2E-2F

Question 1

________ is a process by which two opposing parties attempt to merge their respective interests in an effort to yield a balanced and beneficial outcome for both parties.

Answer 1

Negotiation

Question 2

_______ ______ are harder to assign dollar amounts to and factor in issues like mental duress and comparative negligence.

Answer 2

Liability Claims

Question 3

_____ ______ claims addresses the cost to repair or replace, is simple and straightforward.

Answer 3

Property damage

Question 4

Before negotiations begin, an adjuster must determine what three things?

Answer 4

1. Is there coverage?
2. What is the insured’s liability? (liability claims only)
3. What are the damages?

Question 5

What damages should never be negotiated?

Answer 5

Punitive

Question 6

_______ is not strictly speaking a negotiation method; rather, it is a last option when negotiations fail.

Answer 6

Litigation

Question 7

In _______ insurance claims, the claimant is typically the insured.

Answer 7

Property

Question 8

Who is the claimant in liability cliams?

Answer 8

Third Party

Question 9

Everything in a claim file is discoverable. True or False

Answer 9

True

Question 10

Criminal Trial is when the _____ (plaintiff) vs. ______(defendant).

Answer 10

State

Citizen

Question 11

Civil trial is when a ______(plaintiff) vs. _______ (defendant).

Answer 11

Citizen

Citizen

Question 12

Claims disputes are settled in _____ trials.

Answer 12

Civil

Question 13

When more evidence supports the plaintiff’s case than contradicts it (51% or more evidence supports) this is called what?

Answer 13

Preponderance ofevidence

Question 14

________ negligence is any negligence on the part of the plaintiff equals no settlement.

Answer 14

Contributory

Question 15

_________ negligence reduces the settlement by the percentage of the plaintiff’s negligence.

Answer 15

Comparative

Question 16

Policy ______ establish the terms of the agreement between the insurer and the insured.

Answer 16

Provisions

Question 17

What are ISO and AAIS?

Answer 17

Insurance Services Office

American Association of Insurance Services

Question 18

The cancellation/nonrenewal condition establishes when and how the insurer or the insured can
terminate an active insurance contract. True or False

Answer 18

True

Question 19

An _______ premium is a payment you’ve made for coverage that you never received.

Answer 19

Unearned

Question 20

The ________ Clause states that any change to a policy form that broadens coverage without increasing the premium will automatically apply to the issued policies of that type.

Answer 20

Liberalization

Question 21

The representations condition simply states that any information provided by the named insured on the declarations page must be complete and accurate, and clarifies that the insurer has based the provisions of the policy on the information that the insured gave. True or False

Answer 21

True

Question 22

The Concealment, Misrepresentation, and Fraud condition of a policy protects the _______ from the dishonesty of the insured.

Answer 22

Insurer

Question 23

Resending a policy means what?

Answer 23

That the policy was never valid to begin with.

Question 24

The Assignment condition states that a policyholder cannot _____ the policy to someone else unless the insurer agrees to the change in writing.

Answer 24

Transfer

Question 25

The _______ ______ provision lets the first named insured add other people or entities to the policy.

Answer 25

Additional Insured

Question 26

The ______ _______, or Apportionment, clause establishes how the policy will respond if the insured risk is covered by two or more policies.

Answer 26

Other Insurance

Question 27

A _______ policy will pay first, and up to the policy limit, regardless of the presence of other insurance. An ______ policy will only pay once the primary policy has paid up to its limits.

Answer 27

Primary | Excess

Question 28

Under this provision, each policy pays an equal share of the loss up to the lowest policy limit.

Answer 28

Contribution by Equal Shares.

Question 29

Under the ___ ____ apportionment clause, each insurer agrees to pay its share of the loss according to its share of all policy limits.

Answer 29

Pro Rata

Question 30

Define nonconcurrency.

Answer 30

The situation in which two or more policies covering the same risk have different inception and expiration dates.

Question 31

When the amount of insurance covering a risk which exceeds the insurable value of that risk this is known as what?

Answer 31

Overinsurance

Question 32

After a loss occurs and the insurer indemnifies the policyholder, what happens to the policy limit?

Answer 32

Restoration of Limits, Reinstatement of Limits, or Non-reduction of Limits.

Question 33

The Legal Action Against an Insurer condition sets certain requirements that must be met before anyone can sue an insurer. What are they?

Answer 33

Insured must comply with all policy obligations | Insurer not liable for damages above policy limit

Question 34

What are the policyholder's duties when a loss occurs?

Answer 34

Notify the police if the loss may have involved a crime. Notify the insurer about what property was involved, and the circumstances surrounding the loss. Submit a description of how, where, and when the loss occurred. Try to prevent further damages, and keep track of expenses incurred doing this Give insurer a list of damaged property.

Question 35

Remove coverage for uninsurable losses, manage moral and morale hazards, eliminate duplication of coverages, remove coverages that typical consumers don't need, remove coverages that need special treatment and lower premiums are all purposes of _______.

Answer 35

Exclusions

Question 36

The Vacancy condition establishes when a building is considered "vacant". Why is this important?

Answer 36

Some perils are excluded from coverage when a structure has been vacant for a while, since this increases the chance of certain types of loss.

Question 37

What does the Recovered Property condition state?

Answer 37

If either party recovers property involved in a claim after the claimant has already been indemnified, that party must notify the other of the recovery.

Question 38

Property insurance policies have an abandonment clause that prohibits the policyholder from abandoning damaged property to the ______.

Answer 38

Insurer

Question 39

The ____ and ____ clause states that, if part of a set or an instrumental part of a whole is lost or destroyed, the policy will pay to replace, restore, or repair the set, or it will pay the difference in the set’s actual cash value that was caused by the loss.

Answer 39

Pair and Set

Question 40

Premium Audit, Inspection and Surveys, Examination of Books and Records are all __________ provisions.

Answer 40

Commercial

Question 41

What does the loss payment condition clarify?

Answer 41

How, when, and to whom a claim will be paid.

Question 42

“Company’s Options” is a provision in the standard ____policy that lays out the insurer’s settlement options.

Answer 42

Fire

Question 43

What clause ensures that the lender will be listed as a payee under the policy if a loss or damage occurs?

Answer 43

The loss payable or loss payee clause

Question 44

Similar to the Loss Payee clause, the _______ Clause protects the lender’s financial interest in the property, but it takes it one step further. Not only does this provision ensure that the lender will be indemnified in the event of a loss, it also establishes the mortgagee's rights to receive notice if the policyholder either fails to adhere to the contract, or does not pay policy premiums

Answer 44

Mortgagee

Question 45

If the policyholder qualifies for replacement cost, when will the receive their Recoverable Depreciation?

Answer 45

Once repairs are complete and the claimant submits proof to the insurer.

Question 46

In commercial policies, the _______ __ ______ condition protects the property of the insured from the negligent actions of persons other than the named insured.

Answer 46

Control of Property

Question 47

The No Benefit to Bailee condition, states that insurance coverage will not benefit a third party who has custody or control of the insured’s property, even if it is with the insured's granted permission. True or False

Answer 47

True

Question 48

This provision states that coverage applies to each “insured” separately, as if no other “insured” existed.

Answer 48

Separation of Insureds

Question 49

In Liability Coverage Provisions, the Duties after an Occurrence, addressed the policyholder and _____ separately.

Answer 49

Claimant

Question 50

Finally, a condition sometimes included in liability policies is that the bankruptcy or insolvency of the insured does not relieve the insurer from the obligation to pay claims. True or False

Answer 50

True