EXAM QUESTIONS AND VERIFIED ANSWERS | 2026–2027
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1. An adjuster is assigned a first-party auto claim where liability is clearly established. What is
the adjuster’s primary responsibility when initiating the claim investigation?
A. Deny the claim immediately to prevent fraud
B. Determine coverage, liability, and damages accurately
C. Advise the insured to accept the first settlement offer
D. Refer the claim directly to litigation
Correct Answer: B. Determine coverage, liability, and damages accurately
Rationale: The adjuster’s core duty is to evaluate coverage, establish liability, and assess
damages. Immediate denial or pushing settlement without investigation violates fair claims
handling standards.
2. Which principle best defines “utmost good faith” in insurance claims handling?
A. Prioritizing insurer profit over policyholder claims
B. Allowing claims without verification to speed up payment
C. Honest and fair disclosure by both insurer and insured
D. Denying questionable claims automatically
Correct Answer: C. Honest and fair disclosure by both insurer and insured
Rationale: Utmost good faith requires transparency and honesty from both parties. The other
options misrepresent or violate insurance ethics.
3. A claimant submits incomplete documentation for a property loss. What should the
adjuster do first?
A. Close the claim immediately
B. Request additional supporting documentation
C. Reduce the claim payout by default
D. Refer the case to fraud investigation
Correct Answer: B. Request additional supporting documentation
Rationale: Adjusters must gather sufficient evidence before making determinations. Immediate
closure or fraud referral without basis is inappropriate.
,4. Which document typically defines the scope of insurance coverage?
A. Police report
B. Insurance policy
C. Claim diary notes
D. Repair estimate
Correct Answer: B. Insurance policy
Rationale: The policy contract defines coverage terms, exclusions, and limits. Other documents
support but do not define coverage.
5. What is the purpose of depreciation in property claims?
A. Increase claim payout value
B. Reflect wear and tear over time
C. Eliminate replacement costs
D. Penalize the insured for filing claims
Correct Answer: B. Reflect wear and tear over time
Rationale: Depreciation accounts for aging and usage. It does not punish insureds or eliminate
replacement value.
6. An insured disagrees with an adjuster’s settlement offer. What is the most appropriate next
step?
A. Immediately close the claim
B. Escalate to regulatory authorities
C. Re-evaluate damages and negotiate further
D. Deny the claim based on disagreement
Correct Answer: C. Re-evaluate damages and negotiate further
Rationale: Claims should be resolved through fair negotiation and reassessment when disputes
arise.
7. Which type of insurance policy typically covers an individual’s personal belongings in a
rented apartment?
A. Commercial liability policy
B. Renters insurance policy
C. Builders risk policy
D. Marine insurance policy
Correct Answer: B. Renters insurance policy
Rationale: Renters insurance covers personal property in leased residential spaces.
8. What is the primary purpose of a recorded statement in a claim investigation?
A. To intimidate the claimant
B. To document facts while memory is fresh
, C. To finalize settlement immediately
D. To assign legal liability
Correct Answer: B. To document facts while memory is fresh
Rationale: Recorded statements preserve accurate accounts of events for evaluation.
9. Which factor is MOST important when evaluating bodily injury claims?
A. Adjuster personal opinion
B. Medical documentation and causation
C. Claimant occupation only
D. Policy premium amount
Correct Answer: B. Medical documentation and causation
Rationale: Medical evidence and causal relationship determine validity of injury claims.
10. What does “liability” refer to in an insurance claim?
A. The premium paid by insured
B. Legal responsibility for damages
C. Policy cancellation status
D. Deductible amount
Correct Answer: B. Legal responsibility for damages
Rationale: Liability determines who is legally responsible for causing loss.
11. An adjuster suspects potential fraud. What should be the FIRST step?
A. Deny the claim immediately
B. Gather supporting evidence and indicators
C. Report directly to the police
D. Inform the claimant of suspicion immediately
Correct Answer: B. Gather supporting evidence and indicators
Rationale: Fraud suspicion must be supported by evidence before escalation.
12. What is the purpose of a deductible in an insurance policy?
A. Increase insurer profit
B. Reduce small claims frequency
C. Eliminate coverage eligibility
D. Replace policy limits
Correct Answer: B. Reduce small claims frequency
Rationale: Deductibles encourage insureds to absorb minor losses.
13. Which best describes “subrogation”?
A. Insurer cancels policy after loss
B. Insurer recovers costs from responsible third party