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A comprehensive set of practice questions for the pa exam, covering various aspects of insurance principles and practices. Each question includes a detailed explanation of the correct answer, enhancing understanding and knowledge retention. Ideal for students preparing for the pa exam, offering valuable insights into key concepts and common exam topics.
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"Claims filed with the insurance company by the insured are known as A) First-party claims B) Third-party claims. C) Self-insured claims
Claims filed against the insurance company by the insured are known as first-party claims." "A gas line explodes outside of Mindy's Mending Shop, ruining her new landscaping. Which coverage extension of Mindy's Commercial Property policy would cover the cost of replacing the damaged trees and shrubs? A) Property On-Premises". B) "Newly Acquired Property". C) "Property Off-Premises".
Explanation: The coverage extension "Outdoor Property" adds coverage for trees and shrubs that were excluded in the "property not covered" section of the policy." "Which of the following would be considered a "breakdown" as defined in an Equipment Breakdown policy? A) Malfunctions after adjusting equipment. B) Leakage at any valve. C) The functioning of any safety or protective device.
equipment failure Explanation: "Pressure or vacuum equipment failure." is the only answer choice that IS considered a "breakdown". All of the other answer choices are on the list of items NOT considered to be a "breakdown"."
"Samantha has renewed her Commercial Property policy, and it will take effect in 7 days. 14 days prior to Samantha signing the renewal policy, the insurer adopted a form revision that included broadened coverage, with a slight increase in premium. Samantha would like her renewal policy to include this broadened coverage. Which of the following statements is true regarding the required method for Samantha to receive the broader coverage? A) The liberalization clause will not require that Samantha's renewal policy include the broadened coverage automatically because there is an additional premium to have the broadened coverage included. B) Samantha must do nothing to receive the broadened coverage because the insurer adopted the coverage within 45 days of the renewal (inception) of Samantha's policy, therefore the coverage will apply automatically due to the liberalization clause.
not require that Samantha's renewal policy include the broadened coverage automatically because there is an additional premium to have the broadened coverage included Explanation: The liberalization clause will not require that Samantha's renewal policy include the broadened coverage automatically because there is an additional premium to have the broadened coverage included. The liberalization clause only provides for the broadened coverage to be automatically included if there is NOT an additional premium involved." "A formal request to an insurance company requesting a payment according to the terms of an insurance contract is known as A) A notice of lawsuit. B) A declaratory judgement request. C) An insurance claim.
An insurance claim is a formal request to an insurance company requesting a payment based on the terms of an insurance policy (contract)." "The Commercial Property condition known as "Concealment, Misrepresentation, or Fraud" calls for the policy A) To pay damages to the insured if the insurance company has intentionally concealed or misrepresented a material fact from the insured concerning what coverage the policy provides. B) To be cancelled if the insured intentionally concealed or misrepresented a material fact on the application for insurance. C) To be voided if the insured intentionally concealed or misrepresented a material fact on the application for insurance.
emergency is permitted to make an offer to purchase the salvage of a covered claim and to expedite its removal. Explanation: No public adjuster may require, demand, charge or accept any fee, retainer, compensation, commission, deposit, or other thing of value, prior to receipt by the insured or claimant of a payment on the claim by the insurer." "An insured has suffered a property loss and reported the claim promptly. Which of the following is NOT an immediate duty of the adjuster who received the claim? A) Immediately seek subrogation rights against a third party. B) Verify the effective date of the coverage. C) Verify the proximate cause of loss.
Immediately seek subrogation rights against a third party. Explanation: Subrogation of a claim occurs after the claim has been paid. Afterwards, the adjuster may seek subrogation against a third party who may have caused the loss." "Which of the following best describes when an aircraft is "in motion?" A) When the plane is being pushed from the gate by another vehicle. B) When the plane is moving under its own power or from momentum generated from its own power. C) When the plane's engines are creating movement.
from its own power Explanation: "In motion" describes anytime the plane is moving under its own power or from momentum generated by its own power." "The Florida mandatory Homeowner endorsement form HO 01 09 amends the "Suit Against Us" provision, that allows the insured to bring a lawsuit against the insurer within: A) 2 years B) 3 years C) 5 years
The ISO policy does not specify a number of years that the insured has to bring a suit, but Florida specifies it as 5 years."
"When Chris' car is stolen from his apartment's parking lot, he heads down to the local dealership and buys a new car. Three months later, Chris decides he may as well report the stolen car to his insurer, so he can get some money for it. What is the most likely reason the insurer might deny his claim? A) Chris did not promptly report the stolen vehicle. B) Chris was not listed as an "insured. C) "Chris didn't protect his vehicle from being stolen.
stolen vehicle The "duties after a loss condition" specifies that the insured is required to report a claim promptly or the claim may be denied" "Which of the following "additional coverages" under the Building & Personal Property coverage form does not increase the limit of liability of the policy? A) Preservation of Property. B) Electronic Data. C) Fire Department Service Charge.
Explanation: The Preservation of Property additional coverage does not increase the limit of insurance." "All of the following are characteristics of a principal that a surety will scrutinize during the underwriting process, EXCEPT A) Capability B) Character C) Consideration
Explanation: Consideration is NOT one of the characteristics a surety would look for in a principal during the underwriting process. Capability, character, and capital ARE characteristics a surety will be looking for in a principal. Topic covered in the Surety Bonding chapter; Module A in the Virtual Classroom." "In Florida, a notice of claim in the event of a hurricane or windstorm loss must be provided to the insurer within: A) 1 year. B) 2 years C) 30 months.
"Which of the following statements is true regarding "catastrophic ground cover collapse" in Florida? A) It provides broader coverage than "sinkhole collapse" coverage. B) It must be offered along with sinkhole collapse coverage. C) It provides more limited coverage than "sinkhole collapse" coverage.
more limited coverage than "sinkhole collapse" coverage.. Explanation: Catastrophic ground cover collapse coverage provides more limited coverage than "sinkhole collapse" coverage." "All of the following would be covered under a Builders Risk Policy, EXCEPT: A) Prospective buyer. B) Contractor. C) Owner.
Explanation: A prospective buyer could not be added to the policy as an insured. They would not have an insurable interest in the property" "If an insured fails to report a claim in a timely fashion, the adjuster will immediately A) Deny the claim. B) Send the insured a reservation of rights letter. C) Cease the claims investigation.
reservation of rights letter Explanation: Failure to report a claim in a timely fashion denies the insurer of the opportunity to promptly investigate the circumstances of the claim. Valuable information from witness could be lost, as well as other physical evidence. When this occurs, the insurer will normally send the insured a reservation letter to protect the rights of the insurer." "Manny is purchasing a Commercial Property policy with a Business Income form included. Manny can select from any of the following as a method to provide coverage, while avoiding the coinsurance requirement, EXCEPT: A) The maximum monthly limit of indemnity optional coverage. B) The maximum period of indemnity. C) The monthly limit of indemnity.
coverage
Explanation: The maximum monthly limit of indemnity optional coverage does not exist. The other three answer choices are all methods of coverage under a Business Income form that permits an insured to avoid the coinsurance requirement." "There are several different Commercial Property coverage forms that can be added to a Commercial Package policy. Which of the following is NOT described on a Commercial Property coverage form? A) Any property that is excluded from coverage. B) A description of the property being covered by the policy. C) The number of buildings the insured owns that are not covered by the policy.
the insured owns that are not covered by the policy. Explanation: It would not be necessary to include a description of the buildings the insured owns that are not covered under the policy." "The insurer and the Department of Insurance must be given a ______ advance notice if an insured brings a civil action action an insurer A) 30 day. B) 60 day C) 90 day
Explanation: As a condition precedent to bringing a civil action, the Department and the authorized insurer must have been given 60 days written notice of the violation. If the Department returns the notice for lack of specificity, the 60 day time period does not begin until a proper notice is filed." "Under the comprehensive coverage of a Business Auto policy, which of the following would not be a covered loss? A) After sliding on an icy pavement, a driver hits a guard rail. B) Electrical wiring in the vehicle catches fire when the ignition is turned on. C) All four tires are removed and a truck is put on blocks while it is parked over the weekend, even though there is no evidence of forcible entry into the company parking lot.
sliding on an icy pavement, a driver hits a guard rail Explanation: Since the vehicle sustained damage by hitting the guard rail, it is considered a collision claim. This is because the definition of collision includes the upset of a vehicle, its impact with another vehicle or object; anything else would be other than collision and thus be covered by comprehensive coverage"
Answer: Suggesting to the insured some improvements in their insurance coverage that would be beneficial for possible claims filed in the future Explanation: Suggesting to the insured some improvements in their insurance coverage that would be beneficial for possible claims filed in the future, is NOT a violation of the ethics code. However, the other three answer choices ARE violations of ethics. Topic covered in the Florida Adjuster Laws & Regulations section of the course." "Suggesting to the insured some improvements in their insurance coverage that would be beneficial for possible claims filed in the future, is NOT a violation of the ethics code. However, the other three answer choices ARE violations of ethics. Topic covered in the Florida Adjuster Laws & Regulations section of the course. A) Assumed names B) Legal name C) Name as specified in the Department records
Any advertisement by a public adjuster must state the full name as specified in Florida Department records of the public adjuster who has caused the advertisement to appear" "What penalty may be imposed upon a person who makes a fraudulent or false application for licensure in Florida? A) Refusal of, the non-renewal of, or the termination of the license B) Possible imprisonment of up to 6 month C) A possible fine of up to $3,
correct Explanation: A cease and desist order would also be issued in this instance. If this order is violated the CFO has the power to impose an administrative fine of up to $50,000" "In Florida, when can an adjuster settle a third-party claim involving a minor with the parents of the child? A) When the claim is less that $20,000. B) When the claim is less than $15,000. C) When the claim is less than $10,
Explanation: Under Florida law, the adjuster should settle a third-party liability claim of an injured minor child with both parents of the injured child, presuming the settlement is for an amount not in excess of $15,000. If the settlement is for a larger amount, then it must be consummated through the Circuit or County Courts." "Under the DP-3 special form, which of the following would be covered? A) Earthquake. B) Theft of outside lighting attached to the dwelling. C) Vandalism in a dwelling that has been vacant for 89 days. D) The gradual soot build-up on the siding of the covered dwelling from the insured's gas grill being used
dwelling Explanation: The special DP-3 form provides open peril coverage on the structures. This covers the light because it is attached to the building." "Records of all adjusting contracts and estimates in Florida must be maintained in the adjuster's records for a minimum of: A) 3 years. B) 2 years. C) 1 year
Florida adjusters must maintain any adjusting contracts or written estimates within their records for a minimum of 5 years." "Which of the following is covered property under the HO-3 form?I. Belongings of the insured's daughter, while she is away at college.II. The insured's pool table stored in the garage located under the bonus room of the insured dwelling.III. The insured's prize-winning show dog.IV. The personal property of a tenant who is renting the insured's bonus room. A) I, II, and III only B) I, II, III, and IV C) I and II only
Explanation: Pets, no matter how valuable, are excluded under Coverage C, as is the property of boarders or renters." "The rental reimbursement provision (or transportation expense provision) of an automobile mechanical breakdown policy provides:
the walkway leading to the outdoor swimming pool, and the pool itself. Which of damaged property would be covered by the policy? A) The roof and the personal property located inside the covered dwelling. B) The roof and the foundation of the home. All other damaged items are specifically excluded. C) The roof, personal property, and swimming pool. The foundation of the home and the walkway are excluded.
Explanation: The roof and the personal property inside the home are covered. All the other answer choices include items that are specifically excluded under the broad form peril "Weight of Ice, Snow or Sleet"." "All of the following are reasons that an adjuster should keep very detailed log notes, EXCEPT: A) To assist in determining the negligent parties. B) To assist in determining if the claim is fraudulent. C) To produce notes that will support a fraudulent denial of claims.
Explanation: The adjuster's log notes are used to determine negligent parties, to assist in detecting fraud, to become a part of the claims file, and to be used in future proceedings. The log notes are not intended to produce a fraudulent record to deny a claim." "Claims adjusters have a close relationship to the legal profession but must be careful not to become involved in the unauthorized practice of law. Which of the following would be an example of an adjuster who is engaged in the unauthorized practice of law? A) The adjuster has transmitted settlement offers on behalf of the principal. B) The adjuster has managed claims in compliance with their state's adopted Unfair Claim Settlement laws. C) The adjuster has expressed an opinion, formed from a factual analysis, regarding the extent of damage or injury.
Answer: The adjuster has drafted the legally binding settlement papers on a claim Explanation: Adjuster are not permitted to draft any document that is intended to have a legally binding effect." "In which of the following situations would trees, shrubs, and other plants be covered by the Homeowners additional coverages?
A) The insured's fruit trees are destroyed when an ember from a nearby brush fire lands on them and burns them. B) The insured's shrubs are destroyed when a 100-year snow storm hits the area and the weight of the snow is so heavy, it snaps the branches. C) The insured's 150-year-old oak tree is pushed over by high winds. D) The insured's fruit trees are ruined when snow and ice from a storm build up on the trees, causing
trees are destroyed when an ember from a nearby brush fire lands on them and burns them. Explanation: The perils of wind, hail, and the weight of ice and snow are excluded under the Homeowners additional coverage for trees, shrubs and other plants. Therefore, the only situation that would be covered is: "The insured's fruit trees are destroyed when an ember from a nearby brush fire lands on them and burns them"." "All of the following statements regarding eligibility of self-storage facilities for a standard BOP policy are true, EXCEPT A) The facility cannot exceed two stories in height. B) The facility cannot exceed more than 500 individual self-storage units. C) The facility cannot be used to store items at a specific cold temperature to avoid spoilage.
cannot exceed more than 500 individual self-storage units. Explanation: The BOP DOES NOT require a self-storage unit to be limited to no more than 500 individual self-storage units to be eligible for coverage. All of the other answer choices are eligibility requirements of the BOP for coverage of self-storage facilities." "An adjuster is engaged in the unauthorized practice of law if they perform any of the following duties, EXCEPT A) Drafting a legally binding document in the course of adjusting a claim. B) Providing information gained through the claims investigation to the principal. C) Filling in the blanks of a form with factual data.
Explanation: Filling in the blanks of a form with factual data is NOT engaging in the unauthorized practice of law." "Commercial inland marine policies require the insured to submit a signed, sworn statement of loss A) Within 60 days of the date of the loss. B) Within 30 days of the insurer requesting it. C) Within 30 days of the date of the loss.
Explanation: The maximum payable for the loss is the $85,000 policy limit which would be split at $20,000 for the mortgage lender and a $65,000 check for Heather. The policy also contains an additional coverage of $500 for fire department service charges. This is paid in addition to the policy limits. There is no mention in the question of the deductible amount so you do not assume there is one in answering this question." "What limits of liability under a personal auto policy satisfies the Florida Financial Responsibility Law? A) $10/20/ B) $20/10/ C) $10/40/
Explanation: The minimum limits of liability required to satisfy the financial responsibility law in Florida are $10,000 each person/$20,000 for multiple injuries and $10,000 property damage to others. These are third party coverages. PIP are first party coverages." "Which of the following statements best describes the process of mediation? A) It is the most common alternative dispute resolution (ADR) used to resolve claim disputes. B) Both parties select an impartial expert and those experts select a third. The decision reached by all three impartial experts is legally binding on the disputing parties C) Both parties present their dispute to a neutral third party, but no decision reached by the mediator is legally binding. D) Both parties present their dispute to a neutral third party and the decision of the mediator is legally
no decision reached by the mediator is legally binding. Explanation: In mediation, both opposing parties present their dispute to an objective and neutral (impartial) third party who helps the parties analyze their dispute and devise a compromise. No decision reached in mediation is binding on either party, unless they come to an agreement and sign documents agreeing to the decision." "When an insured suffers a property loss, he or she is obligated by the terms of the policy to do all of the following, EXCEPT A) Separate the damaged from the undamaged property. B) Mitigate the loss. C) Produce books and records relevant to the claim.
public adjuster to represent them in the claims process
Explanation: The insured is not obligated to employ a 'public adjuster" to assist in the claim against the insurance company. It is an option on the part of the insured." "Under a Personal Articles Floater, a pair of antique salt and pepper shakers is insured for $1,000. When one of the shakers is broken, the remaining shaker is worth only $200. How much will the insured receive for the loss without taking into account the deductible? A) $1,000. B) $ C)$
Explanation: In this case, the loss would be determined by taking the value of the item that is remaining and deduct that from the limit of insurance" "Choosing between two right or legally acceptable choices is known as A) Making a legal decision. B) Making a moral decision. C) Making an ethical decision.
Explanation: Choosing between two right (correct) or legally acceptable choices is known as making an ethical decision" "A licensee in Florida has moved and changed his address without notifying the Department within the required period of time. What monetary penalty can be imposed by the Department? A) A fine of up to $100. B) A fine of up to $250.00. C) A fine of up to $200.00.
Explanation: A fine not to exceed $250.00 for the first offense and a fine of $500.00 or suspension or revocation of the license for a subsequent offense can be applied." "Which of the following losses would NOT be covered by an unendorsed Commercial Property policy with the special cause of loss form attached? A) Carolyn's Fine Gifts must shut down for a month to repair flood damage. B) When a riot breaks out in the town square, Bonnie's Boutique is looted and vandalized in the commotion. C) A tornado whips through town, leveling a warehouse belonging to Johnson's Industries.
public adjuster must retain such written estimate for at least five years and make it available to the claimant or insured and the Department upon request." "In Florida, the records of an adjuster relating to a particular claim or loss must be retained in the adjuster's place of business for a period of: A) Not less than 6 months after completion of the adjustment. B) Not less than 2 years after completion of the adjustment. C) Not less than 3 years after completion of the adjustment.
than 5 years after completion of the adjustment. Explanation: Records must be retained for a period of not less than 5 years after completion of the adjustment. This used to be 3 years, but changed to 5 years as of January 1st, 2018." "Which of the following statements is TRUE regarding the definition of "mysterious disappearance" as it applies under a Crime insurance policy? A) Mysterious disappearance" may apply to any type of property theft. B) For "mysterious disappearance" to apply, theft of the property must be ruled out. C) The "mysterious disappearance" of property is only covered if the insured can prove the property was stored in an area where the safety of that property can be presumed. D) The "mysterious disappearance" of covered property is considered negligence on the part of the
theft of the property must be ruled out. Explanation: For "mysterious disappearance" to apply under a Crime policy, theft of the property must be ruled out" "Robert is retired and lives in an older home in Maine. He has an old floor furnace to heat his home that is in need of repair and he forgets to have it checked. In the winter he stays in Florida for a month with his daughter. While Robert is away, the furnace malfunctions, allowing the temperature in the house to drop so low that all his water pipes freeze and burst, causing massive water damage. His house is covered under a Homeowners broad cause of loss form, that includes water damage from a heating or plumbing system. How will the adjuster handle this claim? A) Pay for all damage except the furnace. B) Deny the entire claim because of neglect of the insured. C) Pay for the furnace and the resulting water damage only. D) Pay for the water damage and depreciate the payment for the replacement of the furnace. -
Explanation: In this case, most insurers would pay for all damage except the destroyed furnace. The policy does not pay for the wear and tear of a heating or air conditioning system. Even though the
insured was neglectful, the ensuing damage resulting from the frozen pipes would be covered. If the insured had been advised by a contractor that the furnace needed immediate repairs and the insured failed to make them, most adjusters would deny the entire claim. This would then be considered an increased hazard not known to the insurer and intentional neglect on the part of the insured." "Under a Businessowners policy, the "Hired and Nonowned Auto Liability" endorsement would cover A) The employer who uses his/her auto for personal use. B) Vehicles borrowed by the insured. C) The employee who uses his/her vehicle on personal business.
the insured Explanation: This endorsement is used with the BOP when the insured does not carry coverage for liability under a Commercial Auto policy" "Which of the following is the additional limit provided by a standard Businessowners policy "Debris Removal" in the event that the policy limit is exhausted in paying the loss? A) $25,000. B) $20,000. C) $10,
Explanation: The additional limit is $25,000 when the basic coverage provided by the policy is not enough. The basic coverage provides debris removal coverage up to 25% of the actual amount of the loss up to the policy limit. Sometimes the amount of the loss PLUS the debris cleanup will exhaust the limit and the company will pay up to an additional $25,000 for debris removal." "Whose responsibility is it to complete a "proof of loss" A) The insurer's adjuster. B) The agent or producer. C) The insurer.
Explanation: The claimant must complete the proof of loss form and submit it to the insurance company. A PUBLIC adjuster, if hired by the claimant, would assist with filling out the proof of loss." "The insured awoke and found that a water line on his side of the water meter has broken. Several thousand gallons of water have escaped. The water company bills the insured for the loss of the water, because the breakage in the waterline occurred on his side of the water meter. The insurance company will: