Answer-Individuals can hold an independent/staff adjuster
license and a public adjuster license concurrently.
What do other states prohibit? - Correct Answer-Other states prohibit an individual form
holding both an independent/staff adjuster license and a public adjuster license at the
same time, citing a conflict of interest
What does it mean if you are a fiduciary agent adjuster? - Correct Answer-A fiduciary
agent adjuster must represent the interest of "the principle".
Does an independent adjuster act as a fiduciary agent to the insurer? - Correct Answer-
Yes
If an independent adjuster acts as a fiduciary agent to the insurer, who is the principle? -
Correct Answer-The insurance company
What happens when the principle is the policyholder? - Correct Answer-The public
adjuster acts as a fiduciary agent with respect to the policyholder
What should the adjuster as a fiduciary agent of the principle not do? - Correct Answer-
1. Not represent interests that are averse to those of the principle
2. The adjuster should not profit, or seek to profit, from any outside source as a
consequence of actions for, or on behalf of, the principle
What are the six ways an adjuster must carefully act on behalf of his or her principle to
avoid engaging in the unauthorized practice of law? - Correct Answer-1. An adjuster
cannot legally advise the principle as to how the claim should be settled.
2. The adjuster may express an opinion on the extent of damage or injury, but only as
part of a factual analysis.
3. The adjuster must manage claims in compliance with all state laws and regulations.
