Download FLORIDA CLAIMS ADJUSTER EXAM QUESTIONS WITH ACTUAL VERIFIED ANSWERS 2025 and more Exams Nursing in PDF only on Docsity!
FLORIDA CLAIMS ADJUSTER EXAM QUESTIONS WITH
ACTUAL VERIFIED ANSWERS.
Frank,owned,a,home,that,was,destroyed,by,a,hurricane.,Both,ABC,and,XYZ,Banks,were,listed,as,additional, interests,on,his,homeowner,policy.,The,insurance,company,will,make,a,payment,to:, A.,The,first,mortgagee,,ABC B.,The,Insured C.,Jointly,to,ABC,and,XYZ D.,All,listed,interests,,ANS,-,D.,All,listed,interests Remember,that,the,insurer,is,not,responsible,to,know,the,degrees,of,interest.,In,the,event,of,a,loss,,one,p ayment,is,made,by,the,insurer,and,it,is,up,to,the,additional,interests,on,working,out,their,share. Insurance,applies,separately,to,each,insured,as,if,other,insureds,did,not,exist.,This,is,defined,as: A.,Severability B.,Conditional C.,Warranty D.,None,of,the,above,,ANS,-,A.,Severability Property,insurance,policies,usually,contain,a(n),__________,clause,,stating,the,insured,cannot,dump,dam aged,property,on,the,insurer,and,demand,its,full,value: A.,Pro,Rata B.,Abandonment C.,Liberalization D.,All,of,the,above,,ANS,-,B.,Abandonment A(n),__________,is,one,wherein,economic,loss,would,be,suffered,from,an,adverse,happening,to,the,subje ct: A.,Conditional,Contract B.,Personal,Contract C.,Economic,Contract D.,Insurable,Interest,,ANS,-,D.,Insurable,Interest
States,that,if,the,insurer,adopts,a,revision,which,would,broaden,coverage,without,additional,premium,wit hin,some,period,of,time,prior,to,the,policy,period,or,during,the,policy,period,,the,insured,receives,the,ben efit,of,such,broadened,coverage. A.,Cancellation,Clause B.,Policy,Period C.,Pro,Rata D.,Liberalization,,ANS,-,D.,Liberalization The,time,frame,is,typically, 60 ,days. The,__________,states,that,when,there,is,an,unbroken,connection,between,an,occurrence,and,damage,t hat,grows,out,of,the,occurrence,,then,the,resultant,damage,is,all,a,part,of,the,occurrence. A.,Doctrine,of,Proximate,Cause B.,Doctrine,of,Perils,&,Hazards C.,Insurance,Policy,Handbook D.,Doctrine,of,Property,Insurance,,ANS,-,A.,Doctrine,of,Proximate,Cause For,example,,if,a,property,insurance,policy,covers,the,peril,of,fire,but,further,damage,is,caused,by,smoke,, water,used,to,extinguish,,and,the,process,of,moving,property,away,- ,fire,is,considered,to,be,the,proximate,cause,of,all,of,the,damage. The,Loss,Settlement,Valuation,that,subtracts,an,allowance,for,depreciation,is,defined,as? A.,Actual,Cash,Value B.,Replacement,Cost C.,"Old,for,New" D.,None,of,the,Above,,ANS,-,A.,Actual,Cash,Value A,policy,condition,,either,based,on,information,in,the,insured's,application,or,inserted,by,the,insurer,,is,de fined,as: A.,Warranty B.,Misrepresentation C.,Concealment
Used,vehicles:, 12 ,Months/12,000,Miles If,financial,responsibility,doesn't,exist,at,the,time,of,an,accident,,which,of,the,following,things,must,happe n,to,avoid,penalties? A.,The,legally,valid,claims,of,others,must,be,satisfied,(up,to,10/20/10) B.,The,owner,and,operator,must,provide,certification,of,future,responsibility,for,future,accidents C.,Both,A,&,B D.,None,of,the,Above,,ANS,-,C.,Both,A,&,B As,to,required,proof,for,future,accidents,by,purchase,of,auto,liability,insurance,,the,insurer,must,make,a,fi ling,(Form,SR- 22),certifying,that,coverage,is,in,effect,,and,this,certification,must,remain,on,file,for,__________,years:, A., 1 B., 3 C., 4 D., 2 ,,ANS,-,B., 3 The,Business,Automobile,Policy,includes,all,of,the,following,coverage,forms,except: A.,The,Garage,Coverage,Form B.,The,Trailer,Interchange,Coverage,Form C.,The,Truckers,Coverage,Form D.,The,Business,Auto,Coverage,Form,,ANS,-,B.,The,Trailer,Interchange,Coverage,Form Personal,Injury,Protection,,or,PIP,,has,a,__________,per,person,,per,accident,limit. A.,10, B.,20, C.,1, D.,Depends,on,the,damaged,property,,ANS,-,A.,10, Used,to,insure,businesses,engaged,in,selling,,servicing,,repairing,,parking,or,storing,automobiles:
A.,Servicing,Coverage,Form B.,Garage,Coverage,Form C.,Truckers,Coverage,Form D.,None,of,the,Above,,ANS,-,B.,Garage,Coverage,Form The,following,examples,are,referred,to,as,__________,liability,limits:,25/50/25,or,10/20/10. A.,Split B.,Single C.,Straight D.,None,of,the,Above,,ANS,-,A.,Split 10/20/10,=, 10,000,per,person,injured 20,000,all,injuries,combined 10,000,property,damage Example,of,straight,liability,limit,=,$30, Jeremy,has,a,not,at,fault,accident.,If,he,has,PIP,with,a,$1,000,deductible,,how,much,can,he,expect,his,PIP,c overage,to,pay,toward,his,medical,bills,that,total,$3,000? A.,$1, B.,$1, C.,$2, D.,$3,000,,ANS,-,A.,$1, 3000 ,(bills),-, 1000 ,(deductible),=, 2000 ,x,.80,(eighty,percent) Frank,has,a,not-at- fault,accident,,he,has,basic,PIP,,no,deductible,and,Med,pay,of,$5,000.,How,much,will,his,Med,Pay,contrib ute,to,medical,bills,of,$15,000? A.,$15, B.,$5,
C.,DP-3,,or,the,Special,Form D.,None,of,the,Above,,ANS,-,C.,DP-3,,or,the,Special,Form When,the,basic,liability,limits,provided,by,the,policy,are,insufficient,for,an,insureds,needs,,two,coverage,f orms,are,used,to,provide,the,additional,amounts,of,coverage: A.,Excess,Liability B.,Umbrella C.,Both,A,&,B D.,None,of,the,Above,,ANS,-,C.,Both,A,&,B Which,of,the,following,is,not,covered,under,Coverage,C,,Personal,Property? A.,A,fire,breaks,out,in,the,residence,and,an,overnight,guest,loses,his,clothes,in,the,fire B.,A,fish,dies,because,he,has,been,left,alone,for,a,week,without,food C.,The,insureds,daughters,tennis,racket,is,stolen,from,her,locker D.,The,insureds,suitcase,and,clothing,,valued,at,$1,500,,are,stolen,from,his,hotel,,ANS,- ,B.,A,fish,dies,because,he,has,been,left,alone,for,a,week,without,food Animals,are,listed,as,an,"exclusion",under,a,Homeowner's,policy. All,of,the,following,are,eligible,for,a,Homeowner's,Policy,,except? A.,An,apartment,tenant B.,A,condominium,owner C.,Four-family,dwelling,owner-occupant D.,A,business,condo,owned,by,a,local,insurance,company,,ANS,- ,D.,A,business,condo,owned,by,a,local,insurance,company Commercial,property,is,not,eligible,for,a,Homeowner's,policy. Which,of,the,following,are,characteristics,of,Homeowner's,Insurance? A.,Protects,against,economic,loss,to,residences,and,household,property,and,legal,liabilities B.,Owner-occupants,of, 1 - 4 ,family,dwellings C.,Renters,who,maintain,residential,occupancy,in,any,type,of,building
D.,All,of,the,Above,,ANS,-,D.,All,of,the,Above Also,included:,personal,,non- business,risk,,no,more,than, 2 ,roomers/boarders,,condominium,unit,owners,and,cooperative,apartment,o ccupants Jeremy,owns,a,home,that,is,recently,damaged,due,to,a,hurricane.,The,repair,estimate,is,averaged,at,$25, 000 ,and,Jeremy,decides,to,stay,in,a,hotel,because,most,of,the,damage,is,to,his,bedroom,and,kitchen.,Und er,a,Homeowner's,Policy,,what,coverage,will,pay,for,the,hotel,room,bill? A.,Fair,Rental,Value B.,Value,Obligation C.,Loss,of,Use D.,Insurers,Duties,,ANS,-,C.,Loss,of,Use The,insurer,will,pay,any,necessary,and,reasonable,expenses,associated,with,a,daily,living,routine. An,insured,who,wishes,to,purchase,flood,insurance,,but,is,located,in,a,moderate,or,low,risk,flood,zone,ma y,do,so,by,purchasing,a: A.,Preferred,Risk,Flood,Policy B.,Standard,Flood,Policy C.,Universal,Flood,Insurance D.,None,of,the,Above,,ANS,-,A.,Preferred,Risk,Flood,Policy Although,Flood,Insurance,is,provided,by,the,Federal,Government,,those,who,are,not,in,a,"flood,zone",ma y,purchase,a,preferred,risk,policy,to,cover,them,for,a,flood,claim. Used,only,for,Commercial,Condominiums,,it,covers,the,unit- owners,business,personal,property,and,the,personal,property,of,others,in,the,insured's,care,,custody,or,c ontrol: A.,Condominium,Dwelling,Form B.,Personal,Condominium,Unit,Owners,Form C.,Condominium,Unit,Owners,Form D.,None,of,the,Above,,ANS,-,C.,Condominium,Unit,Owners,Form Does,not,cover,buildings,since,coverage,would,typically,be,provided,under,the,Condo,Association,coverag e,form,issued.
D.,None,of,the,Above,,ANS,-,C., 45 Also,,notice,must,state,reasons,the,policy,is,not,to,be,renewed. When,a,business's,personal,property,values,fluctuate,,a,single,,fixed,amount,of,insurance,could,produce,e ither,over-,or,under- insurance,at,any,given,time.,With,this,option,,the,limit,of,coverage,is,set,at,an,amount,somewhat,higher,t han,expected,peak,values. A.,Value,Reporting B.,Replacement,Cost C.,Agreed,Value D.,None,of,the,Above,,ANS,-,A.,Value,Reporting Replacement,Cost,is,incorrect,b/c,it,calculates,monetary,value,of,one's,personal,property Liberalization,states,,"The,insured,gets,the,benefit,of,any,broadened,coverage,if,the,company,,within,___ _______,days,of,inception,,adopts,a,form,revision,that,is,broader,and,without,increase,in,premium." A., 10 ,days B., 55 ,days C., 65 ,days D., 45 ,days,,ANS,-,D., 45 ,days Used,to,cover,buildings,in,the,course,of,construction: A.,Builders,Risk,Policy B.,Builders,Replacement,Policy C.,Construction,Replacement,Policy D.,None,of,the,Above,,ANS,-,A.,Builders,Risk,Policy Includes:,structure,being,built,(including,foundations),,fixtures,and,machinery,,equipment,to,service,build ing,,owned,materials,and,supplies,used,for,construction.,Temporary,structures,built,or,assembled,on,site, are,also,included,if,not,covered,by,insurance. First,developed,as,an,extension,of,Ocean,Marine,coverage,,to,provide,coverage,for,cargo,traveling,over,la nd,,instead,of,by,sea.
A.,Commercial,Inland,Marine,Coverage B.,Personal,Inland,Marine,Coverage C.,Ocean,Commercial,Coverage D.,None,of,the,Above,,ANS,-,A.,Commercial,Inland,Marine,Coverage Definition:,to,help,identify,kinds,of,risks,which,are,eligible,for,either,Ocean,or,Inland,Marine,insurance. Protects,against,loss,of,business,income,that,results,from,damage,to,covered,property,from,a,covered,cau se,of,loss. A.,Business,Income,Insurance,Coverage B.,Business,Income,Replacement,Coverage C.,Business,Income,Actual,Value,Coverage D.,None,of,the,Above,,ANS,-,A.,Business,Income,Insurance,Coverage Period,of,restoration,begins, 72 ,hours,after,date,of,direct,damage.,In,effect,,coverage,has,a, 72 ,hour,deduct ible., Coverage,ends,on,either,1.,date,when,damaged,property,could,be,repaired,,rebuilt,,or,replaced,2.,date,bu siness,resumes,operations,at,new,,permanent,location,(whichever,comes,first) What,payment,covers,several,areas,of,costs,related,to,claims,,and,are,payable,in,addition,to,the,policy,lim its? A.,Supplementary B.,Liability C.,Personal,Injury D.,All,of,the,Above,,ANS,-,A.,Supplementary Generally,,all,costs,of,litigation,are,covered,(court,costs,,prejudgment,interest,,judgement,interest,,cost,of ,bonds,to,release,attachments) Three,full- time,employees,from,a,local,furniture,company,are,horsing,around,and,one,is,pushed,into,a,machine,that, cut,his,foot.,How,will,the,company's,General,Liability,respond? A.,The,Med,Pay,Section,must,pay,Primary B.,The,General,Liability,Policy,will,pay,up,to,$20,000,in,medical,payments
The,Commercial,General,Liability,__________,identifies,the,named,insured,and,address,,states,the,policy, period,and,premium,and,miscellaneous,information,about,the,insured,,and,specifies,the,limits,of,coverag e,that,apply. A.,Declarations B.,Contract C.,Policy D.,None,of,the,Above,,ANS,-,A.,Declarations States,the,pertinent,information,of,the,policy The,Nuclear,Energy,Liability,Exclusion,endorsement,,in,general,,__________,all,hazards,related,to,nuclear, energy. A.,Includes B.,Excludes C.,Prohibits D.,Summarizes,,ANS,-,B.,Excludes Firms,involved,in,Nuclear,activities,receive,protection,from,special,insurer,pools,organized,for,that,purpos e. Toxic,wastes,escaped,from,a,gas,station,disposal,tank.,The,insured,operator,discovers,the,leak,and,cleans, up,the,spill.,Unfortunately,,the,waste,quickly,seeped,into,the,ground,and,has,caused,illness,among,the,res idents,of,a,neighboring,community,This,is,an,example,of? A.,Loss,Known B.,Known,Loss C.,Claims-Made D.,None,of,the,Above,,ANS,-,B.,Known,Loss Insurer,should,have,been,notified,and,further,investigation,of,the,spill,and,effective,clean- up,would,have,been,observed. Applies,to,BI,or,PD,which,occurs,during,the,policy,period,,regardless,of,any,later,time,at,which,a,claim,is,m ade: A.,Occurrence,Form B.,Claims-Made,Form
C.,Premises,and,Operations,Exposure D.,None,of,the,Above,,ANS,-,A.,Occurrence,Form vs.,Claims- Made:,applies,only,to,BI,or,PD,occurring,on,or,after,retroactive,date,for,which,claim,is,received/recorded, during,policy,period Applies,only,to,a,BI,or,PD,which,occurs,on,or,after,the,retroactive,date,,and,for,which,the,claim,is,received, or,recorded,by,an,insured,or,the,company,during,the,policy,period: A.,Occurrence B.,Claims-Made C.,Operations,Completed D.,None,of,the,Above,,ANS,-,B.,Claims-Made Retroactive,date,is,stated,in,Declarations,and,will,normally,be,same,date,as,issuing,company's,first,claims- made,effective,date,for,insured. All,of,the,following,are,components,of,Workers,Compensation,,except: A.,Up,to,$750,000,in,Death,Benefits B.,Reimbursement,for,Medical,Expenses,incurred C.,Reimbursement,for,lost,wages,on,percentage,basis D.,Funeral,costs,up,to,$7,500,,ANS,-,A.,Up,to,$750,000,in,Death,Benefits Compensation,for,death,is,payable,if,death,results,within,one,year,of,an,accident,or,if,it,follows,disability, within,five,years,of,accident. The,following,are,classes,of,disability,,except: A.,Permanent,Total B.,Temporary,Total C.,Permanent,Impairment D.,Temporary,Full,,ANS,-,D.,Temporary,Full Also,included:,Temporary,Partial
Also,included:,immediate,contact,with,insurer,,providing,immediate,medical,or,other,services,,do,nothing ,to,interfere,with,insured's,right,of,recovery,,make,no,voluntary,payments,or,assume,any,obligation,excep t,at,employer's,own,cost. Under,Workers,Compensation,,Employers,Liability,includes: A.,Claims,by,others,for,the,liabilities,to,insureds,employees B.,Claims,by,relatives,of,injured,employees,for,consequential,damages C.,Claims,made,by,employees,that,are,not,subject,to,Workers,Comp,Laws D.,All,of,the,Above,,ANS,-,D.,All,of,the,Above Samantha,eats,uncooked,chicken,at,a,local,barbecue,joint,and,becomes,violently,ill.,Which,of,the,followin g,workers,compensation,benefits,would,pay,for,this,occurrence? A.,A,products,and,completed,operations,form B.,A,premises,and,operations,form C.,An,owners,and,contractors,protective,liability,form D.,None,of,the,Above,,ANS,-,D.,None,of,the,Above Samantha,is,not,an,employee,of,the,barbecue,joint;,Workers,Comp,does,not,apply. An,optional,alternative,providing,for,adjustment,of,premium,after,expiration,,based,on,a,guaranteed,basi c,premium,to,the,insurer,to,which,is,added,the,actual,losses,incurred,by,the,insured.,This,is,defined,as: A.,Cost-Plus,Rating,Plan B.,Experience,Rating,Plan C.,Retrospective,Rating,Plan D.,None,of,the,Above,,ANS,-,C.,Retrospective,Rating,Plan Often,referred,to,as,Cost-Plus,Programs Under,Employer's,Liability,,the,minimum,limits,of,liability,are: A.,100/100/ B.,100/500/ C.,500/100/
D.,100/500,,ANS,-,A.,100/100/
$100,000,for,all,claims,in,each,accident $100,000,per,employee,for,disease $500,000,for,all,disease,claims Under,Inside,The,Premises,- ,Robbery,or,Safe,Burglary,of,Personal,Property,,a,special,limit,of,__________,per,occurrence,applies,to,art icles,whose,principal,value,is,precious,metals,,precious,or,semiprecious,stones,,pearls,or,furs,,and,to,the,p hysical,or,intrinsic,value,of,manuscripts,,drawings,or,records: A.,$1, B.,$2, C.,$4, D.,$5,000,,ANS,-,D.,$5, Under,Crime,Insurance,,losses,must,be,discovered,within, 1 ,year.,This,is,defined,as: A.,The,Discovery,Period B.,The,Loss,Sustained,Period C.,The,Open,Period D.,All,of,the,Above,,ANS,-,A.,The,Discovery,Period Crime,Insurance,is,_________,over,any,other,Insurance,coverage. A.,Primary B.,Secondary C.,Excess D.,Recess,,ANS,-,C.,Excess A,situation,may,arise,where,another,form,of,insurance,will,pay,claim,-,that,insurance,would,be,primary. Cover,only,losses,that,both,occurred,and,were,discovered,during,the,policy,period,,or,within,one,year,of,it s,expiration.,This,is,defined,as: A.,Discovery
Taking,or,attempted,taking,of,property,from,within,a,locked,safe,or,vault,,by,unlawful,entry,,with,visible, marks,of,forcible,entry,,or,taking,of,the,safe,or,vault,from,inside,the,premises.,This,is,defined,as: A.,Safe,Burglary B.,Inside,the,Premises C.,Custodial,Burglary D.,None,of,the,Above,,ANS,-,A.,Safe,Burglary Exclusions:,accounting,errors,,giving/surrendering,property,,voluntarily,parting,,fire,(except,damage,to,sa fe/vault),,vandalism,,transferring,property,to,someone,based,on,unauthorized,instructions,or,from,threat ,to,harm Covers,for,all,types,of,property,,when,surrendered,away,from,the,premises,as,a,result,of,a,threat,to,do,bo dily,harm,to,the,insured,or,an,employee,,or,to,a,relative,or,invitee,of,either,,who,is,(or,allegedly,is),being,h eld,captive.,This,is,defined,as: A.,Extortion B.,Surrendered,Property C.,Client's,Property D.,None,of,the,Above,,ANS,-,A.,Extortion Also,triggered,by,threats,to,damage,the,premises,or,property,within,the,premises. Employee,Theft,Coverage,may,be,written,in,the,following,ways: A.,Scheduled,Persons,Coverage B.,Scheduled,Position,Coverage C.,Blanket,Coverage D.,All,May,Apply,,ANS,-,D.,All,May,Apply Employee,Theft,may,be,written,in,three,ways. Which,of,the,following,are,NOT,a,type,of,bond? A.,Contract B.,Fiduciary
C.,Court D.,Apprentice,,ANS,-,D.,Apprentice Contract,-,fulfill,obligation Fiduciary,-,make,good,to,court,for,any,deficiencies,found,in,performance Court,-,protect,opposing,party,from,loss Which,of,the,following,are,characteristics,of,a,License,Bond? A.,To,guarantee,the,licensee,will,act,according,to,laws B.,Protect,public,from,unfair,business,practice C.,Proper,collection,and,payment,of,taxes D.,All,of,the,Above,,ANS,-,D.,All,of,the,Above Guarantees,the,performance,between,the,principle,and,the,obligee: A.,Principal B.,Obligee C.,Surety D.,All,of,the,Above,,ANS,-,C.,Surety aka,Bonding,Company;,Surety,is,a,"guarantee" This,bond,guarantees,indemnification,to,the,obligee,for,any,losses,resulting,from,the,principal's,failure,to, complete,the,contract,work,in,accord,with,specifications: A.,Performance B.,Bid C.,Court D.,Maintenance,,ANS,-,A.,Performance Considered,a,contract,bond One,who,undertakes,to,perform,,to,fulfill,a,contract,or,to,meet,an,obligation,is,known,as: A.,Principal
