Florida Claims Adjuster Exam, 6-20 All Lines
Adjuster- Florida- Review
Peril
Something that causes a loss.
Hazard
Something that increases the probability that a loss will occur.
Warranty
A policy condition, either based on information in the insureds application or inserted by
the insurer. It is a guarantee of a fact.
Misrepresentation
An untrue statement by the insured, made in an application for insurance but which
does not become a part of the policy.
Concealment
The failure of the insured to reveal relevant facts known to the insured in applying for
insurance.
Abandonment
Property insurance policies usually contain an abandonment clause, stating the insured
cannot dump damaged property on the insurer and demand its full value.
Severability
The insurance applies separately to each insured as if other insureds did not exist.
Proximate Cause
The cause having the most significant impact in bringing about the loss under a first-
party property insurance policy, when two or more independent perils operate at the
same time (i.e., concurrently) to produce a loss. Courts employ a set of rules to resolve
causation disputes when a property policy states that it covers or excludes losses
"caused by" a peril and there is more than one peril at work in a fact pattern. Under
common law, whether the policy provides coverage depends on which peril is chosen
as the proximate cause.
Direct Loss
Physical harm to tangible property.
Indirect Loss
Economic loss which flows as a result of direct loss.
Actual Cash Value(ACV)
Replacement Cost minus Depreciation
Coinsurance
The amount, generally expressed as a fixed percentage, an insured must pay against a
claim after the deductible is satisfied. It's ultimately a way for the insured and insurer to
share responsibility for the risk. It can also help reduce the cost of the insurance policy
premium. Coinsurance can be written on an 80/20, 90/100, or 100% rule.
Personal Contract
Policies cover people who own and operate things, such as automobiles.
Conditional Contract
Also called a hypothetical contract, is a contract agreement that only requires
performance once the delineated conditions are met. This legal agreement requires
,prior performance of another agreement or clause in order to be enforceable. If the
other agreement or condition is performed, then the conditional contract is enforceable
and the parties are bound to carry out the terms of the contract.
Contract of Indemnity
Principle of insurance that provides that when a loss occurs, the insured should be
restored to the approximate financial condition he/she occupied before the loss
occurred, no better or no worse.
Insurable Interest
the reasonable concern of a person to obtain insurance for any individual or property
against unforeseen events such as death, losses, etc.
Waiver
1.) Implied voluntary relinquishment, abandoning a legal advantage, need, claim or
right.
2.) Agreement or added clause of a policy that excludes some losses or limits the sum
of a claim, or extends coverage to add items not in a normal policy.
Express Waiver
Occurs when the insurer or its representative knowingly gives up a known right under
the insurance contract.
Implied Waiver
A waiver that is assumed to be in effect from a person's behavior and shows he is
waiving a right.
Damages
Monetary compensation that is awarded by a court in a civil action to an individual who
has been injured through the wrongful conduct of another party.
Subrogation
When an insured has a right to collect damages from another party, but instead elects
to claim the damages under his insurance policy, his rights against the other party are
transferred to the insurer.
Changes
All policies provide that any changes to the policy be made by the insurer, in writing.
Policy Period
The condition states that coverage applies only to losses or occurrences that take place
during the policy period. (Prior to the stated date and time of termination).
Policy Territory
Condition limiting coverage to occurrences or losses that take place only within a stated
geographical region.
Other Insurance
The principle of indemnity dictates against duplicate recovery for the same loss.
Cancellation
The insured may cancel at any time, for any reason, without advance notice. If the
conpany wishes to cancel, it must provide some degree of advance notice so the
insured will have time to replace the coverage.
Appraisal
A written contract of or written agreement for or effecting insurance, or the certificate
thereof, by whatever name called, and includes all clauses, riders, endorsements and
papers which are a part thereof.
,Insurance
Is a contract whereby one undertakes to indemnify another or pay or allow a specified
amount or a determinable benefit upon determinable contingencies.
Binder
Acts as a temporary contract until the policy is issued.
How many days should an insurer give for prior notice of cancellation of a
binder?
5 days.
Property Insurance
Any insurance wherein payment by the insurer will be paid directly to the insured or
other specifically named interests.
Liability Insurance
Payment will be on behalf of the insured to another, based upon the insureds liability to
the recipient. Simply stated, Liability is "Negligence of the Insured".
Loss Payee Clause
A Clause in a contract of insurance that provides, in the event of payment being made
under the policy in relation to the insured risk, that payment will be made to a 3rd party
rather than to the insured beneficiary of the policy.
Mortgage Clause
A property insurance provision granting special protection for the interest of a
mortgagee named in the policy, in effect setting up a separate content between the
insurer and the mortgagee.
Other Structures
Covers items that are not permanently attached to the main dwelling, such as a shed,
fence, etc.
Commercial Inland Marine
Helps identify the kinds of risk which are eligible for either ocean or inland Marine
insurance.
Building Ordinance Coverage
This endorsement covers the insured for enforcement of laws which require demolition
of undamaged portions of buildings.
Umbrella Policy
Covers a much higher limit and goes above and beyond claims directly relating to your
home and auto, it provides your assets from an unforeseen event, such as a tragic
accident in which you are held responsible for damages or bodily injuries.
Known Loss
Prevents an insured from coverage if the insured knew the loss was probable at the
time of the insurance contract.
Value Reporting
The limit of coverage is set at an amount somewhat higher than expected peak values.
Commercial Property Insurance
Covers direct and indirect losses related to properties other than one to four family
dwellings and farm properties.
Employee Theft
, Provides coverage for loss of or damage to money, securities, and other property
resulting from theft committed by an employee. Theft is defined as the unlawful taking of
money, securities or other property to the deprivation of the insured.
Bid
Aggreement to fulfill a contractual obligation used frequently in construction and
supplying goods.
Health Maintenance Organization (HMO)
Provides comprehensive health services to its members for a prepaid fixed fee,
equivalent to an insurance premium.
Preferred Provider Organization
(PPO)
A selected group of hospital's and medical practitioners in a given area who have joined
together in an effort to reduce medical costs.
Estoppel
Is an equitable principle to the effect that if one intentionally or unintentionally creates
the impression that a certain fact exists, and an innocent party relies on that impression
and is damaged as a result, the guilty party may be legally prohibited(estopped) from
asserting that the fact does not exist.
Salvage
Motor vehicle or mobile home is a total loss.
Junk
Any material which is or may have been a motor vehicle or mobile home, with or without
all component parts, which is inoperable and which material is in such condition that its
highest or primary value is either in its sale or transfer as scrap metal.
Fiduciary Agent
Agent for a principal/Client. The legal or special relationship of trust, confidence, or
responsibility between 2 or more parties.
Domestic Insurer
Insurer is one formed under the laws of its this state.
Foreign Insurer
Insurer is one formed under the laws of any state, district territory, or commonwealth of
the United States other than this State.
Alien Insurer
Insurer is an insurer other than a domestic or foreign insurer.
Appointment
The authority given by an insurer or employer to a licensee to transact insurance or
adjust claims on behalf an insurer or employer.
Derelict
Material which is or may have been a motor vehicle or mobile home, with or without all
component parts, which is inoperable and which material is in such condition that its
highest or primary value is either in its sale or transfer as scrap metal or component
parts or both.
Mechanical Breakdown Coverage
Covers repairs to mechanical parts of your vehicle that break. Even covers break in
events not related to an accident.
Sliding
Adjuster- Florida- Review
Peril
Something that causes a loss.
Hazard
Something that increases the probability that a loss will occur.
Warranty
A policy condition, either based on information in the insureds application or inserted by
the insurer. It is a guarantee of a fact.
Misrepresentation
An untrue statement by the insured, made in an application for insurance but which
does not become a part of the policy.
Concealment
The failure of the insured to reveal relevant facts known to the insured in applying for
insurance.
Abandonment
Property insurance policies usually contain an abandonment clause, stating the insured
cannot dump damaged property on the insurer and demand its full value.
Severability
The insurance applies separately to each insured as if other insureds did not exist.
Proximate Cause
The cause having the most significant impact in bringing about the loss under a first-
party property insurance policy, when two or more independent perils operate at the
same time (i.e., concurrently) to produce a loss. Courts employ a set of rules to resolve
causation disputes when a property policy states that it covers or excludes losses
"caused by" a peril and there is more than one peril at work in a fact pattern. Under
common law, whether the policy provides coverage depends on which peril is chosen
as the proximate cause.
Direct Loss
Physical harm to tangible property.
Indirect Loss
Economic loss which flows as a result of direct loss.
Actual Cash Value(ACV)
Replacement Cost minus Depreciation
Coinsurance
The amount, generally expressed as a fixed percentage, an insured must pay against a
claim after the deductible is satisfied. It's ultimately a way for the insured and insurer to
share responsibility for the risk. It can also help reduce the cost of the insurance policy
premium. Coinsurance can be written on an 80/20, 90/100, or 100% rule.
Personal Contract
Policies cover people who own and operate things, such as automobiles.
Conditional Contract
Also called a hypothetical contract, is a contract agreement that only requires
performance once the delineated conditions are met. This legal agreement requires
,prior performance of another agreement or clause in order to be enforceable. If the
other agreement or condition is performed, then the conditional contract is enforceable
and the parties are bound to carry out the terms of the contract.
Contract of Indemnity
Principle of insurance that provides that when a loss occurs, the insured should be
restored to the approximate financial condition he/she occupied before the loss
occurred, no better or no worse.
Insurable Interest
the reasonable concern of a person to obtain insurance for any individual or property
against unforeseen events such as death, losses, etc.
Waiver
1.) Implied voluntary relinquishment, abandoning a legal advantage, need, claim or
right.
2.) Agreement or added clause of a policy that excludes some losses or limits the sum
of a claim, or extends coverage to add items not in a normal policy.
Express Waiver
Occurs when the insurer or its representative knowingly gives up a known right under
the insurance contract.
Implied Waiver
A waiver that is assumed to be in effect from a person's behavior and shows he is
waiving a right.
Damages
Monetary compensation that is awarded by a court in a civil action to an individual who
has been injured through the wrongful conduct of another party.
Subrogation
When an insured has a right to collect damages from another party, but instead elects
to claim the damages under his insurance policy, his rights against the other party are
transferred to the insurer.
Changes
All policies provide that any changes to the policy be made by the insurer, in writing.
Policy Period
The condition states that coverage applies only to losses or occurrences that take place
during the policy period. (Prior to the stated date and time of termination).
Policy Territory
Condition limiting coverage to occurrences or losses that take place only within a stated
geographical region.
Other Insurance
The principle of indemnity dictates against duplicate recovery for the same loss.
Cancellation
The insured may cancel at any time, for any reason, without advance notice. If the
conpany wishes to cancel, it must provide some degree of advance notice so the
insured will have time to replace the coverage.
Appraisal
A written contract of or written agreement for or effecting insurance, or the certificate
thereof, by whatever name called, and includes all clauses, riders, endorsements and
papers which are a part thereof.
,Insurance
Is a contract whereby one undertakes to indemnify another or pay or allow a specified
amount or a determinable benefit upon determinable contingencies.
Binder
Acts as a temporary contract until the policy is issued.
How many days should an insurer give for prior notice of cancellation of a
binder?
5 days.
Property Insurance
Any insurance wherein payment by the insurer will be paid directly to the insured or
other specifically named interests.
Liability Insurance
Payment will be on behalf of the insured to another, based upon the insureds liability to
the recipient. Simply stated, Liability is "Negligence of the Insured".
Loss Payee Clause
A Clause in a contract of insurance that provides, in the event of payment being made
under the policy in relation to the insured risk, that payment will be made to a 3rd party
rather than to the insured beneficiary of the policy.
Mortgage Clause
A property insurance provision granting special protection for the interest of a
mortgagee named in the policy, in effect setting up a separate content between the
insurer and the mortgagee.
Other Structures
Covers items that are not permanently attached to the main dwelling, such as a shed,
fence, etc.
Commercial Inland Marine
Helps identify the kinds of risk which are eligible for either ocean or inland Marine
insurance.
Building Ordinance Coverage
This endorsement covers the insured for enforcement of laws which require demolition
of undamaged portions of buildings.
Umbrella Policy
Covers a much higher limit and goes above and beyond claims directly relating to your
home and auto, it provides your assets from an unforeseen event, such as a tragic
accident in which you are held responsible for damages or bodily injuries.
Known Loss
Prevents an insured from coverage if the insured knew the loss was probable at the
time of the insurance contract.
Value Reporting
The limit of coverage is set at an amount somewhat higher than expected peak values.
Commercial Property Insurance
Covers direct and indirect losses related to properties other than one to four family
dwellings and farm properties.
Employee Theft
, Provides coverage for loss of or damage to money, securities, and other property
resulting from theft committed by an employee. Theft is defined as the unlawful taking of
money, securities or other property to the deprivation of the insured.
Bid
Aggreement to fulfill a contractual obligation used frequently in construction and
supplying goods.
Health Maintenance Organization (HMO)
Provides comprehensive health services to its members for a prepaid fixed fee,
equivalent to an insurance premium.
Preferred Provider Organization
(PPO)
A selected group of hospital's and medical practitioners in a given area who have joined
together in an effort to reduce medical costs.
Estoppel
Is an equitable principle to the effect that if one intentionally or unintentionally creates
the impression that a certain fact exists, and an innocent party relies on that impression
and is damaged as a result, the guilty party may be legally prohibited(estopped) from
asserting that the fact does not exist.
Salvage
Motor vehicle or mobile home is a total loss.
Junk
Any material which is or may have been a motor vehicle or mobile home, with or without
all component parts, which is inoperable and which material is in such condition that its
highest or primary value is either in its sale or transfer as scrap metal.
Fiduciary Agent
Agent for a principal/Client. The legal or special relationship of trust, confidence, or
responsibility between 2 or more parties.
Domestic Insurer
Insurer is one formed under the laws of its this state.
Foreign Insurer
Insurer is one formed under the laws of any state, district territory, or commonwealth of
the United States other than this State.
Alien Insurer
Insurer is an insurer other than a domestic or foreign insurer.
Appointment
The authority given by an insurer or employer to a licensee to transact insurance or
adjust claims on behalf an insurer or employer.
Derelict
Material which is or may have been a motor vehicle or mobile home, with or without all
component parts, which is inoperable and which material is in such condition that its
highest or primary value is either in its sale or transfer as scrap metal or component
parts or both.
Mechanical Breakdown Coverage
Covers repairs to mechanical parts of your vehicle that break. Even covers break in
events not related to an accident.
Sliding
