ADJUSTER EXAM
Claim - CORRECT ANSWER-An assertion of an alleged legal
right against a person, entity, company or insurer that carries
with it a demand for money as compensation for injuries or
damage
What are you really buying when you purchase insurance? -
CORRECT ANSWER-Peace of mind
Why is insurance such a unique product? - CORRECT
ANSWER-It is a financial product. The purchase of a promise
base totally on trust that is absolutely essential in today's world.
First foremost and always what is an adjuster's most important
objective in today's world of insurance? - CORRECT ANSWER-
To help those who have been injured, or who have suffered a
loss that is covered by the insurance contract or for which an
insured policy holder is responsible while at the same time
minimizing loss for the insured party and or carrier
In today's society, the most important factor in the purchase of
insurance is - CORRECT ANSWER-Trust
What would Joe do as an adjuster? - CORRECT ANSWER-
INVESTIGATE, EVALUATE, AND SETTLE INSURANCE
CLAIMS ON BEHALF OF AN INSURER OR INSURED.
Joe saw an ad in the paper..... difference between an adjuster
who works in the healthcare industry versus an adjuster in the
property/casualty, insurance industry. What would you say? -
CORRECT ANSWER-Healthcare adjusters are processors,
,who reimburse medical bills if they fall within a list of approved
conditions or treatment. A property/casualty adjuster evaluates
a legal responsibilities, determines what or how much is owed
and pays or settles claims.
If Joe, where to go to work for an insurance company, what
kind of adjuster with Joe be? - CORRECT ANSWER-A
company/staff adjuster
Joe is really intrigued by his neighbors work and ask him who
he works for. His neighbor told him that he owns his own
adjusting company and adjust claims are several different
companies. In other words he takes claim assignments from
whoever calls. What kind of adjuster is he? - CORRECT
ANSWER-An independent adjuster
Joe's neighbor tells him that field adjusting is "the best job in
the insurance industry". Joe doesn't envision himself sitting
behind a desk, so he is intrigued by this as well and white lines
of business business with Joe need to experience to have the
greatest chance of getting a good field adjusting job -
CORRECT ANSWER-Multi-line adjusting
Joe sister is a nurse who works in a nearby hospital. As he
talks to her about his interest, she asked him what type of
adjusting she would be most qualified for if she were interested,
which kind of adjusting would present her with the greatest
opportunity? What would you tell her? - CORRECT ANSWER-
Worker's compensation
Joe's neighbor told him that he really prefers working with
litigated claims dealing with the lawyers, getting it in
negotiations and going to depositions and trials. What kind of
claims does Joe's neighbor prefer? - CORRECT ANSWER-
Liability adjusting
,If Joe, we're just strictly handle, hurricane tornado hellfire, and
other claims of this nature, what line of business would Joe be
adjusting - CORRECT ANSWER-Property
While driving home from an interview, Joe was rear ended.
He's not injured so he makes a claim against the other drivers
insurance policy for damages to his vehicle. The person taking
the claim advises Joe that he will be contacted within 24 hours
by an adjuster. From what type of adjuster will Joe likely hear? -
CORRECT ANSWER-An auto physical damage adjuster
The claims manager told Joe a story of one of the best
adjusters he had ever known, and how he had been forced to
fire the man because he just would not document to clean files
with ongoing status. What kind of responsibility did the adjuster
fail to fulfill? - CORRECT ANSWER-Communicating and
reporting
The claims manager then told Joe a story about one adjuster
who made a deal with a body shop to pay the adjuster $100 for
every damaged automobile that he referred, referred for repair.
The adjuster is ultimately fired. What responsibility did that
adjuster fail to fulfill? - CORRECT ANSWER-Fiduciary
responsibility
The claims manager also told about a young adjuster who lost
his temper and cursed out an insured policyholder. He was
arguing about a claim the adjuster has denied. The insured
policyholder sued the company and collected $50,000 for
slander in the embarrassment caused the insured what
responsibility did that adjuster fail to fulfill? - CORRECT
ANSWER-Agency: the power to bind
Which of the following is NOT one of the basic adjusting
functions? - CORRECT ANSWER-Inspection
, Which of the following best describes the functions of claims
evaluation? - CORRECT ANSWER-Establishing a dollar value
for a claim
In which of the following settlement types, would you pay what
is owed and invite the claimant to contact you with any further
expenses or questions? - CORRECT ANSWER-No release
"walk away"
True or false; an adjuster's claim file is considered "work
product" and therefore confidential - CORRECT ANSWER-
False
The main components of the investigative process are: -
CORRECT ANSWER-Inquiry verification and comparison
The adjusters code of ethics starts with a basic premise, which
states: - CORRECT ANSWER-The work of adjusting engages
the public trust
Which of the following would not be a preferred claims practice
or behavior under Florida's unfair insurance, trade practices
act? - CORRECT ANSWER-Not responding to an insured's
calls because you haven't made up your mind yet
Upon conclusion of a claims, investigation and adjuster
determines if there was no coverage in effect for the loss and
denies the claim. The adjuster later received notification that he
in the carrier being sued due to a violation of Florida's unfair
insurance trade practices act. Which of the following actions in
the adjusters claim handling process would be considered a
violation of the act? - CORRECT ANSWER-The adjuster inform
the policyholders attorney of the denial over the phone, closed
the file and moved onto his next case