Florida Adjuster Licensing Practice Exam with Complete Solutions

Florida Adjuster Licensing Practice Exam with Complete Solutions A claim in the property/casualty industry Is defined as: ✔✔an assertion of an alleged legal right against a person, entity, company or insurer that carr ...

Florida Adjuster Licensing Practice Exam with Complete Solutions A claim in the property/casualty industry Is defined as: ✔✔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 damages when you purchase insurance, you are buying: ✔✔peace of mind that if an insured event does occur, that the insurance company will keep its promise and provide the financial protection that you purchased in today's society, the most important factor in the purchase of insurance is: ✔✔trust One of the most important claim handling goals of an insurance company is: ✔✔to help those who have been injured or who have suffered loss for which the insured is responsible, while at the same time minimizing loss for the insured party and carrier what is the primary difference between a company employee adjuster and an independent adjuster ✔✔a company employee adjuster works for an insurance company and an independent adjuster works independently for themselves or for adjusting firms who represent many clients an adjuster's responsibility as a fiduciary means: ✔✔the adjuster represents, and controls, the property and financial interests of the client to whom he/she owes a high degree of loyalty and good faith the basic and primary functions of an adjuster are: ✔✔investigating, evaluating, reporting, negotiating and disposing of claims once an adjuster is licensed, he or she must maintain a continuing education requirement. What is that adjuster's compliance requirement in order to retain a license? ✔✔an adjuster must complete 24 hours of continuing education in every 2 year compliance period, of which 5 hours must be taken in a properly certified 5 hour law and ethics update course the adjuster's code of ethics starts with a basic premise which states: ✔✔the work of adjusting engages the public trust Which of the following would NOT be a preferred claims practice or behavior under FL Unfair Insurance Trade Practices Act? ✔✔Not responding to an insured calls because you haven't made up your mind what are the four critical elements of a contract? ✔✔1. agreement to terms (must understand what is given and received) 2. adequate consideration for the promises made 3. legal capacity of the parties to contract 4. contract must have legal purpose an insurance policy is often referred to as a contract of adhesion which means: ✔✔if any of the wording or language in the policy is vague or ambiguous, making it difficult to understand or interpret, the law is well settled that the interpretation shall be in favor of the party who did not control its terms (the policyholder) breach of contract by a carrier or its adjuster through non-payment or on-compliance with policy requirements, could have the following consequences for a carrier ✔✔if found guilty of a breach of contract, the carrier could be punished with a "bad faith" verdict that would cost it millions of dollars what are the fundamental parts of an insurance policy? ✔✔1. Declarations Page 2. Insuring Agreement 3. Exclusions 4. Conditions What is one of the duties of an insured following a loss? ✔✔giving prompt notice of loss to the insurer describe the difference between a peril and a hazard ✔✔a peril is a cause of loss, like fire. A hazard is a condition that exists beforehand that increases the likelihood of such a loss, like a messy storeroom or garage the doctrine of proximate cause is defined as ✔✔if there is an unbroken chain of events, or series of consequences, flowing from the initial loss caused by the insured peril to a subsequent loss, the insured peril causing the initial loss will be considered the "proximate cause" of the subsequent loss A couple had Coverage A limits of $250K on their home located in FL. A tornado spawned by Hurricane Ernesto damaged their roof resulting in estimated repair costs of $11,500. The adjuster deducted the FL hurricane deductible of $5,000 from the estimate and paid them $6,500 in settlement of their property claim. This is known as the application of: ✔✔a percentage deductible (hurricane deductible) A restaurant was damaged after a grease fire erupted in the kitchen. Damage to the structure totaled $78,300. The owner's commercial property policy provided Coverage A limits of $250,000 with a deductible of $1,000. How much would the policyholder be paid? ✔✔$$77,300 a couple has insured their home for $150,000. a fire ensues and guts their home, resulting in a total loss. An appraisal of the home prior to loss results in a value of $120,000, yet the adjuster is required by law to pay the couple $150,000. This is known as the application of: ✔✔valued policy law Assume that 5 years ago a couple insured their home for its then appraised value of $60,000. 2 weeks ago they had a stove fire resulting in an estimated loss of $15,000. The adjuster finds that the value of their home is now $100,000 but the home is still only insured for $60K and there is a deductible of $500. The policy has an 80% coinsurance clause. How much should the adjuster pay to the couple? ✔✔($15,000-$500)($60,000/$100,000(.80))= $10,875 describe the coverage's provided in a split limit policy of 10/20/10 ✔✔the coverage provides up to $10,000 of liability protection for bodily injury to any one individual, an aggregate of $20,000 for all bodily injuries regardless of how many individuals, and $10,000 for property damage negligence is described as ✔✔fault that arises from doing something you shouldn't have done, or not doing something you should have done what are examples of "compensatory damages"? ✔✔tangible, documentable financial losses such as medical expenses and lost wages (special damages) intangible losses such as pain and suffering, mental anguish, permanent injury and disfigurement (general damages) What are the defenses to a claim of negligence ✔✔no negligence, contributory negligence, comparative negligence and assumption of risk what are the laws that affects one's legal liability ✔✔Statutes of Limitations, Wrongful Death Act, Workers comp. and Auto No Fault, Waiver of Sovereign Immunity and Breach of Product Warranty What statement is NOT true? ✔✔if a question of coverage arises and can't be swiftly resolved in favor of the insured, the carrier should immediately tender the claim to its attorney and deny the claim