Super-Duper Texas Adjuster License Test Review
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Terms in this set (309)
Coverage by contract whereby one party undertakes
Insurance History and
to indemnity (hold harmless) or guarantee another
Regulation: Insurance
against loss by a specified contingency or peril.
An organization whose purpose is to organize the
Insurance History and regulatory and supervisory efforts of the various state
Regulation: NAIC insurance commissioners from around the United
States.
Protection of Consumer Regulates the consumer interest in regard to
Interests: The Texas insurance.
Department of Insurance
(TDI)
Protection of Consumer Insurance Commissioner
Interests: Head of the
Texas Department of
Insurance
Protection of Consumer was set up by the State of Texas to establish certain
Interests: Chapter 541 - practices which constitute unfair and/or deceptive
Unfair and Deceptive insurance acts.
Insurance Practices
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Protection of Consumer within 15 days 1) acknowledge receipt of a claim 2)
Interests: Texas Insurance begin investigation 3) request items from the claimant.
Code requires what within
how many days of receipt
of a claim that the insurer?
Insurance: What is the to provide a way to spread risk over a large group of
purpose of insurance? people
IS AN INSURANCE PRINCIPLE STATING THAT AN
INSURED MAY NOT BE COMPENSATED BY
Insurance: Principle of INSURANCE COMPANY IN AN AMOUNT
Indemnity EXCEEDING THE INSURED'S ECONOMIC LOSS. It is a
principle that returns the insured to their previous
financial condition.
Insurance: What are the 1) to prevent the insured from profiting from a loss 2)
two purposes of to reduce moral hazard
indemnity?
(1) the potential for a financial loss or the statistical
chance of danger from exposure to a hazard or peril
Insurance: what is risk?
(2) the uncertainty about loss that exists whenever
more than one outcome is possible
Insurance: Proximate is the first event in an uninterrupted chain of events
Cause that leads to a loss
Speculative: affords the opportunity for gain as well as
Insurance: What are the 2 the possibility of loss
types of risk? Pure: a risk where there is the potential of real loss
due to exposure to a peril
Insurance: example of risk to avoid risks associated with swimming pools, don't
avoidance buy a home with a pool.
Insurance: example of risk to reduce fire damage, install a sprinkler system in
reduction home
Insurance: Example of risk insurance company accepts risk when they've
retention accepted the insured.
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Insurance: example of risk purchasing insurance, transfers the risk from insured to
transference insurance company.
Insurance: what is a peril? The actual cause of a loss.
1) named peril -- specifies which perils are insured
Insurance: what are the
against 2) open peril / all risk peril -- insures against
two types of perils?
all perils unless specifically excluded in the policy
1. lightning/fire
2. sudden & accidental damage from smoke
3. explosions
4. windstorms, hurricane or hail
5. theft
6. vehicle damage
7. aircraft damage
Insurance: 14 most
8. vandalism/malicious mischief (V/MM)
common named perils
9. falling objects
10. weight of snow, ice or sleet
11. sudden and accidental water damage from
plumbing, heating, or A/C overflow
12. freezing damage to plumbing
13. riots
14. civil disobedience
Insurance: What is a situations or behaviors that increase the risk of loss of
hazard? property
1) Physical -- large hole in the front yard where
Insurance: Name the three someone could step in and hurt themselves
kinds of hazards and give 2) Morale -- leaving a home with the doors unlocked
an example of each and the windows opened
3) Moral -- embezzlement
1) Direct loss -- damage that is a direct result of a
covered peril such as a fire destroying a home
Insurance: List and define
the 2 types of losses 2) Indirect loss -- consequential loss resulting
indirectly from a direct loss due to a covered peril
such as loss of business income or loss of use
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work for the insurance company such as State Farm
Claims Adjuster: What is a
and handle claims on behalf of the insurer; they are
Staff/Company Adjuster?
paid a salary with benefits.
work for the insurance companies to handle and
Claims Adjuster: What is an
evaluate certain claims on an as-needed basis; they
Independent Adjuster?
are paid a percentage of the claims they settle
work for the insured to make an evaluation of loss to
Claims Adjuster: What is a be presented to the insurer; they are paid on a fee
Public Adjuster? basis (usually 10%) and are usually required to carry an
adjuster bond
represent the insurance company that hired the
Claims Adjuster: CAT (
catastrophic adjusting company that you are doing
catastrophic) Adjusters
claims for
1) Determine coverage
2) determine amount of damage
3) prepare report of findings
4) Try to work out a fair settlement
Claims Adjuster: 11 things 5) prepare a claim file
that a claims adjuster may 6) interview with insured and/or witnesses
do 7) inspect and estimate property damage or loss
8) consult police, fire dept. and medical reports
9) take pictures and draw diagrams
10) make advance settlement payments
11) attend court hearings if necessary
1) a combination of related education and on-the-job
Claims Adjuster: 4
experience
educational requirements
2) at least a high school diploma
that are suggested for
3) some post high school education is an asset
adjusters to have
4) a valid driver's license
Claims Adjuster: Initial 24 hours
contact with the insured
should be within __________
of receiving the claim.
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