Insurance Regulation Quiz Cards Flashcards
(34 cards)
Who is ultimately responsible for ensuring that proper procedures are in place for claims investigation and settlement?
A.
The arbitrator
B.
The insurance company
C.
The repair shop
D.
The adjuster
B.
The insurance company
The insurance company is ultimately responsible for ensuring that proper procedures are in place for claims investigation and settlement.
All of the following are prohibited acts and grounds for license suspension or revocation in California, except:
A.
violating a court order
B.
failing to renew adjuster’s license by the due date
C.
purchasing a tear gas weapon
D.
making a false statement on a license application
B.
failing to renew adjuster’s license by the due date
Failing to renew an adjuster’s license by the due date is not a prohibited act or grounds for license suspension or revocation in California.
The California Auto Body Repair Consumer Bill of Rights lists all of the following policyholder’s rights, EXCEPT:
A.
right to choose the repair shop
B.
right to get an independent repair estimate directly from a registered auto body repair shop
C.
right to declare a vehicle as a total loss if not satisfied with repair options or outcomes
D.
right to receive an itemized written estimate and a detailed invoice of repairs
C.
right to declare a vehicle as a total loss if not satisfied with repair options or outcomes
The California Auto Body Repair Consumer Bill of Rights does NOT allow the insured to determine whether the vehicle is a total loss.
All of the following are steps that each insurer should take to help the commissioner conduct an examination of claim files, EXCEPT:
A.
maintain all file documentation in electronic format.
B.
maintain files for at least four years.
C.
keep files in a place that allows for quick access.
D.
keep files organized in a way to easily reconstruct events.
A.
maintain all file documentation in electronic format.
An insurer does not need to maintain all file documentation in electronic format.
Sam was just hired by XYZ Insurance. He must receive anti-fraud orientation training within ____ of starting his new job.
A.
30 days
B.
14 days
C.
60 days
D.
90 days
D.
90 days
Sam must receive anti-fraud orientation training within 90 days of starting his new job.
When a California residential or commercial property policy provides replacement cost coverage, all of the following standards apply, EXCEPT:
A.
The insurer must provide a recommendation for a specific individual or company for repair.
B.
The insured should not pay for depreciation, or any other cost, except the deductible.
C.
The insurer must cover any additional damage caused during replacement or repair.
D.
The insurer must give the claimant a copy of the scope or estimate the settlement is based on.
A.
The insurer must provide a recommendation for a specific individual or company for repair.
The insurer may not suggest a specific individual or company for repair unless the claimant requests a recommendation and has been notified of his right to select a repair person.
Danielle is a licensed adjuster in California who would like to begin doing business under the fictitious name “Amiable Adjusting.” What must she do to begin conducting business under this new name?
A.
She must submit a fee and obtain written authorization from the commissioner.
B.
She can begin conducting business under that name whenever she likes.
C.
She must claim rights to that name by notifying the commissioner within ten days of beginning to conduct business under that name.
D.
She must first ensure no one else is doing business under that name and then she is free to use it.
A.
She must submit a fee and obtain written authorization from the commissioner.
If a licensee wishes to conduct business under a fictitious name, he must first obtain the written authorization of the commissioner and pay a fee for that authorization.
Which of the following statements about insurance is true?
A.
Insurance is mainly regulated at the federal level.
B.
In an insurance contract, the insurer gives the insured a premium in exchange for peace of mind.
C.
Insurance is the transfer of the right to collect a debt from one entity to another.
D.
For regulatory purposes, insurance code divides lines of insurance into classes based on the coverage each provides.
D.
For regulatory purposes, insurance code divides lines of insurance into classes based on the coverage each provides.
For regulatory purposes, insurance code divides lines of insurance into classes based on the coverage each provides.
An insurer must maintain complete files for all claims from the current year and the last:
A.
2 years.
B.
5 years.
C.
4 years.
D.
7 years.
C.
4 years.
An insurer must maintain complete files for all claims from the current year and the last 4 years.
When making a claim payment, the insurer should always:
A.
provide information on the arbitration process.
B.
initially deny coverage until an investigation can be completed.
C.
try to settle for a lower amount to save money.
D.
explain the amounts and each coverage providing for them.
D.
explain the amounts and each coverage providing for them.
When making a claim payment, the insurer should always explain the amounts and under which coverage they are being paid.
An adjuster must report a change of address to the Insurance Commissioner:
A.
within 60 days.
B.
within 15 days.
C.
within 45 days.
D.
within 30 days.
D.
within 30 days.
An adjuster must report a change of address to the Insurance Commissioner within 30 days.
The commissioner does NOT have the power to:
A.
incarcerate an adjuster.
B.
fine an adjuster.
C.
revoke an adjuster’s license.
D.
suspend an adjuster’s license.
A.
incarcerate an adjuster.
The commissioner does not have the power to incarcerate an adjuster, but she can administer a fine and suspend or revoke the adjuster’s license.
Every insurer in California is required to submit an SIU report to the Department of Insurance:
A.
every two years.
B.
every five years.
C.
every three years.
D.
every year.
D.
every year.
Every insurer in California is required to submit an SIU report to the Department of Insurance every year.
An insurer may not:
A.
charge higher premiums to elderly drivers.
B.
expand coverage without requiring the insured to sign a new, revised policy.
C.
distribute pamphlets or advertisements.
D.
try to settle a claim using an application that was altered without the knowledge of the insured.
D.
try to settle a claim using an application that was altered without the knowledge of the insured.
An insurer may not require an insured to submit a preliminary claim report and then formal proof of loss forms before moving forward on the claim.
Before he can be licensed, an adjuster applicant in California must file with the commissioner a surety bond of __________.
A.
$4,000
B.
$5,000
C.
$1,000
D.
$2,000
D.
$2,000
An applicant cannot receive her license unless she files with the commissioner a surety bond of $2,000 conditioned for the faithful and honest conduct of business.
Which of the following is NOT an acceptable reason for the Commissioner of Insurance to revoke an insurance professional’s license?
A.
Taking on too many claims at one time
B.
Having been convicted of a felony
C.
Intentionally misrepresenting the terms of a contract
D.
Forging another’s name on an insurance document
A.
Taking on too many claims at one time
The Commissioner would not revoke an adjuster’s license because he took on too many claims at one time.
Which of the following insurers is committing an Unfair Claims Settlement Practice?
A.
XYZ Insurance denies a claim because the investigation proved the loss was not covered under the policy.
B.
Acme Insurance tells a first party claimant, who was injured by a third party, that her claim is denied because she must file a claim with the guilty party’s insurer.
C.
An agent of Trust Insurance fails to verbally review each policy provision with an insured before accepting the first premium payment.
D.
When investigating a claim in which arson is suspected, Steadfast Insurance takes 25 days to make a decision on the claim.
B.
Acme Insurance tells a first party claimant, who was injured by a third party, that her claim is denied because she must file a claim with the guilty party’s insurer.
Paul is a licensed insurance adjuster in California during a natural disaster. To help with the abundance of claims, Paul employs his friend Billy, who does not have yet have a California license but has done some adjusting in other states. Paul is required to register Billy as an emergency adjuster with the commissioner within ______ days.
A.
5
B.
10
C.
25
D.
15
D.
15
Within 15 days of an emergency adjuster beginning to work, a supervising adjuster must register the emergency adjuster with the commissioner.
Which of the following breaks one of the rules for settling auto loss claims?
A.
The insurer informs the insured about a specific car that meets the comparable auto requirements and is available to purchase in the local area.
B.
An insurer tells a repair shop that is can use a non-OEM part to repair an insured car as long as the part is equal to the original manufacturer parts in terms of kind, quality, safety, fit, and performance.
C.
The insurer refuses to reopen a claim file when the insured states, 60 days after the settlement, that he was unable to find a comparable vehicle for the settlement amount.
D.
An insurer tells the insured about a specific repair shop he must go to to get his vehicle repaired.
D.
An insurer tells the insured about a specific repair shop he must go to to get his vehicle repaired.
An emergency adjuster license in the State of California is good for ____ days.
A.
180
B.
30
C.
60
D.
90
A.
180
The commissioner can grant temporary licenses to adjust catastrophe-related claims in CA for 180 days, with an 180-day extension possible.
It is considered a/an ________________ to knowingly falsify your fingerprints or photographs on your adjuster application.
A.
violation
B.
felony
C.
infraction
D.
misdemeanor
B.
felony
In California, it is considered a felony to knowingly falsify your fingerprints or photographs.
An adjuster whose license has been suspended or revoked must:
A.
keep his license in a safe place for use after reinstatement.
B.
destroy his license.
C.
surrender his license to the commissioner.
D.
diagonally strike through his license and fax a copy to the state.
C.
surrender his license to the commissioner.
Any adjuster whose license is revoked or suspended must surrender the license to the commissioner.
Who is responsible for examining an insurer’s SIU and related operations to determine compliance with California state law?
A.
The Commissioner of Insurance
B.
The District Attorney
C.
The Attorney General
D.
The Chief of Police
A.
The Commissioner of Insurance
The Commissioner can conduct an examination of an insurer’s SIU and any related operations, including operations under contract with the insurer, as deemed necessary to determine compliance with California state law.
When a California residential or commercial property policy provides replacement cost coverage, but a replacement item does not match others like it in size, kind, or quality, the insurer must:
A.
replace all of the items in the damaged area so that they are consistent.
B.
pay the insured the ACV of the damaged items instead.
C.
bring the settlement to arbitration.
D.
offer to buy from the claimant the undamaged items that are unlike the replacement items.
A.
replace all of the items in the damaged area so that they are consistent.
If a replacement item does not match others like it in size, kind, or quality, the insurer must replace all of the items in the damaged area to be consistent.
