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Claims Adjuster Glossary of Terms Exam Questions and Answers – Well-Illustrated Study Guide and Practice Material

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This document contains a comprehensive glossary of claims adjuster terminology alongside exam questions and answers designed to reinforce understanding of key insurance concepts. It covers essential terms related to claims handling, policy coverage, liability, investigations, settlements, subrogation, indemnity, and insurance regulations. The material includes well-illustrated explanations and practice questions to help learners apply terminology in real-world claims scenarios. It is an effective resource for exam preparation, revision, and professional development in the insurance industry.

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Instelling
Claims Adjuster
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CLAIMS ADJUSTER




CLAIMS ADJUSTER GLOSSARY OF TERMS EXAM QUESTIONS AND ANSWERS
WELL ILLUSTRATED.




Accumulated Depreciation answer >>>>The total decrease in an item's value over
a period of time. Formula: (Annual Depreciation X Number of years used)


Actual Cash Value (ACV) answer >>>>A valuation method used bay insurers to
reflect an item's current market value right before being damaged or destroyed.
Formula: (Replacement cost - Accumulated Depreciation)


Adhesion answer >>>>One of the characteristics of an insurance contract. Means
that one party (the insurer) sets the terms, and the other (the insured) can 'take it
or leave it.'


Adjusted Gross Revenue (Crop Insurance) answer >>>>Narrowest (and least
expensive) form of Crop Revenue Insurance. Insures farm revenue as a whole
instead of individual crops. Guarantees a percentage of the insured farm's
average revenue.


Adjuster answer >>>>An agent who, for compensation, processes insurance
claims. Can represent either the insured or the insurer.


Adjuster - Emergency answer >>>>Adjusters who are temporarily licensed by the
insurance commissioner to handle claims during catastrophes or emergencies
that produce an overwhelming number of claims in a short period of time.

,CLAIMS ADJUSTER




Adjuster-Independent answer >>>>Self-employed adjusters who contract with
multiple insurers at the same time. Paid on a commission or fee-plus-expenses
basis for each claim. Also called: Fee Adjuster, Bureau Adjuster


Adjuster-Public answer >>>>An adjuster who is hired to represent the claimant
and help determine a fair indemnification. Usually specializes in appraisals and
negotiation. Paid commission, usually a percentage of final settlement.


Adjuster-Staff answer >>>>Salaried employee of one insurance company who can
work locally, regionally, or nationally. Also called: Company Adjuster


Advance Payment Settlement answer >>>>A settlement option that lets the
insurer offer some financial relief to the claimant before the claim has been fully
settled. The insurer makes advance payments to the claimant, which are then
subtracted from the final settlement amount. Often used when a claimant suffers
bodily injury and is unable to work.


Agency Authority answer >>>>The Agent's authority to act on behalf of someone
else, usually an insurer. This authority is derived from the agent's contract with
the insurer.


Agency Authority - express answer >>>>Authority that is expressly given to the
agent in writing. Allows agent to act on behalf of the principal.


Agency Authority - implied answer >>>>Authority that an agent possesses by
implication of his behavior, regardless of whether this authority is expressly
granted in writing.

,CLAIMS ADJUSTER


Agency Authority - apparent answer >>>>Authority that an agent possesses based
on the appearance of representing an insurer.


Agent answer >>>>Someone who has received authority from an insurer to sell or
service insurance policies.


Aggregate Limit answer >>>>A type of policy limit found in some health, liability,
and property damage policies. It represents the total amount the insurer will pay
for all losses (as opposed to an occurrence limit, which denotes the total amount
the insurer will pay per occurrence).


Agreement answer >>>>One of the four requirements of a legally binding
contract. All parties involved must agree to the terms of the contract. Can also
refer to a binder, which is the preliminary substance of a contract.


Agricultural Producer answer >>>>A business that grows, harvests, and sells crops
for profit.


Lavatory answer >>>>A characteristic of insurance contracts. Lavatory means
"depending on an unknown future
event." An insurance contract will only pay IF and WHEN covered damages occur.
Neither party
knows how much the contract will end up paying when they enter into the
contract.


Answer answer >>>>In liability cases, the defendant's response to a complaint.
There are three possible answers: 1)

, CLAIMS ADJUSTER


accept complaint and pay for damages, 2) deny the complaint, or 3) accept the
complaint with a
right to insert evidence into the case.


Annual Depreciation answer >>>>An item's Replacement cost divided by the
number of years in its expected lifespan.


Appraisal answer >>>>A negotiation method which allows the claimant and the
insurer each to select an appraiser.
The two appraisers in turn select an Umpire. The appraisers then work together
to determine a
settlement amount. If they cannot agree, the Umpire steps in. Agreement by any
two of the
three is binding.


Arbitration answer >>>>A negotiation method in which the opposing parties each
submit their evidence to a mutually agreed-
upon and neutral third party, called an arbitrator. The arbitrator reviews the
positions of
each opposing side, and makes a final and legally binding decision.


Arbitrator answer >>>>The mutually-agreed-upon and neutral third party in an
arbitration who reviews the positions of
each opposing side, and makes a final and legally binding decision.


Auto Policy answer >>>>Insurance policy designed to protect the policyholder
while owning, occupying, or operating a

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