Intro To Claims Adjusting Flashcards
Express Authority
The authority specifically provided to the agent by the principal and written or orally
Implied authority
This allows, the agent to perform all the usual task required to adjust the claim and to exercise their expressed authority
Apparent authority
This is the authority that a normal prudent person would assume the agent has to act on the behalf of the principal
Reservation of rights letter
The document indicates that insurance company is investigating the coverage for the claim, but reserves the right to deny coverage
When did you send out a reservation of rights letter?
Should be sent to the insured as soon as the adjuster recognizes a potential coverage problems, such as a late notice of a claim by the insured and exclusion, and the policy that applies to the claim, their insured failed to cooperate
Non-waiver agreement
Sign by both the insured and the claim adjuster non-waiver agreements are only used with first party claims
Types of adjusters reports
Initial/field/preliminary report, status/interm report, summary/captioned report
Advanced payments
These payments are deducted from the final settlement amount
What is a claimant?
An individual that makes a claim for payment after loss
What is adjusting?
The process of comparing the claimants losses to the promises made by their insurance company
What is an insurance adjuster?
Is an agent who for compensation processes, insurance claims
Three responsibilities of an insurance adjuster
To act as the fiduciary agent, the power to bind, to report the principal
What is a claim?
A formal request to settle a claim, the climate must prove the loss, the insurance sons and adjuster who must decide if the claimant have adequate proof of loss
Property claim
Insurance claims the claim is typically the insured when the insured demands more than their sure is willing to pay the claim and in court
Liability claim
By contract, the claimant is a third-party seeking payment for damages. Their insured is responsible for.
