LA Claims Adjuster Property and Causality Practice Exam 1 100% correct!

LA Claims Adjuster Property and Causality Practice ExamInsurable Interest - ANSWER ______in the property and would suffer a financial loss if the property were damaged by an insured peril, their family members (names need not be listed in the policy), and others such as a lien holder, for example, the bank that holds the mortgage on a house. Cause of Loss Forms - ANSWER ____establish and define the causes of loss (or perils) for which coverage is provided under the form. (Please do not confuse the "cause of loss" forms with the "proof of loss" form, which is the form submitted to the insurance company by the insured when they have a claim.) Basic Cause of Loss Form - ANSWER This form is a "named peril" form, that specifies the perils insured against. The perils listed on this form will usually be, as the name implies, the most basic perils. This form will only cover those perils that are specifically named in the form. Broad Cause of Loss Form - ANSWER This form is also a "named peril" form and provides coverage for the perils named in the basic form, but adds additional perils and names them on the form. Special Cause of Loss Form - ANSWER ___form is an "open peril" or "all risk" form that provides coverage for all risks of loss, from any peril, except those that are specifically excluded in the policy. Remember for your state licensing exam that when coverage is provided under an open peril form, the burden of proof lies with the insurance company to prove that the cause of loss is excluded. Appraisal Clause - ANSWER This property insurance provision allows either the insured or the insurance company to demand a binding appraisal of the damaged property in the event of a dispute as to the value of the property. The clause also establishes the required appraisal procedure. Coinsurance Clause - ANSWER A provision in property insurance policies stating that the insurance company and the insured will share in the loss incurred by the insured, based on a fixed percentage of the value of the insured property. In addition, the insured will face a penalty, and must pay a higher percentage on the loss if they do not insure the property for a certain percentage of its full value (usually at least 80%). Sometimes, in Dwelling & Homeowners policies this clause is called the "Loss Settlement Clause". Concurrent Causation - ANSWER This term, when referring to property insurance, is a doctrine stating that if loss or damage to property occurs as a result of more than one cause, one of which is covered under the policy, while the other cause is not covered, the damages are still likely to be compensated by the insurer. However, this doctrine is being revisited frequently in the courts and a number of recent cases have been decided in favor of denying the claim. Pair or Set Clause - ANSWER This policy provision states that if part of a pair or set is lost or damaged, the loss will be valued as a fair proportion of the total value of the set. It gives consideration to the importance of the damaged article to the set. The insurer is not required to pay for the value of the whole set The Standard Mortgage Clause (Mortgagee Rights) - ANSWER This provision protects the interests of the bank/financial institution that holds the mortgage on the insured property. This clause also grants coverage to the mortgagee, even if the insured intentionally 1 100% correct!