Adjusting Test

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A customer claims he tripped on a stair in John's Art Gallery and broke his leg. The only way the customer will have a successful claim against John's insurance is?
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Terms in this set (150)
Jason was involved in a serious accident after his braking system on his brand new car failed to function properly while he was driving on the highway. The manufacturer for his car has had several complaints regarding this faulty braking system. What type of claim should jason file against the manufacture of his vehicle.
Your policyholder submitted a claim or fire damage to his structure that was caused by fire. The origin of the fire was caused by a defective wiring harness in the electrical system of his stove. After you process and pay the claim, you will need to notify the manufacturer of his stove of your intent to ________ against them for the damages the were caused by their defective product?
What are the types of adjuster licenses approved for issuance in Texas?All Lines, Property, Property and Casualty, Surety, Workers CompensationYou are handling a flood claim in Houston, Texas. Your Policyholder has a flood policy on his home. The replacement cost of his dwelling is $230,000. The flood related damages to the dwelling are valued at $220,000. The replacement cost of the damaged contents on his claim is $85,000. The actual cash value of the damaged contents is $63,000. How much will you pay him for his damaged contents? Do not consider a deductible.$63,000Replacement cost less depreciation best definesActual Cash ValueJohn has a homeowners policy with he following coverage's (Coverage A- $90,000, Coverage B- $50,000: Clause 1 deductible 1%, Clause 2 deductible - $1,000). His Cloth awning was damaged during the fire. His cloth awning is valued at $4,000. How much are you going to pay on his claim?$3,500Joseph Ross owns a 2014 Toyota Avalon. While at the mall shopping someone hits his car and left a big dent on the right side of his car. He does not know who hit his car and there were no witnesses to this accident. What type of insurance protection does he need to protect him from financial loss in this situation?Uninsured MotoristIn the course of making repairs to a rental house, a fire break out. The landlord's Texas dwelling policy for the building would cover all of the following EXCEPTThe tenant's damaged personal PropertyMark Johnson is a licensed Public Adjuster in the state of Texas. Why does Mark need to purchase an adjuster bond?The requirement of bonds is for the public interest to guarantee that the laws ordinances and regulations relating to insurance adjusting will be complied with.Lewis has a Texas dwelling policy on his property in Lewisville Texas. His tenant called him to tell him that the property was broke into and all of his contents were stolen. Lewis files a claim for his tenant's stolen contents. What do you tell Lewis about his claim?The contents are covered up to 10% of the Coverage B limit of liability.What is the process when the insured and insurer are unable to agree on the amount of a claim to be paid?AppraisalYour customer has HO-B homeowners policy with a Coverage A limit os $300,000. His mortgage payment is $1,400 per month. He can't stay in his home for 1 month due to a claim that was caused by smoke. He is staying in a local hotel for 1 month. The cost of the hotel is $900 for the moth. How much will you pay your policyholder for Additional Living Expenses.$900Your re handling a claim, and your policyholder has hired a Public Adjuster. Which of the following is NOT an appropriate response?Include the Public Adjuster in all communicationsLittle Toys company sells a toy meant to be used by 3 years. What type of liability would Little Toys face if the toy self-destructed and caused injury to a 3 year old?Product LiabilityThis type of Bond guarantees contractual obligation will be fulfilled?Contact BondBlake Nelson's license expired two years ago. He would like to obtain his adjusters license so that he can resume his adjusting career. What must he do to obtain his license?Start over by taking the Pre-licensning course & exam and resubmitting applicationMary Johnson owns a local maid service. She want to get some form of protection to protect her company against dishonesty on the part of her employees. What type of bond does she need to get to protect her company?Fidelity BondPam's home has been burglarized. The total value of the stolen contents is $7,000. You advise her that she needs to file a police report. Which of the following statements is correct?A police report is needed per section 1 conditions_________ is a situation involving a person other than the insurer and insured?Third Party Loss_____ is the size of a loss, the extent of damages?SeverityThe following amounts are added for Overhead and Profit.10% and 10%Insurance for ocean vessels is the ______ type of insurance?OldestThe insured's pet dog "Lucky" caused damage to the front screen door. How much re you going to pay on this claim? The damage to the door is $1,000. (Coverage info: Coverage A- $80,000, Coverage B $40,000, Deductive 1%)$0You have just completed the handling of John Wood's roof claim. Mr. Wood disagrees with your coverage determination to deny his claim. What must you provide to Mr. Wood?A written explanation with fill/partial rejection of the claim____ is a person hired to handle a claim on behalf of the insured?Public AdjusterAs an adjuster you investigate Angie Belton's claim for smoke damage. You see that the damage is not caused by a covered peril. What is the best way to handle this?Explain to the insured there is no coverage and show her the policy languageYou have received a new claim for damages caused by a leaking pipe. You should call and make contact with your policyholder within what time frame?within 24hoursJohn's property sustained damage from a windstorm. His fence was damaged during the windstorm. He want to know his fence will be settled. You advise him?it will be settled based on the actual cash valueStephen jumped over the security fence of the Auto Repair shop and proceeded to vandalize some of the vehicles that were there for repair. While running away from the Repair shop. Stephen tripped and fell over some repair equipment. Stephen's stars in this situation is that of a?TrespasserIf an automobile policy has split limits of 30/65/25. What is the maximum amount of liability coverage that would be paid in a covered loss where three people are involved.$30,000Which of the following statements best describes an inland marine policy?Pertains to Cargo with no fixed locationWhile adjusting a claim, your investigation reveals that the damage was caused by a defective value on the plumbing. You would notify the insurance company that the following conditions may exist:SubrogationAn adjuster bond is required for all licensed Public Adjusters in Texas for this very important reason?An adjuster bond is a denial bond for a specific amount conditioned for the faithfully and honest conduct of business by the licensed adjusterYour policyholder has the following coverage information: Coverage A limit $80,000, Coverage B limit $50,000, deductible clause 1 $1,000, Deductive Clause 2- 1%. Her property sustains damage from a loss caused by windstorm. What will her deductible be on her claim?$1,000_____ is a significant misstatement in an application form?Material MisrepresentationAlex is traveling through College Station and hits a deer, and the damages are $1500. He has comprehensive coverage with a $500 deductible. What will you pay?$1,000The amount an insured must pay in a loss before any payment is due from the company?DeductibleDavid Williams is handling an Ocean Marine claim for Texas Lloyds insurance company that resulted from the negligence of the ship's captain. Which of the following statements is correct?Ocean marine covers negligence on the part of the captain or the crew.You have completed your inspection on Robert lem's roof. Robert is very anxious to know whether or not you will estimate to replace his roof or not. Your re not certain whether or not the damage to the roof is covered. What should you do?Advise Mr. Lem you will review your scope notes and phots with your manager and call him back as soon as possiblejake has a homeowners policy with the following coverages (Coverage A $80,000, Coverage B $60,000, Clause 1 deductible $300, Clause 2 deductible $200. His son John who resides with him backed Jake's care out of the driveway and ran over his oak tree The oak tree is valued at $400. How much are you going to pay on his claim?$100Millienim Vessel Company sustained damage to one of their vessels that was transporting goods across the Gulf of Mexico. Which policy would they need in order to get their damaged vessel repaired?They would need an Ocean Marine PolicyBill Lewis has filed a Workers compensation claim. What must Bill do in order for his claim to be valid.Choose a trading doctor from an approved list_______ establishes the major responsibilities of the insured in the policy?Policy ConditionsJoan has a worker's compensation claim. She feels as though she is not being adequately compensated. The Texas Department for Worker's Compensation has reviewed her claim. What are her remedies?She can hire an attorney and take her matter to court.Bobby Emanuel's adjuster license is no longer valid. What could be the reason?It has been 2 years and 6 months since it was issued.Karen, your insured had $900 worth of stolen contents from her home. She has an HO-B policy with a contents limits of $20,000 and a $500 deductible. How much would you pay for her stolen contents?$400The insured has how long to comply with requests made by the adjuster?No time limitJason is an unauthorized insurer and wants to do business in Texas. Under what circumstances could he operate in Texas?After receiving a Certificate of Approval from the Texas Department of InsuranceJacob livingston is a Doctor in Houston, Texas. What type of professional liability insurance would he need to protect him for claims against his wrong doing?Medical MalpracticeSteve Garcia is exempted from taking the State Adjuster License Exam. Which of the following is a reason for his exemption?Within the past 12 months he completed a certified adjuster pre-licenseing education program and pass the required exam.John's home has a $100,000 market value but is insured for $80,000. What is the most John can receive on a claim this is a total loss?$80,000Dr. Phillips completed a surgical procedure on his patient. It was later determined his method was completed incorrectly and has caused more damage. What type of liability is this?Professional LiabilitySamantha purchased a brand new SUV 2 years ago. She bought the new SUV for $45,000.00. The Kelly Blue Book value of her SUV today is $28,000.00. Samantha still owes $36,000.00 on her SUV. She is involved in a total loss accident. What type of insurance protects her for financial loss in this situation?Guaranteed Auto ProtectionLarry is an Insurance Agent with Texas Capital insurance company. One of his customers called his office and requested a change in coverage on his policy. Larry advised the customer he would make the change on the policy, but failed to change it in the system. His customer's claim is denied 6 months later for not having the proper coverage. The claim department paid the customers claim and filed what type of claim on Larry's commercial property.Errors and OmissionsVince apple white has provided you with all of the documentation that you requested from him to handle his theft claim. How long do you have to accept/reject his claim?15 calendar daysFred has a homeowner's policy with the following coverage's (Coverage A $90,000, Coverage B $50,000, Clause 1 deductible 1% Clause 2 deductible $1,000. His fence was damaged during the windstorm. His fence is valued at $4,000. How much are you going to pay on his claim?$3,000You have been assigned Mary Johnson's theft claim. In order for you to do a thorough investigation, you need for her t provide documentation to you. How long do you have to request required items from Mary?15 calendar daysThe type of loss that involves only the insurer and the insured?First party lossYou have concluded your claim investigation and called your policyholder to discuss the settlement of their claim. How long do you have to make payment to your policyholder?5 Calendar daysAs a public administrator you want to get insurance for your county's bridges and tunnels. What kind of policy would you look for?Inland MarineIt has been 2 years since Dan Green's adjuster license expired. Which of the following statements is correct?His license is no longer validIf the bonded individual does not perform as promised, who needs to perform the obligation or pay for any damages?The principleBrandon Jones has let his adjuster license expire. Under what circumstances can he still renew his license?If the license has not been expired for more than 90 days.The period a policy is in force, from the beginning or effective date to the expiration date is the?Policy PeriodYour insured has a homeowners policy with a Coverage A limit of $50,000, His coverage B limit is $20,000. His deductible is 1%. He has 30 trees that are damaged during the fire. How much are you going to pay on his claim?$2,500What was established in 1991 to ensure the prompt payment of insurance claims?Article 21.55Mona insurer is going to cancel her insurance policy. In order for the cancelation to be legal, what must the insurer do?Notify Mona in writing that her policy is being canceled with the reason why.____ is an event that results in an insured loss with damages?OccurenceAdam was shopping in his favorite Grocery Store last Tuesday around 6:00pm. While shopping he slipped and fell on a wet spot on aisle 7 that hadn't been attended to. Adam's stars in this situation is that of an?InviteeWhich of the following is NOT grounds for license denial or revocation?Never having lived or never intending to reside in the state of texas.Donovan has homeowner's policy in Austin, TX with the following coverages Coverage A- $20,000 Coverage B $9,000 Deductible $200. His contents were stolen from his hotel room in New York while he was on vacation. The total value of his contents is $1,000. How much are you going to pay on his claim?$800Lisa received 3 new claims today. What does Lisa have to do within 15 days of receiving the new claims.Acknowledge the claim, begin the investigation, request al items neededDante harris license expires in two weeks. What should he do?Complete the required Continuing Education and complete the renewal formA homeowner lives in a costal area of Texas. Insurance companies exclude wind and hail coverage for that area of Texas. How can the homeowner ge protection for wind and hail?Apply through the Texas Windstorm insurance associate (TWIA)If you have a covered loss, in excess of a limit, you can apply that excess towards the deductible. This best describes?Absorbing the deductibleYou have an inland marine policy with no endorsements. Your transport truck has been damaged by a tornado while on a delivery route. The goods inside that were being transported would be covered under what type of policy?Inland Marine PolicyWhat is the Responsibility to another for one's negligence?LiabilityYour policyholder Sandra Miller accuses you of unfair trade practices. You disagree with her opinion and explain to her that:Your are attempting in good faith to provide a prompt and equitable settlementYour policyholder has a homeowners policy with the following limits on it: Coverage A $140,000 Coverage B $70,000. What is the maximum that he can receive for his contents that were stolen out of his hotel rom while he was on vacation? Do not consider a deductible$7,000Your policyholder has a homeowners policy with the following limits on it: Coverage A $140,000 Coverage B $70,000. Deductible 1%. Her home was burglarized and she has filed a theft claim for stolen contents. What will be her deductible on this theft claim?$700An unknown person drove into Mark's yard and caused damage to his tree. What is the maximum you can pay for the damage to his tree? Mark has a $200.00 deductible. The damage to the tree is estimated at $500.00$250Gloria Peterson has a home insurance policy with a $200,000 limit of liability. The damage on her home is $215,000. The deductible for the policy is $1,000. How much will Gloria receive as her loss settlement amount?$200,000A tenant in Mr. Floyd's home unintentionally started a small fire that damaged the tenant's personal property. Is the tenant's personal property covered under Mr. Floyd's homeowners policy, and if so, to what extent?The entire amount of the damage is covered less Mr. Floyd's deductible.You are handling a flood claim in Galveston, Texas. Your policyholder Jason Watson has a flood policy on his home. His flood policy has a Coverage A limit of $240,000. The flood damages have made Jason's home inhabitable. What is the maximum amount that you can pay Jason for additional living expenses of his flood claim?The total amount of incurred expensesAn insured has a Texas HO-B policy and his Coverage A limit of liability is $100,000. He has a 1% deductible. What is his deductible?$1,000Sherry has a homeowners policy in Houston, TX with the following coverages: Coverage A- $20,000 Coverage B- $9,000, Deductible 1%. Her contents were damaged when her hotel room in New York caught on fire while she was on vacation. The total value of her contents is $1,300. How much are you going to pay on her claim?$1,100Danny Jones has a home insurance policy with a $200,000 limit of liability. The damage on his home is $201,000. The deductible for the policy is $2,000. How much will Mr. Jones receive as his loss settlement amount on a total loss?$199,000Your policyholder lives in Arlington, Texas. He is on vacation in Miami, Florida. While on vacation in Miami, a heavy rainstorm hits the Arlington area. No openings were created on his roof, but water enters around the chimney flashing and causes damage inside the home. How much are you going to pay on this claim? Damages: Camera $800, Clothing $500, Drywall Damage $800, Furniture $500, Necklace $600, Wallpaper damage $600 (Coverage information: Coverage A- $70,000, Coverage B $40,000, Deductible- 1%$3,000Your policyholder lives in Houston. They are on vacation in Colorado. I won vacation in Colorado, his home in Houston catches on fire and the following items are damaged. How much are you going to pay on his claim? Damaged items include clothing at $15,000 electronics at $10,000 furniture at $15,200 detached garage at $8200 damage to home at $50,000 cloth on a valued at $10,000 roof damage is $11,900 attached garage $8200 coverage information: coverage a $80,000 coverage be $40,000 clause one deductible is 1% cost to deductible is $1000$127,500Your insured had $750.00 stolen from his wallet while at the gym. What is the maximum you can pay him on his claim? Do not consider a deductible.$100.00Steve has a flood policy on his property in Corpus Christi, TX. In the event of a claim, in order for Steve's dwelling to be eligible for Replacement cost, it must be insured for at least ____% of the replacement cost?80%Your policy holder has a HO-B homeowners policy with a Coverage A limit of liability of $200,000. The Coverage B limit of liability on his policy is $100,000. What is the maximum limit of liability for Other Structures on his policy?$20,000Which of the following statements is true?Business personal property is covered up to $2,500 on premises.Attachments that broaden or amend coverage in a policy are known as?EndorsementsYour policyholder has an HO-B homeowners policy. He files a theft claim that occurred away from his residence premises. What is not covered under the claim?Golf CartsYour policyholder has sustained damage to his home caused by Explosion. He has a Texas HO-B Homeowners policy. Which policy deductible will apply on his claim?Deductible Clause 2Flood is defined as general and _______ condition of partial or complete inundation by water of what is normally dry land?TemporaryThe special limit of liability for Bullion/Valuable Papers is?$500Which of the following is NOT subject to special limits of liability under the Texas HOB policy?BooksWhat are the three Texas Dwelling Policy Forms?Basic Form, Broad Form, General FormThe most common cause of action in a product liability claim is?NegligenceYou are adjusting a claim for damages caused by a covered peril. Which of the following items would you NOT cover under personal property?Kitchen CabinetsWhich of the following is not a form of Commercial General Liability?General LiabilityThe national flood insurance policy has three policy forms:Dwelling form, General property form, Condominium AssociationWood fences are settled at ______ under a standard fire policy?Actual Cash ValueThe party to whom money or insurance proceeds is to be paid in the event of a loss, such as the mortgagee on real property?Loss PayeeWhich of the following is not a common cause of action in a product liability claim?Improper assembly of the productExtra charges covered by homeowners policies over and above the policyholders normal living expenses?Additional Living expensesYour policyholder has a homeowners policy with the following limits on it: Coverage A- $140,000, Coverage B $70,000 Deductible 1%. What is the maximum that he can receive for damage to his other structures?$1,400Your policyholder has an HO-B homeowners policy with a Coverage A limit of liability of $200,000. His policy has a Coverage B limit of liability of $100,000. He has filed a theft claim for contents that were stolen from his home. He has a 2% deductible. What will his deductible be on this contents claim?$2,000Your policy holder lives in San Antonio, Texas. He is renting a lake house in Austin for 8 days during his summer vacation. This lake house is _______?Not covered because he does not own itYour policyholder has an HO-B homeowners policy. His overage A limit of liability is $400,000. His Coverage B limit of liability is $100,000. He has a 1% deductible. How much will his deductible be for a hail damage claim on his structure?$4,000Provisions in an insurance policy that indicates what is not covered?ExclusionsUnder the Texas HO-B policy, cloth awnings are not covered for losses caused by?WindstormsYou are investigating a claim from damage caused by windstorm. The insured has shown you cracks in her walls that may have been caused by the windstorm. You need to consult with an engineer to help you with your coverage determination. By doing so, you can request additional ______ to complete your investigation.45 Calendar daysPam's home was damaged and her and her family will need to move to a hotel for 2 weeks. You are the adjuster on this loss, what would you NOT pay for while they are out of the home?Movie TicketsYou have asked Mr. Jones to prepare a list of damaged personal property to help you adjust his claim. Which of the following items should be listed as personal property?FurnitureYou have asked Mr. Brown to prepare a list of damaged personal property to help you adjust his claim. Which of the following items should he NOT list as personal property?Vinyl FlooringYour policyholder lives in Dallas Texas. His Uncle John resides with him. John's 23 year old son Stephen also resides in the home with them. Who is considered an insured under your policyholders policy?Insured and his Uncle JohnAngie has a HO-B policy. An unknown intruder broke into her home and stole a T.V. valued at $800.00. Angie has a $500.00 deductible. How much can you pay her on her claim?$300.00Under the premises liability law of most jurisdictions it is necessary to determine the status of the plaintiff. To do so, you will need to determine is the Plaintiff was an?Invitee, Licensee, TrespasserWhile you are adjusting a claim, a homeowner asks you to clarify what is considered part of his residence premises. All the answers below are correct EXCEPT:A lake house in Austin that he is going to rent out for 5 days during spring breakThe roof on Trent's home was damaged during a Tornado. Under his policy, the cost of the roof will have to be depreciated. What needs to be considered?Age, Condition, and life expectanyA fire damaged Joe's property stored in his garage. What is NOT covered under his Texas HO-B Homeowners policy?AutomobileMorris has a Texas Dwelling Form 1 policy. Which of the following statements is not true regarding his limited Form 1 policy.The structure is covered for TheftAngie Smith has excess continuing education hours in a reporting period. Which is the correct answer below?She can not carry forward any excess continuing education hoursUnder the HO-B policy, Coverage A dwelling is covered for _____ unless excluded.At risks of Physical LossUnder the National Flood Insurance Program, Increased Cost of Compliance (ICC) provides coverage up to _____?$30,000Which of the following Perils is specifically excluded under the Texas HO-B policy?Wear and TearWhich of the following statements is correct in regards coverage for trees under the Texas HO-B Homeowner's policy.The deductible clause does not apply to trees, shrubs, plants, and lawns.Under the National Flood Insurance Policy, which of the following would prevent the building (structure) from qualifying for replacement cost?Insured for at least 80% of the Replacement Cost of the DwellingWall to wall carpeting, attached to the building is considered _______ under the HO-B policy?A dwelling structure itemExpenses that have already been sustained and that have not yet been paid are known asIncurred ExpensesBusiness Personal Property stolen while away from the residence premises is ____?Not CoveredThe Texas Department of Insurance specifically requires the adjuster applicants complete at least two hours of continuing education inConsumer Protection and Adjuster ethicsJohn's oak tree was damages from windstorm, what do you tell him?Its covered for $250.00Maria's shrubs have sustained damage, what would you tell her?Shrubs are covered under the policy, subject to Trees, Shrubs, Plants, and lawns.The total limit of liability for all Loss of Use is10% of the Coverage A (Dwelling) limit of liabilityWhich of the following items are not covered under the Flood Policy?FencesMost homeowner polices exclude losses caused by _____?FloodingProfessional Liability for Insurance Adjusters and Agents is called?Errors and OmissionsWhat are the four sections of the Flood Policy?Dwelling, Contents, Debris Removal, Increased Cost of Compliance