Florida Claims Adjuster Exam Review (6-20 All Lines Adjuster) 2023 EXAM QUESTIONS AND ANSWERS LATEST UPDATE

Florida Claims Adjuster Exam Review (6-20 All Lines Adjuster) 2023 EXAM QUESTIONS AND ANSWERS LATEST UPDATE Peril (Ans- Something that causes a loss. Hazard (Ans- Something that increases the probability that a loss will occur. Warranty (Ans- A policy condition, either based on information in the insureds application or inserted by the insurer. It is a guarantee of a fact. Misrepresentation (Ans- An untrue statement by the insured, made in an application for insurance but which does not become a part of the policy. Concealment (Ans- The failure of the insured to reveal relevant facts known to the insured in applying for insurance. Abandonment (Ans- Property insurance policies usually contain an abandonment clause, stating the insured cannot dump damaged property on the insurer and demand its full value. Severability (Ans- The insurance applies separately to each insured as if other insureds did not exist. Proximate Cause (AnsThe cause having the most significant impact in bringing about the loss under a first-party property insurance policy, when two or more independent perils operate at the same time (i.e., concurrently) to produce a loss. Courts employ a set of rules to resolve causation disputes when a property policy states that it covers or excludes losses "caused by" a peril and there is more than one peril at work in a fact pattern. Under common law, whether the policy provides coverage depends on which peril is chosen as the proximate cause. Direct Loss (Ans- Physical harm to tangible property. Indirect Loss (Ans- Economic loss which flows as a result of direct loss. Actual Cash Value(ACV) (Ans- Replacement Cost minus Depreciation Coinsurance (Ans- The amount, generally expressed as a fixed percentage, an insured must pay against a claim after the deductible is satisfied. It's ultimately a way for the insured and insurer to share responsibility for the risk. It can also help reduce the cost of the insurance policy premium. Coinsurance can be written on an 80/20, 90/100, or 100% rule. Personal Contract (Ans- Policies cover people who own and operate things, such as automobiles. Conditional Contract (Ans- Also called a hypothetical contract, is a contract agreement that only requires performance once the delineated conditions are met. This legal agreement requires prior performance of another agreement or clause in order to be enforceable. If the other agreement or condition is performed, then the conditional contract is enforceable and the parties are bound to carry out the terms of the contract. Contract of Indemnity (Ans- Principle of insurance that provides that when a loss occurs, the insured should be restored to the approximate financial condition he/she occupied before the loss occurred, no better or no worse. Insurable Interest (Ans- the reasonable concern of a person to obtain insurance for any individual or property against unforeseen events such as death, losses, etc. Waiver (Ans1.) Implied voluntary relinquishment, abandoning a legal advantage, need, claim or right. 2.) Agreement or added clause of a policy that excludes some losses or limits the sum of a claim, or extends coverage to add items not in a normal policy. Express Waiver (Ans- Occurs when the insurer or its representative knowingly gives up a known right under the insurance contract. Implied Waiver (Ans- A waiver that is assumed to be in effect from a person's behavior and shows he is waiving a right. Damages (Ans- Monetary compensation that is awarded by a court in a civil action to an individual who has been injured through the wrongful conduct of another party. Subrogation (Ans- When an insured has a right to collect damages from another party, but instead elects to claim the damages under his insurance policy, his rights against the other party are transferred to the insurer. Changes (Ans- All policies provide that any changes to the policy be made by the insurer, in writing. Policy Period (Ans- The condition states that coverage applies only to losses or occurrences that take place during the policy period. (Prior to the stated date and time of termination). Policy Territory (Ans- Condition limiting coverage to occurrences or losses that take place only within a stated geographical region. Other Insurance (Ans- The principle of indemnity dictates against duplicate recovery for the same loss. Cancellation (Ans- The insured may cancel at any time, for any reason, without advance notice. If the conpany wishes to cancel, it must provide some degree of advance notice so the insured will have time to replace the coverage. Appraisal (Ans- A written contract of or written agreement for or effecting insurance, or the certificate thereof, by whatever name called, and includes all clauses, riders, endorsements and papers which are a part thereof. Insurance (Ans- Is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Binder (Ans- Acts as a temporary contract until the policy is issued. How many days should an insurer give for prior notice of cancellation of a binder? (Ans- 5 days. Property Insurance (Ans- Any insurance wherein payment by the insurer will be paid directly to the insured or other specifically named interests. Liability Insurance (Ans- Payment will be on behalf of the insured to another, based upon the insureds liability to the recipient. Simply stated, Liability is "Negligence of the Insured". Loss Payee Clause (Ans- A Clause in a contract of insurance that provides, in the event of payment being made under the policy in relation to the insured risk, that payment will be made to a 3rd party rather than to the insured beneficiary of the policy. Mortgage Clause (Ans- A property insurance provision granting special protection for the interest of a mortgagee named in the policy, in effect setting up a separate content between the insurer and the mortgagee. Other Structures (Ans- Covers items that are not permanently attached to the main dwelling, such as a shed, fence, etc. Commercial Inland Marine (Ans- Helps identify the kinds of risk which are eligible for either ocean or inland Marine insurance. Building Ordinance Coverage (Ans- This endorsement covers the insured for enforcement of laws which require demolition of undamaged portions of buildings. Umbrella Policy (Ans- Covers a much higher limit and goes above and beyond claims directly relating to your home and auto, it provides your assets from an unforeseen event, such as a tragic accident in which you are held responsible for damages or bodily injuries. Known Loss (Ans- Prevents an insured from coverage if the insured knew the loss was probable at the time of the insurance contract. Value Reporting (Ans- The limit of coverage is set at an amount somewhat higher than expected peak values. Commercial Property Insurance (Ans- Covers direct and indirect losses related to properties other than one to four family dwellings and farm properties. Employee Theft (Ans- Provides coverage for loss of or damage to money, securities, and other property resulting from theft committed by an employee. Theft is defined as the unlawful taking of money, securities or other property to the deprivation of the insured. Bid (Ans- Agreement to fulfill a contractual obligation used frequently in construction and supplying goods. Health Maintenance Organization (HMO) (Ans- Provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. Preferred Provider Organization (PPO) (Ans- A selected group of hospital's and medical practitioners in a given area who have joined together in an effort to reduce medical costs. Estoppel (Ans- Is an equitable principle to the effect that if one intentionally or unintentionally creates the impression that a certain fact exists, and an innocent party relies on that impression and is damaged as a result, the guilty party may be legally prohibited(estopped) from asserting that the fact does not exist. Salvage (Ans- Motor vehicle or mobile home is a total loss. Junk (Ans- Any material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal. Fiduciary Agent (Ans- Agent for a principal/Client. The legal or special relationship of trust, confidence, or responsibility between 2 or more parties. Domestic Insurer (Ans- Insurer is one formed under the laws of its this state. Foreign Insurer (Ans- Insurer is one formed under the laws of any state, district territory, or commonwealth of the United States other than this State. Alien Insurer (Ans- Insurer is an insurer other than a domestic or foreign insurer. Appointment (Ans- The authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf an insurer or employer. Derelict (Ans- Material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or component parts or both. Mechanical Breakdown Coverage (Ans- Covers repairs to mechanical parts of your vehicle that break. Even covers break in events not related to an accident. Sliding (Ans- Selling an item and stating that it is required by law. What is the Death Benefit amount for PIP ? (Ans- $5,000 What is the amount for medical and disability benefits afforded by PIP ? (Ans- $10,000 Who is the Financial Responsibility Law administered by ? (Ans- The Department of Highway Safety and Motor Vehicles. What are the Basic PIP Benefits ? (Ans- -Medical-80% of responsible expenses are paid for necessary medical, surgical, X-Ray and dental. -Work Loss-60% of any loss of gross income and loss of earning capacity reimbursed. -Replacement Services-100% for the cost of having household services performed by others. -Death-Effective 01/01/2013 the death benefit will be $5,000 in addition to the $10,000 in medical and disability benefits afforded by PIP. Company or Staff Adjuster (Ans- Are salaried employees under the supervision of the home, branch or regional claims department of insurers. Fee Adjusters (Ans- Offer their services on a fee-for-service basis. They represent many insurers. Bureau Adjuster (Ans- Employee or agent of an adjustment bureau which serves multiple company clients such as the GAB Business Services, Inc and Underwriters Adjusting Company both national firms