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FLORIDA ADJUSTER FINAL REVISION
GUIDE
Which of the following is NOT one of the duties of the Department of Financial Services? b. Dept does NOT set rates nor write policies - Answer Set rates and write policies for various company products The adjuster has a particular relationship to his principal, the insurer. Which of the following best describes this relationship? - Answer It is a fiduciary relationship. The Claims Adjuster's role in the insurance industry includes all the following EXCEPT: - Answer Gives appropriate legal advice and writes binding contracts All of the following activities are illegal for an adjuster, EXCEPT: - Answer Use only company forms to prepare releases All of the following are part of the conditions imposed upon the insured in the event of a loss, EXCEPT: - Answer Insured should negotiate on behalf of the company for 3rd party claimants. A claimant was given a settlement, which stipulated, that if the claimant did not contact the company within a certain period of time, the claim would automatically close. No release was signed. Which of the following best describes this method of settlement? - Answer No release or walk-away The Continuing Education requirement to maintain an Adjuster license in Florida is: - Answer Twenty four hours every two years. An adjuster received written notice from the Department of Financial Services regarding a claim. What length of time does he have to respond to the inquiry? - Answer 21 calendar days
Comparative negligence is determined through - Answer Investigation & AnalysisAgreement between parties or by mediation or arbitrationJudge and/or jury During what period of time must an adjuster reply to communication from a policyholder on a claim? - Answer 14 days Which of the following is NOT a goal in the adjusting process? - Answer always pay the maximum limit of the policy An adjuster offered a claimant a settlement where the full payment would be presented and a release was signed. This is called a: - Answer A Full Release settlement Adjuster Jane moved from one city in Florida to another. What length of time does she have to notify the Insurance Department of the address change? - Answer 30 Days Which of the following is TRUE? - Answer If an appointment is terminated, an adjuster has 48 months to secure another appointment Bad Faith & Adjusting Practices - Under the Florida Unfair Trade Practices Act & the Unfair Methods of Competition and Unfair or Deceptive Acts, all of the following are prohibited, EXCEPT: - Answer Adjuster keeps accurate records on a claim Florida's Administrative Code contains a Code of Ethics for Adjuster - which of the following is FALSE? - Answer An Adjuster owes fair and prompt treatment to their own company's policyholders only Which of the following is a duty owed to an invitee? - Answer land owner must make reasonable efforts to maintain property in safe condition What is the difference between liability and coverage? - Answer liability is a legal doctrine and coverage is a contractual obligation Which of the following is NOT one of the fiduciary responsibilities of an adjuster? - Answer Withhold pertinent information from the company to please a client
In Section II of the Business Auto Policy, liability is available for: - Answer Named insured. Permissive operators of autos owned, hired or borrowed. Anyone insured is vicariously liable for. Exclusions under the liability section of the business auto policy include: - Answer Employee injuries-covered under worker compensation Liability for pollution, except from the normal operating fluids of the vehicle. Liability arising from mobile equipment. Which of the following is covered under the Garage Policy? - Answer Garage location If an insured has $100,000 of "unstacked" UM, and 2 cars on the policy, how much is available under a UM claim? - Answer $100, An insured has $100 deductible Other Than Collision, and $250 deductible Collision. If a rock breaks his windshield and repairs total $675, how much will be paid? - Answer $675, under Other Than Collision, with no deductible When searching for insurance solutions to pay for personal injuries from an auto accident, the order of payment in Florida in most cases, would be: - Answer PIP, Med Pay, Liability, Uninsured Motorist An insured and his spouse have two cars insured under a Personal Auto Policy. What coverage is available for a car that the wife borrows from a friend to use for the weekend? - Answer The borrowed car would have the broadest coverage available on the policy. Jack is involved in an accident - he is driving his car when hit by an at-fault driver, Sam. (Florida residents). Jack has two more cars at home. Both Jack and Sam have Basic PIP with no deductible, Med Pay coverage of $5,000, Liability of 50/100/50, and Stacked Uninsured Motorist of $50, on each car that they own. Jack has a medical claim of $215,000. How much will Jack's Uninsured Motorist pay for this claim? - Answer $150, An insured buys an ISO Mechanical Breakdown Coverage Policy on his used car. For what length of time and mileage will he have coverage? - Answer 12 Months / 12,000 Miles
If Jack has an accident that is his fault, Jack has liability insurance with 10/20/10 limits, Extended PIP with no deductible, & Med Pay of $2, ... what is the maximum potential payment from Jack's Personal Auto Policy to a guest passenger, who suffers injury and does not own an auto, has no auto insurance and has $42,000 in medical expenses? - Answer $22, (PIP $10,000; Med Pay $2,000; BI $10,000) UM (Uninsured Motorist) coverage under the PAP (Personal Auto Policy) pays for: - Answer bodily injury to the insured caused by hit and run driver Lender's interests in REAL property are protected with a Mortgage clause, how are lender's interests protected in personal property - such as automobiles? - Answer Loss payable clause While driving on the Pennsylvania Turnpike, William's auto has a collision with a deer that jumps in front of his car. In order for coverage to be afforded, William's Personal Auto Policy must have: - Answer Other than Collision coverage An insured took his TV to a shop for repairs, on the way, he stopped suddenly and the TV fell off the seat, breaking the TV. How will his PAP (Personal Auto Policy) respond? - Answer The PAP will not respond. An insured has "Stacked" Uninsured Motorist with 25/50 limits on each of 2 vehicles that he owns. How much Uninsured Motorist coverage is available to the insured in the event of an accident with a hit & run driver? - Answer 50/ The "trigger" of the financial responsibility law is: - Answer An accident involving bodily injury or property damage rendering the vehicle inoperable or a serious violation such as DUI. Which of the following is the lowest single limit automobile liability that meets the requirements of the Florida Financial Responsibility Law? - Answer $30, An insured had an accident in another state that required liability limits of 25/50/25. Our insured had 10/20/10 limits. What happens if the liability he incurs exceeds 10/20/10? - Answer Our insured's policy will respond to the higher limit of the other state
Nonresidents must comply with the Florida No Fault law: - Answer If their auto is in Florida over 90 of the last 365 days When is the named insured NOT entitled to PIP benefits? - Answer Injured outside of Florida while a pedestrian struck by a defined motor vehicle Which of the following statements is false concerning No-Fault Auto Insurance? - Answer Negligence must be established. An insured has Basic PIP with no deductible, in an accident he incurs medical bills of $8,000, $1,000 in lost wages, and $500 in replacement services - how much will PIP portion of policy pay? - Answer $7, Jane is a Florida resident with an auto. She has PIP coverage of $10, with no deductible. If she is in an auto accident and has medical bills of $10,000, how much will her PIP pay? - Answer $8, If Jane also has work loss of $1000 due to the auto accident, how much will her PIP pay for work loss? - Answer $ What if Jane's accident happened during the work day while she was driving a GEICO owned auto and Jane was out adjusting auto claims. How much would Jane's PIP pay for her medical injuries? - Answer zero If Jane had an accident while she was driving to Orlando to go to Disney and had borrowed her neighbor's minivan so she could take 5 friends ... how much would Jane's PIP insurance pay for her medical bills of $10, and her work loss due to the accident of $1000? - Answer $ If all 5 of Jane's friends are Florida residents who own automobiles, how much of Jane's PIP coverage is available for each of the 5 friends riding with her in the borrowed minivan? - Answer 0 What if Jane has 5 children and she is taking them all to Disney for the day ... how much total PIP coverage is available from Jane's PIP to Jane and her 5 children in the friend's minivan? - Answer $60,
How much would Jane's PIP pay if the auto accident caused injuries to Jane that created $12,000 in medical bills and Jane had a $1000 PIP Deductible? - Answer $ A health insurance policy was issued containing the provision that the insurance company must renew the policy to a particular age, but could adjust premiums. What is this policy called? - Answer A guaranteed renewable policy A health insurance policy was issued containing the provision that the insurance company must renew the policy to a particular age and could not adjust the premiums. What is this policy called? - Answer A non-cancelable policy A health policy often has a provision which states a period of time between issuance and acceptance before sickness benefits begin. This eliminates people only buying health insurance when they find out that they are ill. This is called a/an: - Answer Elimination Period All of the following are true for Medicare Supplement Insurance EXCEPT: - Answer Policy must contain a 180 day "free look" What type of health insurance plan usually offers the broadest coverage at the lowest cost with the most freedom of choice? - Answer Group Insurance PPO Insurance is considered a two-party contract, Surety Bonds are considered
- Answer a three-party contract A builder contracted for framing on a new section of a hospital. There is a surety bond purchased to guarantee completion of the project. Which of the following best describes the hospital position in the surety bond? - Answer The hospital is the obligee The Surety attempts to avoid default by investigating the principal with regard to: - Answer CharacterCapabilityCollateral The Surety bond that guarantees that companies will not misrepresent securities is - Answer Blue Sky Bond
What is the limit on medical benefits under Workers Compensation? - Answer All medical costs with no limit The following are employees who must have workers compensation EXCEPT: - Answer Pro athletes A claimant ate some undercooked fish and got violently ill at the restaurant. Which of the following would pay for this occurrence? - Answer A premises and operations form Which of the following are covered exposures for bodily injury and property damage under the CGL (Commercial General Liability) Policy: - Answer Products and completed operations Contractual Liability Contingent Liability Who is covered for their exposure under the CGL - Commercial General Liability Policy? - Answer Employees of the business Volunteers, legal representative, trustee Real estate manager Under a CGL Occurrence liability form, which policy would cover an accident that occurred June 1, 1998, and was discovered and reported July 15, 2008: - Answer A policy dated 1/1/98 to 12/31/ Under CGL, the Occurrence form - bodily injury or property damage must occur during the policy period - reporting of the claim may be: - Answer within policy period or thereafter with no limit on time Under CGL Claims-made form, the Supplemental extended reporting period: - Answer May extend the reporting period from one year to an indefinite time. A furniture manufacturing business wanted to serve free beer at its company picnic. What is required for this business to have liability coverage for liquor consumption at the picnic? - Answer The business CGL policy will cover this exposure Insurance agents and adjusters may have their professional activities covered under a type of liability insurance called: - Answer Errors and Omissions Liability
Which of the following is true concerning the definition of "accident" under the CGL (Commercial General Liability)? - Answer An accident may include continuous and repeated exposure to the same condition. The coverage for damage to an aircraft under the care, custody, or control of the insured while the plane is in for storage or service is: - Answer Hangarkeepers liability Under the commercial property form, what length of time must expire before a building is considered "vacant", thus suspending some coverages, while reducing payment on others? - Answer 60 Days A florist wanted coverage on business contents that vary in amount over the course of a year. Which form best covers this situation? - Answer The value reporting endorsement Both commercial property and liability were combined into one policy, thus saving money on underwriting expense. What is this combination called? - Answer A package policy A ship loaded with lumber encountered a terrible storm, and some of the lumber was thrown overboard to save the ship - this action is called: - Answer Jettison A contractor was concerned some of his tools, such as a welder, could be stolen from the job site. What inland marine form is best suited for this exposure? - Answer The contractors equipment floater In Commercial Policies - Vacancy of more than 60 days suspends coverage on all the following EXCEPT : - Answer Windstorm Condominiums may be covered by both an Association (Commercial Condo) Policy and a Unit Owners' (Homeowners) Policy, which of the following is true? - Answer The Association Policy is primary and the Unit Owners' Policy is excess There are advantages of an agent recommending a commercial package policy over several monoline policies. Which of the following is an advantage? - Answer The package policy is easier to rate and sell - more
All of the following are eligible for a Homeowners Policy EXCEPT: - Answer A beach house owned by Acme Corporation The principle of "insurable interest" is important in the dwelling policy as well as other kinds of insurance. Which of the following does not have " insurable interest" in the described property? - Answer One who attends a Mary Kay party at a friend's property Aunt Mary lives with the insured Homeowner. A thief steals her hearing aid. The HO-3 will: - Answer Cover within the limits of the H/O policy Which of the following is eligible for a Homeowners policy? I. Susie, who has purchased a condo unit for her residence. II. John, who buys a duplex and lives in one side. III. Sam, who rents an apartment for his residence. - Answer I, II, and III Which of the following is NOT covered under the HO - Coverage C, Personal Property? - Answer The dead fish when the insured accidentally overturns his tropical fish tank and all the fish die from lack of oxygen. Under both the Dwelling and Homeowners, Coverage B - unattached structures coverage - usually is: - Answer 10% of Coverage A - Structure Which of the following forms is "all risks" on the dwelling policy? - Answer DP-3, or the special form Which of the following is NOT one of the rating factors used in determining a H/O (Homeowners) premium? - Answer Gender of owner Jane has a dwelling policy with the house insured for $40,000. If her detached shed, which is valued at $4500, is destroyed by a covered peril, what can she expect? - Answer She can expect $4,000 to be paid, because unattached structures are covered up to 10% of the dwelling amount. Homeowners Policies usually insure property for which of the following? - Answer Fire, lightning, theft If the policy holder has a HO-3 policy with no endorsements and there is a fire - jewelry worth $20,000 in the house might be covered: - Answer Could be covered for $20,000 if the Coverage C limit is high enough
Liability limits may be expressed as a: - Answer Aggregate Limit Split Limit Single Limit An insured has A SPLIT limit liability policy with 10/20/10 limits. He owes the following people liability bodily injuries claims of: Passenger 1 = $12,000, Passenger 2 = $10,000, Passenger 3 = $18,000. How much liability insurance will his policy pay for these claims? - Answer $ 20, Loss payee - Answer If a lender has an insurable interest in an auto, because of the money loaned to finance the auto, the lender would appear on the policy as the: To turn partially damaged property over to the insurance company and ask them to pay for a total loss is called - Answer Abandonment Firemen caused water damage to a property by spraying water to put out a fire. If the property insurance policy listed "fire" as the only named peril: - Answer The water damage is covered due to the concept of proximate cause. XYZ Insurance Corp. filed its corporate charter in Tallahassee and has its home office in Tampa: - Answer In Florida, XYZ is a domestic insurer. An insured has a home with a replacement cost / value of $100,000, on which he carries an insurance policy for $80,000 with an 80% Coinsurance clause. The insured has a $20,000 partial loss, the insurance company will pay how much for this partial loss of $20,000? (Remember $80,000 is 80% of $100,000) - Answer 20, "Actual Cash Value" ACV means: - Answer Current cost to replace minus depreciation Which of the following is TRUE concerning Subrogation? - Answer Allows the insurer to sue a negligent third party to recover a loss paid. An insurer may sever the interests of 2 insureds so that the insurer can protect an innocent party - this is the Doctrine of: - Answer Severability
