ROLE OF ADJUSTER

Question 0

AGENTS

Answer 0

SELL POLICIES

Question 1

FIDUCIARY RESPONSIBILITIES

Answer 1

ADJUSTERS HOLD A POSITION OF TRUST AS THEY AND HANDLING RESOURCES OF THE INSURER AS CLAIMS ARE PAID

Question 2

ADJUSTERS

Answer 2

HANDLE CLAIMS

Question 3

INSURANCE IS SERVICE-ORIENTED

Answer 3

NEVER ACCEPT GRATUITY OR ANYTHING THAT APPEARS IMPROPER

Question 4

NEVER GIVE LEGAL ADVICE

Answer 4

ADJUSTERS

Question 5

UNFAIR CLAIMS LETTLEMENT PRACTICES; AS DEFINED BY STATE LEGISLATURE

Answer 5

• MISREPRESENTING FACTS REGARDING COVERAGE
• FAILING TO PROMPTLY ACKNOWLEDGE (15DAYS)
• FAILING TO ADOPT STANDARDS
• NOT ATTEMPTING GOOD FAITH SETTLEMENT
• COMPELLING POLICY HOLDERS TO SUE BECAUSE THEY CANT

Question 6

IMPLIED IN EVERY CONTRACT

Answer 6

GOOD FAITH AND FAIR DEALING

Question 7

BAD FAITH

Answer 7

WHEN INSURER DOES NOT ABIDE BY THE TERMS AND SPIRIT OF THE POLICY: MUST PROVE NO REASONABLE BASIS FOR DENIAL CLAIM OR DELAYING PAYMENT

Question 8

RENDERS DECISIONS WHERE LIABILITY, BASED ON TOTALITY OF THE CIRCUMSTANCES OF THE CASE, HAS BECOME REASONABLY CLEAR

Answer 8

ADJUSTERS

Question 9

BUSINESS DAY

Answer 9

A DAY, OTHER THAN SATURDAY, SUNDAY OR HOLIDAY

Question 10

A DAY

Answer 10

IS ANY CALENDAR DAY INCLUDING WEEKENDS AND HOLIDAYS

Question 11

CLAIM

Answer 11

IS A REQUEST FOR INDEMNIFICATION UN AN INSURANCE CONTRACT DUE TO FINANCIAL LOSS

Question 12

CLAIMANT

Answer 12

IS A PERSON MAKING A CLAIM

Question 13

1ST PARTY CLAIM

Answer 13

OCCURS WHEN THE FIRST PARTY TO THE CONTRACT(THE INSURED) TURNS IN A CLAIM FOR INDEMNIFICATION///TEH ADJUSTERS LEVEL OF DUTY TO THIS CLAIMANT IS EXTREMELY HIGH

Question 14

3RD PARTY CLAIM

Answer 14

OCCURS WHEN A THIRD PARTY THE IS NOTY A PARTY TO THE CONTRACT TURNS IN A CLAIM FOR INDEMNIFICATION DUE TO THE INSUREDS LEGAL LIABILITY FOR THE INJURIES OR DAMAGES SUSTAINED

Question 15

DEADLINES

Answer 15

15DAYS

• ACKNOWLEDGE RECEIPT OF THE CLAIM
• COMMENCE AND INVESTIGATION
• FORWARD AND PAPERWORK TO THE CLAIMANT (IE PROOF OF LOSS)

Question 16

AN ADJUSTER MUST NOTIFY A CLAIMANT IN WRITING OF THE ACCEPTANCE OR REJECTION OF A CLAIM

Answer 16

NO LATER THAN 15 BUSINESS DAYS AFTER THE INSURER RECEIVES ALL REQUIRED INFORMATION

Question 17

HOW MANY DAYS TO PAY AFTER THE ADJ AGREES TO PAY?

Answer 17

MUST SEND THE CHECK OR DRAFT WITHIN 5 BUSINESS DAYS