TB - Insurance Claims Adjusting Flashcards
Which of the following is the type of report indicates the initial results of a claim investigation?
Field report
Interim report
Full report
None of the above
Field report
States have adopted statues regarding claims adjusting. To avoid unfit treatment to a claimant the adjuster must not:
Promptly investigate the claim
Follow the laws regarding the number of days in which to commence an investigation
Deny the claim until a fair and prompt investigation has commenced
Pay the claim within a reasonable number of days after the final proof of loss has been received
Deny the claim until a fair and prompt investigation has commenced
Which of the following is not a claim settlement option?
Forcing the insured to sue by offering less than the claim is worth
Repairing property
Replacing with like kind and quality
Replace with new
Forcing the insured to sue by offering less than the claim is worth
The giving up of a known right is called:
Estoppel
Violation of policy conditions
Rebating
Waiver
Waiver
An innocent party relies on certain statements made by the adjuster and is damaged as a result. The guilty party may be legally prohibited from asserting the the fact does not exist because of:
Waiver
Estoppel
Duties of the adjuster
Law of contract
Estoppel
Should an insure fail to report the claim in an untimely fashion the adjuster will usually:
Deny the claim
Send the insured a reservation of rights letter
Cease investigation
Seek the advice of the company’s attorney
Send the insured a reservation of rights letter
A company adjuster primarily represents the interests of:
The insured
The claimant
The insurer
The public
The insurer
An adjusters license will usually be revoked for which of the following reasons:
Denying claims that are not covered
Failing to report a change of address
Having been convicted of a misdemeanor
Having been convicted of a felony
Having been convicted of a felony
The insured has been involved in an automobile accident and has sustained bodily injuries and damage to the insured vehicle. The adjuster will usually:
Withold any payment until the bills have been reviews for payment
Pay to repair the vehicle and pay the medical bills later
Pay for the repair of the vehicle and require a release for all claims
Pay to repair the damage to the vehicle and obtain a partial release and settle the medical payments later and then seek a final release
Pay to repair the damage to the vehicle and obtain a partial release and settle the medical payments later and then seek a final release
Me Jones has damaged his vehicle by striking a tree. He can:
Take the car to a repair garage recommended by the insurer
Take the car to a garage of his/her choice
Accept the payment based on the adjuster’s estimate
All the above
All the above
In case of a total loss to a vehicle the adjuster will pay the insured / claimant which of the following?
The cost to replace the vehicle with like kind and quality of a current year model
Use the most recent publication of an “Official Used Car Guide”
If not listed in the “guide”, obtain quotations from automobile dealers
All of the above depending on the circumstances
All of the above depending on the circumstances
Which of the following is NOT a claim settlement option for liability claims?
Lost wages
Excessive amounts claimed
Loss of use
Disfigurement
Excessive amounts claimed
Which of the following results in immediate payment when the claimant signs a release relinquishing his or her right to sue?
Scheduled Payment Release
Full Release Settlement
Advanced Payment
Structured Settlement
Full Release Settlement
Which of the following relieves the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated?
No Release or Walk-Away
Rehabilitating
Advanced Payment
Open-Ended Release
Advanced Payment
REPRESENTATION of INTEREST
PUBLIC Adjuster = The Insured
COMPANY Adjuster = The Insurer
REPRESENTATION of INTEREST
PUBLIC Adjuster = The Insured
COMPANY Adjuster = The Insurer
