Adjuster Duties and Practices

Question 1

• help the insured prove the loss to the insurer;
• help the insured understand the terms and conditions of the policy; and
• conduct a thorough investigation to determine whether a third person is responsible for the loss so that subrogation can be instituted to recover

Answer 1

The Property Adjuster

Question 2

• to the insured, to protect him or her against exposure to liability to third parties as a result of an accidental tort that falls within the definition of “occurrence”;
• to the claimant, to treat him or her fairly and, if liability exists, to resolve the claim promptly without ignoring the duty to the insured; and
• to the insurer, before agreeing to resolve a claim, to establish that coverage exists for the loss under the terms and conditions of the policy, that the insured is liable to the third party, and that the most reasonable resolution of the claim has been achieved.

Answer 2

The Liability Adjuster

Question 3

Consultants who specialize in assisting insureds in presenting claims to insurance companies in a manner that will maximize their recovery.

Answer 3

Public Adjusters

Question 4

Represent insurers and self-insureds on a contract basis.

Answer 4

Independent Adjusters

Question 5

There are three basic steps in every investigation. They apply to information of all types and all levels of complexity. They are:

Answer 5

• Obtain information
• Verify information
• Analyze information

Question 6

an insured’s formal statement of loss required by an insurance company before it will determine whether the policy covers the loss” (Black’s Law Dictionary, 7th ed.).

Answer 6

A proof of loss

Question 7

The proof of loss should include the following (8 items):

Answer 7

• The date and cause of the loss
• A statement explaining the insured’s interest in the damaged property
• A list of other parties who may have an interest in the damaged property
• A description of other insurance that might pertain to the loss
• A description of the specifications of damaged buildings
• Detailed repair estimates
• A detailed inventory of damaged personal property that is supported by purchase receipts;
• Receipts for additional living expenses incurred;
• Records that support the fair rental value loss.

Question 8

True depreciation must consider:

Answer 8

• Physical deterioration
• Functional obsolescence
• Economic obsolescence due to causes independent of the property
• Effective age as compared with other properties considering renovations and reconstruction
• Future life expectancy

Question 9

traditional definition of the term: the cost to replace with new property of like kind and quality, less depreciation.

Answer 9

Actual Cash Value

Question 10

If the decision is to restore or salvage, areas of concern include the following (5):

Answer 10

• Fire damage
• Damage from smoke and soot
• Water damage
• Odors
• Salvageable stock (in which the insurer has the right to remove insured stock for salvage)

Question 11

All claim file documentation should allow anyone reading the file to know

Answer 11

What
When
Why
By Whom