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Flashcards in TB - Insurance Claims Adjusting Deck (16)
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1

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

2

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

3

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

4

The giving up of a known right is called:


Estoppel

Violation of policy conditions

Rebating

Waiver

Waiver

5

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

6

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

7

A company adjuster primarily represents the interests of:

The insured

The claimant

The insurer

The public

The insurer

8

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

9

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

10

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

11

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

12

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

13

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

14

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

15

REPRESENTATION of INTEREST


PUBLIC Adjuster = The Insured

COMPANY Adjuster = The Insurer

REPRESENTATION of INTEREST


PUBLIC Adjuster = The Insured

COMPANY Adjuster = The Insurer

16

A public adjuster repressed the interest of:


The insurer

The insured

The employer

The interest of the general public

The insured!!!