Ch 3

Question 1

Things adjuster should accomplish in initial visit with insured.

Answer 1

A explain what inspection, appraisal, investigation will be done

Tell about need to protect property from further damage and help make arrangements

Tell insured how to present claim

Give paperwork and instructions

Tell about possible coverage issues, exclusions

Get a nonwaiver agreement if necessary

Give time frame

Be prepared to make emergency payments

Help insured find emergency housing

Question 2

3 things every investigation should determine

Answer 2

Facts about what caused loss

How coverage applies

The amount of loss

Question 3

Purpose of statement

Answer 3

Establish insurers version as to ownership of property, cause of loss, facts surrounding loss, extent of loss, determine if another party is responsible.

Question 4

Why does adjuster have to document the extent of loss or damage

Answer 4

To identify property for coverage and coinsurance

Inform insurer of magnitude of loss for reserving

Establish cost of repair or replacement for settlement

Avoid disputes with insured as to the amount payable.

Help contractors prepare bids for reconstruction

Question 5

What kind of documentation does an adjuster need for loss to personal property?

Answer 5

Bills, receipts, ccard statements, pictures, appraisals, instruction manuals, or warranty paperwork

Question 6

What is scope, what is in it, and how can it be used to achieve an agreement with the contractor?

Answer 6

Almost of damaged areas. Has type of damage, description of proposed type of repairs, measurements of those areas

Question 7

Experts which might be used for fire loss at large manufacturing plant and why

Answer 7

Origin and cause: where started

Private investigators: if fraud suspected

Accountants: inventory and calculate business income claim

Restoration: clean

Salvors: prepare inventory and sell salvage

Attorney: if coverage issues

Engineers: resolve issues related to cause of loss

Architects: draw plans for reconstruction

Contractors: emergency repairs

Question 8

How could an insured break surrogate on condition?

Answer 8

Failing to cooperate in preserving evidence

Giving or failing to give testimony

Release responsible party from liability after loss.

Question 9

Why does an adjuster need to know if there is reinsurance on a property?

Answer 9

So proper notices can be sent. Reinsurer had to be out on notice of threshold is reached.

Question 10

Draft

Answer 10

Can be deposited but if cashed needs to be certified by company.

Question 11

Advance payment receipt

Answer 11

Payment made before investigation complete. Conditional whereas if the claim is denied insured would ow it back.

Question 12

Timing issues with payments

Answer 12

States have regulators. Policies state how long insurer has.

Question 13

Why advance payments might be used

Answer 13

Help make quick repairs or resume business.

Question 14

General rules for content of a denial

Answer 14

All known reasons.

Cite policy language

Invite to provide additional info for consideration

Reservation of rights paragraph.

Question 15

What should adjuster accomplish in initial contact?

Answer 15

Learn FOL, extent of damage, help insured avoid additional damage.