Claims Adjuster Final update (Multiple Choice Questions and answers)
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School
University of Rochester**We aren't endorsed by this school
Course
BUS 2523
Subject
Law
Date
Dec 19, 2024
Pages
17
Uploaded by CommodoreRoseLlama66
Claims Adjuster Final update (Multiple Choice Questions and answers)An adjuster is a fiduciary agent with a responsibility of loyalty to the interest of - The insured and insurerAn insurer gives which of the following as Consideration for an insurance policy? - A PromiseThe interest of the insured and all other persons in the property involved in a claim isfound in - A Proof of LossAn insured rear-ends another driver's vehicle. The auto policy that pays damages torepair the damaged vehicle is a _______? - Liability PolicyYour insurance company wrote an auto insurance binder for an owner who said that hedid not have any prior accidents. Immediately thereafter it was discovered that he did nottell the truth. The company now wants to cancel the binder as quickly as possible. Whatis true? - 5 days notice requiredFor insurance to pay damages, an insurable interest must exist: - When the loss takes placeTexting while driving is best described as a: - HazardA covered loss is $90,000. Policy A has a limit of $100,000. Policy B has a limit of$200,000. Both policies are pro-rata policies. How much will policy B pay for this loss? - $60,000I sold my home yesterday, signed a deed and transferred title. Last night there was a
house fire. I had not yet cancelled my homeowner's insurance. The purchaser also had ahomeowner's policy. Which policy should pay to pay the claim? - Purchaser's policyGiving prompt notice of loss is best described as a policy: - ConditionIf there is a total loss by an insured peril to a FL building, the insurer must pay: - Actual Cash ValueA Loss Payable Clause refers to - Lenders interest in personal propertyMy coin collection was appraised and my insurance company specifically insured thevalued of that collection. That is an example of: - A Valued PolicyAn insurance contract is based on the Principle of: - Utmost Good FaithThe two kinds of waivers are: - express and impliedProximate Cause is the unbroken connection between the occurrence and ____ thatgrows out of the occurrence. - DamagesWhich loss settlement valuation may be a violation of the Principle of Indemnity? - Replacement CostIf the policy limit is $60,000; 80% coinsurance requirement; loss of $60,000 and thevalue of the property is $100,000, what loss amount will the insurer pay? - $45,000The insured has a Homeowner's insurance policy with a 5% Hurricane deductible. If
a hurricane loss of $6,000 occurs to the home that is valued and insured for $100,000,how much will the policy pay? - $1,000A waiver is defined as - Giving up a known right voluntarilyAn insured signs a release to settle a claim. In the event the insured discovers injuriesor damages that were unknown at the time of settlement, what is generally true? - Release extinguishedall causes of actionWhich of the following is not a tort: - Breach of contractThe type of damages that pays medical bills is known as: - SpecialA marine policy has a $1 million limit and a $100,000 franchise deductible. A coveredloss is $110,000. How much will the policy pay? - $110,000Which of the following is NOT included in a proof of loss? - Replacement cost of each itemProperty and Liability policies cover: - PersonsWhat type of tort arises from a negligent act? - UnintentionalA car crash victim sued the negligent-drunk driver for damages 5 years after theaccident. What is true in FL? - Statute of Limitations appliesThe best statement regarding the Appraisal process is: - Appraisal determines the value of a loss
Florida is a ____Negligence state. - ComparativeRule 69B-220.201 prohibits adjusters from - giving legal adviceA defense to a claim made by a person who knowingly competes in an extreme sportand is injured would be: - Assumption of RiskIn Florida property claims must be paid within __ days of notice of claims. - 90'Liability' refers to: - The merits of the claimSelf-interest or self-dealing is a violation of an adjuster's: - Fiduciary dutyA single claimant was injured in an accident with a FL State Employee. What is true? - The maximum recovery is $200,000An insured has a split limit auto policy with limits of 10/20/10. What is true? - The insured can never recover any money from this policyReplacement cost less depreciation is the definition of: - Actual Cash ValueThe FL Unfair Insurance Trade Practices Act penalizes all of the following, EXCEPT: - Keeping accurate records of complaintsAn insured has an auto policy with a single limit of $30,000. What is true? - This is both a liability and property damage policy.
A insured and two family members were hospitalized for injuries suffered in anauto crash caused by a drunk driver. The insured carried a basic auto liabilitypolicy of 10/20/10. What is the maximum that the insured's own liability will payfor these injuries? - 0An insured had a 50/100/50 auto policy that was the subject of lawsuit.Judgment in the amount of $50,000 with interest was entered against the insured.What is true? - The insurer must pay interestAn insured had a 10/20/10 auto policy. The insured was at-fault for two accidentson two consecutive days: One on Friday morning, and another on Saturdayafternoon. The property damage in the Friday accident was $5000; the propertydamage on Saturday was $15,000. What will the policy pay for each propertydamage claim? - Friday claim-$5000/Saturday claim-$10,000The No Fault Law requires: - PIP onlyForm SR-22 certifies that: - Liability coverage is in effectMedical Payments pays for expenses incurred for services for all of the followingarising from an auto accident, except: - Lost wages from an auto accidentAn insured has stacked 50/100 UM coverage for 3 cars. The maximum the policywill pay for the insured's injuries in one accident caused by an uninsured motorist
is: - 150An insured has PIP with a $1000 deductible. If the insured has an accident andincurs covered medical bills in the amount of $1200, what will PIP pay? - $160The Florida Financial Responsibility Law requires: - 10/20/10 LiabilityAn insured owns two cars. One is insured for non-stacked UM. The other is notinsured for UM. If the insured is injured by an uninsured motorist while riding inthe auto not insured for UM, what is true? - No UM is availableIn a motor vehicle accident, auto liability coverage does not cover: - Damage to the insured's vehicle caused by the collisionA speeder's vehicle hit the insured's vehicle from the rear. The speeder wasinsured for PIP and liability. The insured was a vehicle owner but not insured forPIP. The insured has $5,000 in medical bills and $1000 in lost wages as a resultof the accident. If the insured files a lawsuit against the speeder, how much of themedicals and lost wages will be paid by the speeder's PIP? - 4600The claimant was injured in a one-car auto accident while working when he lostcontrol and ran off the road. The claimant is insured for Collision, PIP, MedicalPayments and Workers Compensation. Which could not pay damages to him? - Medical Payments'Direct and Accidental Damage' to a Business Vehicle is the definition of: - Loss
The insured owns a garage and sells cars. The garage policy liability limit is100/300/50. A customer was test-driving a car and caused an accident. At thetime, the customer was not an owner and did not carry insurance. The garagepolicy will provide liability coverage in the amount of: - 10/20/10The insured was in a 2012 automobile accident and had medical bills that totaled$12,000. One month after the accident, and as a result of his injuries, he died.How much will PIP pay for death? - 400Collision is 'first party' insurance which means: - Payment is paid to the insured18. Damages in a UM claim may be achieved by any of the following, EXCEPT: - AppealMy car was damaged when I lost control and it overturned. What coverage am Ilooking for on my policy to repair my car? - CollisionMy Business Auto has physical damage coverage called 'specified causes of loss'.Which of the following will not be covered? - Wear and TearI am a FL resident insured for PIP. I drove my car to Miami where I rear-ended avan causing medicals of $5,000 to a FL driver insured for PIP. Which is true? - I have a tort exemption of $4,000PIP is primary against all of the following, EXCEPT: - Workers' CompensationA FL insurer made the decision to reduce the number of auto policies offered in
the state of Florida. As a result, cancellation notices were sent to insuredsthroughout the state. Which of the following is true? - Insurers may cancel for any reason within the first60 days of a policyAn insured was injured by a drunk driver in an auto accident that occurred onMarch 1, 2017. The insured had a basic PIP policy with a $10,000 limit. OnMarch 16, 2017 the insured was examined for back pain from the accident, in ahospital emergency room, and it was determined that the injuries were serious andmay require surgery. What best describes the PIP benefits available? - 0I was getting out of my parked car when it was hit. The driver that hit my vehiclewas driving drunk. At the time of the accident I was out-of-state in New York. Ihave filed a claim for my medicals with my PIP insurance. What is true? - I was occupying my vehicle, therefore PIP will payAn insured has basic PIP with a $1000 deductible. If the insured is injured in anaccident and has $2,000 in covered medicals, how much will PIP pay? - $800An insured had basic PIP coverage with no deductible. He had an accident thatoccurred January 2, 2018 and sought medical treatment within 14 days, but wasnot diagnosed as having an emergency medical condition. Medical bills totaled$3000. What will PIP pay? - 2400I have Additional PIP-$90,000 and Extended PIP. I was in an accident in 2017and have $100,000 in medicals and $1,000 in lost wages. What will PIP pay? - $100,000
I was in an auto accident on March 2017. I have $1500 in emergency roomcharges from the day of the accident, and $2000 in massage therapy from aphysical therapist. I have basic PIP with a $1000 deductible. How much will PIPpay? - $400I have Collision, Liability, PIP and Medical Payment coverages on my car. I wasinjured while driving. Which of my coverages will never pay me any damages? - LiabilityAn insured had basic PIP with a $1000 deductible. A friend was riding in theinsured's car in Orlando at the time of an accident. The friend did not have PIPbut she did own an automobile registered in FL. In the event of an accident, whatis true? - The friend is not covered by the insured's PIPAn insured had basic PIP. He had an auto accident in 2017. Medicals were$8,000. Lost wages were $2000. What is left from basic PIP for death? - $5000An insured rear-ended an auto at 80 mph in 2017. The insured was injured andhad Additional PIP-$90,000 and Extended PIP. The insured has medicals of$90,000 and lost wages of $2000. What will PIP pay? - $91,600An insured negligently struck a motorcycle rider with his vehicle, causing therider to incur $5000 in covered medicals. The motorcyclist also owned a carinsured for PIP. How much is the insured's tort exemption? - $0A speeding driver struck a FL pedestrian crossing the street. The driver was
insured for PIP, Liability insurance and Uninsured Motorist Coverage. Thepedestrian did not own a vehicle and had no PIP. The pedestrian may be entitledto recover damages from which of the insured's coverages? - PIP and LiabilityPassengers on a cruise ship contracted a serious illness due to the ship's cleanlinessand they are now presenting claims for medicals and damages. This type of claim wouldbe covered by the ship's _______coverage. - Protection and IndemnityA business has been accused of detaining a customer resulting in a false arrest forshoplifting. This claim would be covered by: - Personal and Advertising InjuryWhich of the following is excluded under a standard homeowner's policy? - Flood damageWhich of the following is a 'permanent impairment' under workers' compensation? - Loss of limbWhich of the following is not considered a 'product' under Products/CompletedOperations exposure? - Acreage sold by a realtorA best-selling novelist had computer fraud coverage. His computer was vandalizedand the manuscript of his latest novel was destroyed. What is the best description ofcoverage provided? - Up to $5000 for manuscript, vandalism excludedA bank discovered that one of its' tellers had served time for theft prior toemployment. Employee Theft coverage for that employee would be cancelled: - Immediately
An employee stole merchandise from a business on three separate occasions. Thevalue of each theft was more than the Employee Theft policy limit. The business wantsthe limit to apply separately to each incident. What is true? - The limit applies once to all loss caused by the three theftsEmployee theft is written in all of the following ways, EXCEPT: - Scheduled Location coverageA crime policy values securities on: - The day the loss is discoveredA dry cleaner damages a customers clothes. Damages would be covered by: - Bailee's customer policyHackers damaged broke into a bank's system, transferred money, client'sinformation and inserted a virus that damaged the computers. A claim for damages underComputer Fraud coverage has been presented. What may be covered? - MoneyIf a merchant accepts counterfeit money, what is true regarding coverage underMoney Orders and Counterfeit Paper Currency? - Currency from any country is coveredA drunk driver was arrested and purchased a surety bond (bail bond) to get out ofjail. The parties to the bond are the drunk driver, the Court, the Bonding Company andthe driver's relative who posted collateral and agreed to reimburse the bonding companyif there was a loss. The Court would be the: - ObligeeConstruction employers must have at least ___ employee(s) before being required tocarry Workers' Compensation. - 1
Which of the following is not an employee under Workers' Compensation? - NFL QuarterbackA building contractor hired a plumbing company to complete the plumbing in ahouse that the contractor was building. One of the plumbers was injured on the job and itwas determined that that plumbing company did not carry the required Workers'Compensation. All of the following are true, EXCEPT: - The state of FL will now pay the plumber's benefitsAn employee cannot work at all, but is expected to recover. The class of disabilitythat applies under Workers' Compensation is: - Temporary Total DisabilityAll of the following may be covered under a Homeowner's policy, EXCEPT: - Single family rental homeAll of the following are perils under Homeowners' Coverage C, EXCEPT: - RustA commercial building was vacant for 90 consecutive days prior to a fire loss. Whatis true? - The amount payable is reduced by 15%A home destroyed by a mud-slide would be covered under a: - Flood PolicyInland Marine insurance provides coverage for which of the following? - BridgesThe deductible under a Personal Articles Floater is: - 0Commercial vehicles under the FAJUA residual market may purchase which of thefollowing coverages? - Liability, PIP and UM
An insurer formed under the laws of the NY would be: - A foreign insurerAn adjuster is required to notify the Department of a change in address, telephone andemail with ___days. - 30Transaction of matters arising out of a contract of insurance is governed by FloridaStatute ______? - 624.10A public adjuster may represent a claimant in all of the following matters, EXCEPT: - Workers' Compensation ClaimA public adjuster is required to post a ___bond. - $50,000Adjusters must take 24 hours of continuing education ___. - Every two yearsA catastrophe or emergency adjuster license may be issued for what period of time? - For the period of the emergency determined by the DepartmentAn Auto Policy Physical Damage Coverage has a $500 deductible. The deductibledoes not apply to: - Windshield glass damageA request for mediation of a personal injury claim applies to a claim with a value of___ or less. - $10,000Ethical Requirements require that adjusters must exercise ____when dealing with
elderly clients. - Extraordinary careAn adjuster is negotiating with a claimant. The claim will be barred by the statute oflimitations in less than 30 days. After that date, the adjuster knows that no claim will bepermitted. Ethical Requirements require the adjuster to: - Tell the claimant about the statute of limitationsThe Department contacts an adjuster about a claim. The adjuster must respondwithin: - 21 calendar daysAll of the following apply to public adjuster contracts, EXCEPT: - Signed by the owner of the public adjuster firmA total loss vehicle has two liens on the title. The adjuster is required to: - Make payment to the owner and first lien holderAn adjuster shall make truthful and unbiased reports of the facts after making ___. - A complete investigationAn adjuster must pay or deny a property damage claim within___, unless there arefactors beyond his control. - 90 daysThe cost of mediation is paid ___. - Equally by both partiesDenying claims without____is a violation of Ethical Requirements. - InvestigationA public adjuster may be disciplined for all of the following, EXCEPT: - Receiving a contingency fee
An insurer is required to have a Certificate of Authority for which of the following: - Collection of new premiumsThe Citizens Insurance standard deductible for mobile home homeowners is: - $500/2% hurricaneMedicare Supplement insurance is returnable within ___ of purchase for a fullrefund. - 30 daysAll of the following are typical health insurance exclusions, EXCEPT: - Accidental injuryWhich is not an Aviation policy named peril? - Weight of ice and snowWhich health insurance policy provides for payment of emergency treatment evenif the treated party does not go to a service provider on the approved list. - PPOA ship's captain throws a portion of cargo overboard to save the ship in a storm.Losses from this voluntary sacrifice are settled under a Marine policy using: - The General Average clauseAll of the following are examples of a bailment, EXCEPT a: - Personal Storage UnitWhich of the following may be covered by a Business Owners' Policy? - Apartment housesAll of the following are covered by Farm Livestock Coverage, EXCEPT: - DogsIn order to receive replacement cost under a Flood policy, an insured must live in
the home at least 80% of the time and a $100,000 home must be insured for atleast: - $80,000Builder's Risk Coverage covers a building in the course of construction. Theproper amount of coverage for a building that has an expected completed value of$1 million is ___: - $1 millionA provision in a homeowners' policy that pays additional costs required to rebuilda damaged structure so that it conforms to the latest building codes is known as: - Ordinance or LawDamage to a fence under a homeowners' policy would be paid under: - Coverage BA Temporary Total Disability is compensated under Workers' Compensation fora period not to exceed: - 104 weeksWhen both an attorney and the surety are required to sign checks to disburse anestate's funds, this is an example of: - Joint ControlA 'medical incident' covered by Physician's Professional Liability Insurancewould not include: - Assault of a patientAn Excess Liability policy that has the same terms and conditions as theunderlying policy is an example of: - A Follow Form policyWhich of the following is NOT 'mobile equipment' in a Business Auto Policy? - Work Truck
A driver convicted of driving under the influence must carry liability limits of atleast: - 100/300/50The right to sue when damaged by the practices of an insurance company is basedupon the: - Unfair Trade Practices ActThe cost to replace an item less depreciation is a description of: - Actual Cash ValueAn adjuster is a ___ agent. - FiduciaryAuto liability insurance will pay damages to others for all of the following,EXCEPT: - Injuries caused by intentionally hitting someoneAn auto dealer allowed a customer to test drive a vehicle believing that the personwas interested in buying the car. The customer tricked the dealer and stole thecar. Which coverage would provide physical damage coverage if the car wasdamaged or wrecked by the thief? - The coverage needed by a business to cover the loss of property surrendered as aresult of a kidnapping threat of the insured is: