Chapter 7 Evaluation and Negotiation Flashcards
If the insured loses one earring, what clause of a property policy will determine the basis for settlement?
a. Parts clause
b. Replacement clause
c. Pair and set clause
d. Limit clause
c. Pair and set clause
Under the replacement clause, the insurer must inform the insured, in writing, of the decision to repair, rebuild, or replace within what timeframe?
a. 30 days after the claim is filed
b. 30 days after receipt of the proof of loss
c. 60 days after the claim is filed
d. 60 days after receipt of the proof of loss
b. 30 days after receipt of the proof of loss
A statutory condition provided by the policy allows for what option?
a. Mediation
b. Arbitration
c. Appraisal
d. Litigation
c. Appraisal
What is a method of resolving disputes between parties whereby impartial, neutral persons are chosen by the parties in dispute to determine their rights and/or obligations?
a. Mediation
b. Arbitration
c. Negotiation
d. Litigation
b. Arbitration
Who is responsible to substantiate or prove the loss?
a. Beneficiary
b. Insurer
c. Claimant
d. Agent or broker
c. Claimant
Whenever evidence is to be evaluated in court, a test of credibility is done. This test involves two elements. What are they?
a. The credibility of the lawyers presenting the evidence and their opening and closing statements
b. The credibility of the witness and the opinion of the judge
c. The credibility of the information disclosed and the impression a witness makes
d. The credibility of the prosecution and the weight of the evidence
c. The credibility of the information disclosed and the impression a witness makes
To achieve a reasonable settlement of a claim, the adjuster considers what type of communication in negotiation?
a. Litigation approach
b. Persuasion approach
c. Win-win approach
d. Evidentiary approach
c. Win-win approach
What should negotiations be based on?
a. Concessions
b. Subjective criteria
c. Constructive observations
d. Objective information
d. Objective information
What does the mediator do?
a. Decides the dispute
b. Appoints an appraiser
c. Submits points of contention to the umpire
d. Helps the parties identify the real areas of dispute
d. Helps the parties identify the real areas of dispute
Which situation involves a criminal act?
a. The insured provides replicated receipts.
b. The insured produces false documentation in order to get an insurance payment.
c. The adjuster has suspicions of a wrongful act on the part of the insured.
d. The insured requests overhead and profit on the work that he or she has performed.
b. The insured produces false documentation in order to get an insurance payment.
Establishes that loss or damage to one of a pair or set of individual items does not represent the loss of the entire pair or set.
pair and set clause
Establishes that loss or damage to one part of an item does not represent the loss of the entire item.
parts clause
A clause found in the conditions of property and automobile policies. Instead of making payment, the insurer has the option to repair, rebuild, or replace the property damaged.
replacement clause
An alternative method of dispute resolution in which representatives of each party meet in private with an impartial mediator to try to reach a settlement.
mediation
A method of resolving disputes between parties whereby impartial, neutral persons are chosen by the parties in dispute to determine their rights and/or obligations. The parties agree in advance to abide by the arbitrament. Each party has a chance to be heard, issues are examined, and a settlement is developed. The settlement can be final and binding.
arbitration
