Insurance Claims Adjusting Review Quiz
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Created by:
mjrjolt on September 30, 2009
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Objectives: Understand the difference between a company adjuster and a public adjuster; Know the duties and responsibilities of an adjuster; Learn the claim filing process; Review the standards for fair and equitable investigations and settlement; Review adjusting of property and casualty losses; Le (see more)
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15 terms
Terms | Definitions |
|---|---|
 A public adjuster represents the interest of: A. The insurer; B. The insured; C. The employer; D. The interest of the general public | B. The public adjuster represents the interests of the insured. |
| Which of the following is the type of report that indicates the initial results of a claim investigation? A. Field report; B. Interim report; C. Full report; D. None of the above | A. The initial report is called the field report. |
| States have adopted statutes regarding claims adjusting. To avoid unfair treatment to a claimant, the adjuster must not: A. Promptly investigate the claim; B. Follow the laws regarding the number of days in which to commence an investigation; C. Deny the claim until a fair and prompt investigation has commenced; D. Pay the claim within a reasonable number of days after the final proof of loss has been received. | C. The adjuster is guilty of an unfair claim practice if a proper investigation is not conducted. |
| Which of the following is not a claim settlement option? A. Forcing the insured to sue by offering less than the claim is worth; B. Repairing property; C. Replacing with like kind and quality; D. Replace with new | A. Forcing the insured to sue by offering less than the claim is worth is an unfair claim practice. |
| The giving up of a known right is called: A. Estoppel; B. Violation of policy conditions; C. Rebating; D. Waiver | D. The giving up of a known right is called a waiver. |
| An innocent party relies on certain statements made by the adjuster and is damaged as a result. The guilty party may be legally prohibited from asserting that the fact does not exist because of: A. Waiver; B. Estoppel; C. Duties of the adjuster; D. Law of contract | B. If an innocent person relies on the statements made by an agent or adjuster and is damaged as a result; the guilty party may be prevented (estopped) from denying relief. |
| Should an insured fail to report a claim in a timely fashion the adjuster will usually: A. Deny the claim; B. Send the insured a reservation of rights letter; C. Cease investigating; D. Seek the advice of the company's attorney | B. A late reporting of a claim can prejudice the company's ability to conduct a proper investigation. Therefore, to preserve the insurer's rights, a reservation of rights letter is usually sent to the insured. |
| A company adjuster primarily represents the interests of: A. The insured; B. The claimant; C. The insurer; D. The public | C. An insurance company adjuster primarily represents the interest of the insurer. |
| An adjuster's license will usually be revoked for which of the following reasons: A. Denying claims that are not covered; B. Failing to report a change of address; C. Having been convicted of a misdemeanor; D. Having been convicted of a felony | D. A conviction of a felony will usually cause the insurance department to revoke the adjuster's license. |
| The insured has been involved in an automobile accident and has sustained bodily injuries and damage to the insured vehicle. The adjuster will usually: A. Withhold any payment until all the bills have been reviewed for payment; B. Pay to repair the vehicle and pay the medical bills later; C. Pay for the repair of the vehicle and require a release for all claims; D. Pay to repair the damage to the vehicle and obtain a partial release and settle the medical payments later and then seek a final release. | D. The adjuster can settle certain aspects of a claim and obtain a partial release and leave the rest of the claim open for future settlement. |
| Mr. Jones has damaged his vehicle by striking a tree. He can: A. Take a car to a repair garage recommended by the insurer; B. Take the car to a garage of his/her choice; C. Accept the payment based on the adjuster's estimate; D. All of the above | D. The adjuster can suggest a repair shop but the final decision as to where the vehicle is to be repaired is up to the claimant. |
| In case of a total loss to a vehicle the adjuster will pay the insured/claimant which of the following? A. The cost to replace the vehicle with like kind and quality if a current year model; B. Use the most recent publication of an "Official Used Car Guide"; C. If not listed in the "guide", obtain quotations from automobile dealers; D. All of the above depending on the circumstances | D. All of the responses are options for the settlement of a claim for a total loss to a vehicle. |
| Which of the following is NOT a claim settlement option for liability claims? A. Lost wages; B. Excessive amounts claimed; C. Loss of use; D. Disfigurement | B. Insurance is not for profit. |
| Which of the following results in immediate payment when the claimant signs a release relinquishing his or her right to sue? A. Scheduled Payment Release; B. Full Release Settlement; C. Advanced Payment; D. Structured Settlement | B. A full release is a release that finalizes the claim and usually prevents future claim payment requests. |
| Which of the following relieves the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated? A. No release or Walk-Away; B. Rehabiliation; C. Advanced Payment; D. Open-Ended Release | C. Advance payments help to relieve the financial burden on the claimant until the claim can be settled. |
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