UNIT 21 PRINCIPLES OF CLAIMS ADJUSTING
QUESTIONS WITH ACCURATE RIGHT ANSWERS
/GRADED A+ .
First Party Claim - correct Answers -- claim filed under property insurance policy
- the insured files a claim for payment under his own policy, no third party is involved
Third Party Claims - correct Answers -Claims filed under liability coverage
- insured = 1st party
- insurance company = 2nd party
- claimant = 3rd party
Staff Adjuster - correct Answers -Employee of the insurance company's claim department.
Independent Adjusters - correct Answers -hired by insurers to performs all or part of the functions
involved in handling the companies claims
- self employed or works for private company
public adjusters - correct Answers --hired by insured
-in exchange for a fee
-if claim is complex or negotiations aren't progressing satisfactorily
-paid fee which is usually % of settlement
Documentary Evidence - correct Answers -adjuster's signed and dated reports about actions taken on the
claims and summaries of phone conversations with the insured or claimant
Testimonial evidence - correct Answers -written or recorded statements by individuals who were
interviewed by the adjuster
physical evidence - correct Answers -photographs of damaged property or diagrams of an accident scene
1
, Reserves - correct Answers -an estimate of the costs associated with a claim
- represents money that is set aside to pay covered claims when they arise
Loss Adjustment Expenses - correct Answers --cost of the loss itself & costs associated with handling the
claims
- adjusters salaries and legal expenses related to adjusting the loss
Claims handling process - correct Answers -1. investigation
2. Evaluation
3. disposition (settlement)
burden of proof - correct Answers -the obligation to present evidence to support one's claim
3 Steps of Claims Investigation - correct Answers -1) verify insurance coverage
2) obtain information about the claim
3 verify and compare this information
Step 1: Verify Insurance Coverage - correct Answers -- loss must occur during policy period
- loss must occur in coverage territory
- insurable interest
- who is an insured
- exclusions
- policy conditions
- policy limit
- reservation of rights/nonwaiver agreement
Policy period - correct Answers -when the policy begins and ends
insurable interest - correct Answers -something of value that, if lost, would cause you financial harm
2
QUESTIONS WITH ACCURATE RIGHT ANSWERS
/GRADED A+ .
First Party Claim - correct Answers -- claim filed under property insurance policy
- the insured files a claim for payment under his own policy, no third party is involved
Third Party Claims - correct Answers -Claims filed under liability coverage
- insured = 1st party
- insurance company = 2nd party
- claimant = 3rd party
Staff Adjuster - correct Answers -Employee of the insurance company's claim department.
Independent Adjusters - correct Answers -hired by insurers to performs all or part of the functions
involved in handling the companies claims
- self employed or works for private company
public adjusters - correct Answers --hired by insured
-in exchange for a fee
-if claim is complex or negotiations aren't progressing satisfactorily
-paid fee which is usually % of settlement
Documentary Evidence - correct Answers -adjuster's signed and dated reports about actions taken on the
claims and summaries of phone conversations with the insured or claimant
Testimonial evidence - correct Answers -written or recorded statements by individuals who were
interviewed by the adjuster
physical evidence - correct Answers -photographs of damaged property or diagrams of an accident scene
1
, Reserves - correct Answers -an estimate of the costs associated with a claim
- represents money that is set aside to pay covered claims when they arise
Loss Adjustment Expenses - correct Answers --cost of the loss itself & costs associated with handling the
claims
- adjusters salaries and legal expenses related to adjusting the loss
Claims handling process - correct Answers -1. investigation
2. Evaluation
3. disposition (settlement)
burden of proof - correct Answers -the obligation to present evidence to support one's claim
3 Steps of Claims Investigation - correct Answers -1) verify insurance coverage
2) obtain information about the claim
3 verify and compare this information
Step 1: Verify Insurance Coverage - correct Answers -- loss must occur during policy period
- loss must occur in coverage territory
- insurable interest
- who is an insured
- exclusions
- policy conditions
- policy limit
- reservation of rights/nonwaiver agreement
Policy period - correct Answers -when the policy begins and ends
insurable interest - correct Answers -something of value that, if lost, would cause you financial harm
2
