Section 1: Lesson 1 The role of an Insurance Adjuster Lesson 2: The Art and Practice of Adjusting

Question 1

The very first thing Haywood should do in handling this clam would be to:

Answer 1

Acknowledge receipt of the claim by initiating contact with both the insured and 3rd party.

Question 2

Haywoods thoughts process during the handling of the claims should be as follows:

Answer 2

contact, investigate,evaluate,resolve and close

Question 3

After the investigation and evaluation of this claim, if Haywood determines that his insured is not legally responsible for the 3rd party’s damages,Haywood should

Answer 3

Initiate a discussion with the 3rd party to advise them of his final decision on liability, including the rationale for that decision

Question 4

As an adjuster, Haywood’s responsibility’s include all of th e following except to:

Answer 4

Repair the damaged property

Question 5

Mark Ruffalo has an automobile liability insurance policy. this policy is designed to pay:

Answer 5

Only if Mark is legally responsible, or liable , for causing someone else injury or property damage.

Question 6

Robin is involved in an automobile accident after which she complains of neck pain and headaches. She is taken by ambulance to the hospital where the doctor tells her to stay home from work. Which of the following cannot be claimed under Robin’s PIP coverage?

Answer 6

Reimbursement for pain and suffering

Question 7

Texas law requires that all automobile policies include PIP coverage unless

Answer 7

Rejected in writing by the named insured

Question 8

In which of the following situations would the drivers injuries be excluded from coverage under PIP?

Answer 8

While driving through town, Larry notice that a police officer was trying to pull him over. Because his license was suspended, he tried to outrun the officer. As he ran through a busy intersection, he was hit by a vehicle that ran a red light . Larry was taken to the hospital for serious injuries.

Question 9

Under Texas law, can an insured opt not to accept PIP coverage ? If yes, how can this coverage be rejected?

Answer 9

The insured can choose not to have PIP coverage. The coverage must be rejected by the insured in writing.

Question 10

Beth is involved in an automobile accident where she is at fault. Both her car and the other car sustained extensive damage. Beth sustained minor injuries which required her to see a doctor the next day. The other driver was transported to the hospital by ambulance. Which of the following would be covered under Beth’s PIP coverage?

Answer 10

Reimbursement of the cost of Beth’s doctor’s visit following the accident

Question 11

Jane is an adjuster. Her day is filled with statements from her Insured policyholders after they’ve been involved in an automobile accident,getting damage appraisals, arranging for payment of her insureds collision and other than collision claims( Comp), and pursuing subrogation if someone else was at fault for the accident. in what kind of adjusting is Jane engaged?

Answer 11

Automobile physical damage claims adjusting

Question 12

In what line of business would an adjuster spend a great deal of time inspecting and scoping losses?

Answer 12

Catastrophe claims adjusting

Question 13

If Joe were to become an adjuster, in what lines of business would he spend the most time trying to determine if litigation is eminent, estimate defense costs, and evaluate the probability of success in the event lawsuit?

Answer 13

Casualty(Liability and Work Comp) claims adjusting

Question 14

Is there any difference between adjusting a claim and the “adjustment “of a claim

Answer 14

Adjusting is the art of investigating, evaluate, reporting, negotiating and resolving claims. Adjustment is the completion of the process, characterized by payment, denial or compromise.

Question 15

Brenda is involved in an automobile accident. She is contacted by an adjuster who is investigating who is legally responsible for the accident. To what kind of adjuster is she talking?

Answer 15

A liability claims adjuster

Question 16

An adjuster represents and controls the property and financial interests of the client, to whom he/she owes a high degree of loyalty and good faith. What kind of responsibility is this?

Answer 16

Fiduciary responsibility

Question 17

The elderly claims manage told Joe a story of one of the best adjusters he had ever known, and how he had been force o fire the man because he just would not document the claim files with ongoing status. What kind of responsibility did the adjuster fail to fulfill?

Answer 17

communicating and reporting

Question 18

The elderly claims manager told Joe a story about one adjuster who made a deal with a body shop to pay the adjuster $100 for every damaged automobile that he referred for repair. The adjuster was ultimately fired. What responsibility did that adjuster fail to fulfill?

Answer 18

Fiduciary responsibility

Question 19

The elderly claims manager told Joe a story about a young adjuster who lost his temper and cursed at an insured policyholder who was arguing about a claim that the adjuster had denied. the insured policyholder sued the company and collected $50,000 for slander and the embarrassment it caused the insured. What responsibility did that adjuster fail to fulfill?

Answer 19

Agency: The power to bind

Question 20

A worker’s compensation adjuster is trying to settle a claim. The claimants demand is $10,000 above the adjuster’s authority. The adjuster tries to contact his manager, but he is at lunch. the adjuster decides to agree to claimant’s demand, certain that this manger will approve the settlement when he gets back to the office. Even if the manager fails to approve the adjuster’s settlement, the company will be bound to the settlement. Under what theory of agency, or the power or bind , is the possible?

Answer 20

Perceived authority