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Exam (elaborations)

Florida Claims Adjuster Exam

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Florida Claims Adjuster Exam

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Florida Claims Adjuster Exam questions
and answers



A __________ is a selected group of hospitals and medical
practitioners in a given area who have joined together in an effort
to reduce medical costs.
A. HMO
B. Major Medical Insurance
C. Coinsurance
D. PPO - -D. PPO
Most plans provide that emergency treatment will be paid even if
treated party does not go to service provider on approved list.

-A customer representative appointed by a general lines agent or
agency in transacting only the business of private passenger
motor vehicle insurance from the office of that agent or agency is
defined as:
A. Automobile Agent
B. Automobile Representative
C. Limited Customer Service Representative
D. Limited Customer Service Agent - -C. Limited Customer Service
Representative

-A General Lines Agent instructs a licensed Customer
Representative 4-40 to thoroughly cover the details of a new life
insurance product with every Homeowner customer who calls or
visits the office. The agent provides training on the new product.
Although the Customer Representative does not have a Life
License, he or she feels comfortable with the training and does as
requested.
Which of the following is true?
A. This practice is acceptable if done in the office under
supervision of General Lines Agent
B. This practice is acceptable because adequate training and
product knowledge was provided

,C. This practice is unacceptable and may result in the suspension
or revocation of the Customer Representative's license
D. This practice is only acceptable if the product training was
certified by the Life Insurance Company - -C. This practice is
unacceptable and may result in the suspension or revocation of
the Customer Representative's license

-A General Lines Claim Adjuster is required to obtain the same
number of Continuing Education hours as a licensed Customer
Service Representative.
A. True
B. False - -B. False

-A lender has an insurable interest in a home and finds protection
in the:
A. Loss Payee Clause
B. Mortgagee Clause
C. Lender Clause
D. Additional Insured Clause - -B. Mortgagee Clause
Mortgagee - Homeowner's policy
Loss Payee - Automobile policy

-A licensed General Lines Claim Adjuster is required to complete
how many hours of continuing education every two years?
A. 6
B. 12
C. 18
D. 24 - -D. 24

-A motor vehicle or mobile home which is a total loss is defined
as:
A. Lost Profit
B. Salvage
C. Salvageable
D. All of the Above - -B. Salvage
It cannot be restored to prior condition

-A policy condition, either based on information in the insured's
application or inserted by the insurer, is defined as:

,A. Warranty
B. Misrepresentation
C. Concealment
D. None of the Above - -A. Warranty

-A policy may contain a provision which states a period of time
between issuance and acceptance before sickness benefits begin.
This is defined as:
A. Waiting Period
B. Elimination Period
C. Both A & B
D. None of the Above - -C. Both A & B
This helps keep premiums reasonable by eliminating chance of
persons buying coverage only when they are sick

-A relationship that requires maintenance of a high degree of
fidelity and loyalty to the interests of the principal, whether or not
the adjuster is a direct employee is defined as:
A. Fiduciary
B. Estoppel
C. Public
D. None of the Above - -A. Fiduciary
Should always be maintained whether or not the adjuster is a
direct employee

-A written statement given by the insured to the insurer
acknowledging that money received in the settlement of damages
is received, not as a final payment, but as an advance pending an
outcome of a claim against the person responsible for the
damage. This is defined as a(n):
A. Loan Receipt
B. Subrogation Loan
C. Full Release Statement
D. Partial Release Statement - -A. Loan Receipt
Enables insurer to bring an action for recovery against a third
party

-A(n) __________ is one wherein economic loss would be suffered
from an adverse happening to the subject:

, A. Conditional Contract
B. Personal Contract
C. Economic Contract
D. Insurable Interest - -D. Insurable Interest

-A(n) __________ provides comprehensive health services to its
members for a prepaid fixed fee, equivalent to an insurance
premium.
A. HMO
B. PPO
C. Major Medical Plan
D. All of the Above - -A. HMO
Referred to as an emerging and increasingly important non-
insurance alternative to dealing with risk of health care costs

-Actual Cash Value - -Replacement cost minus depreciation

-After pleading guilty or no contest to a felony, a licensed
individual has _________ days to inform the Department?
A. 10
B. 20
C. 30
D. 40 - -C. 30

-Alien - -Insurer other than domestic or foreign (outside U.S.)

-All of the following are components of Workers Compensation,
except:
A. Up to $750,000 in Death Benefits
B. Reimbursement for Medical Expenses incurred
C. Reimbursement for lost wages on percentage basis
D. Funeral costs up to $7,500 - -A. Up to $750,000 in Death
Benefits
Compensation for death is payable if death results within one
year of an accident or if it follows disability within five years of
accident.

-All of the following are eligible for a Homeowner's Policy, except?
A. An apartment tenant

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Uploaded on
April 1, 2025
Number of pages
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Written in
2024/2025
Type
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