C11 - Insurance - Chapter 11 Exam | Questions & 100% Correct Answers (Verified) | Latest Update | Grade A+

Name & Define the 2 types of Losses an Insured can face? : First Party - A loss experienced by the insured. Involves the insured, the insurer & a lien holder/mortgagee. Third Party- (aka liability coverage) A loss by a person who is not a listed member on the policy. Who is responsible for proving a loss? Who can report a loss, and to who? : The insured is responsible for proving a loss. Either an insured or a third party can report a loss to the broker or insurance company directly What is the first thing than an insurer does before taking any action concerning a reported loss? What is the second an insurer takes concerning a reported loss? : First - Confirm that coverage exists on the policy Second - Open claim & assign claim number, determine how a claim needs to be handled. 2 | P a g e What is a proof of loss, and what does it contain? : A proof of loss is a document completed & signed by insureds making a claim against their own insurer. It releases the insurer of further obligations relating to that loss and transfers title to any useful salvage to the insurer. It contains the following: policy details, loss details, how much is being claimed, who will the claim be paid to. How do insurers determine who investigates a loss? : They appoint an adjuster to investigate the loss. Whether they assign a staff appraiser or a independent appraiser depends on the amount being claimed, and the possibility of fraud in the claim.