ACTUAL EXAM COMPLETE 300 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+
Insurance History and Regulation: Insurance - ANSWER: Coverage by contract
whereby one party undertakes to indemnity (hold harmless) or guarantee another
against loss by a specified contingency or peril.
Insurance History and Regulation: NAIC - ANSWER: An organization whose purpose is
to organize the regulatory and supervisory efforts of the various state insurance
commissioners from around the United States.
Protection of Consumer Interests: The Texas Department of Insurance (TDI) -
ANSWER: Regulates the consumer interest in regard to insurance.
Protection of Consumer Interests: Head of the Texas Department of Insurance -
ANSWER: Insurance Commissioner
Protection of Consumer Interests: Chapter 541 -Unfair and Deceptive Insurance
Practices - ANSWER: was set up by the State of Texas to establish certain practices
which constitute unfair and/or deceptive insurance acts.
Protection of Consumer Interests: Texas Insurance Code requires what within how
many days of receipt of a claim that the insurer? - ANSWER: within 15 days 1)
acknowledge receipt of a claim 2) begin investigation 3) request items from the
claimant.
Insurance: What is the purpose of insurance? - ANSWER: to provide a way to spread
risk over a large group of people
Insurance: Principle of Indemnity - ANSWER: IS AN INSURANCE PRINCIPLE STATING
THAT AN INSURED MAY NOT BE COMPENSATED BY INSURANCE COMPANY IN AN
AMOUNT EXCEEDING THE INSURED'S ECONOMIC LOSS. It is a principle that returns
the insured to their previous financial condition.
Insurance: What are the two purposes of indemnity? - ANSWER: 1) to prevent the
insured from profiting from a loss 2) to reduce moral hazard
Insurance: what is risk? - ANSWER: (1) the potential for a financial loss or the
statistical chance of danger from exposure to a hazard or peril (2) the uncertainty
about loss that exists whenever more than one outcome is possible
Insurance: Proximate Cause - ANSWER: is the first event in an uninterrupted chain of
events that leads to a loss
,Insurance: What are the 2 types of risk? - ANSWER: Speculative: affords the
opportunity for gain as well as the possibility of loss
Pure: a risk where there is the potential of real loss due to exposure to a peril
Insurance: example of risk avoidance - ANSWER: to avoid risks associated with
swimming pools, don't buy a home with a pool.
Insurance: example of risk reduction - ANSWER: to reduce fire damage, install a
sprinkler system in home
Insurance: Example of risk retention - ANSWER: insurance company accepts risk
when they've accepted the insured.
Insurance: example of risk transference - ANSWER: purchasing insurance, transfers
the risk from insured to insurance company.
Insurance: what is a peril? - ANSWER: The actual cause of a loss.
Insurance: what are the two types of perils? - ANSWER: 1) named peril -- specifies
which perils are insured against 2) open peril / all risk peril -- insures against all perils
unless specifically excluded in the policy
Insurance: 14 most common named perils - ANSWER: 1. lightning/fire
2. sudden & accidental damage from smoke
3. explosions
4. windstorms, hurricane or hail
5. theft
6. vehicle damage
7. aircraft damage
8. vandalism/malicious mischief (V/MM)
9. falling objects
10. weight of snow, ice or sleet
11. sudden and accidental water damage from plumbing, heating, or A/C overflow
12. freezing damage to plumbing
13. riots
14. civil disobedience
Insurance: What is a hazard? - ANSWER: situations or behaviors that increase the risk
of loss of property
Insurance: Name the three kinds of hazards and give an example of each - ANSWER:
1) Physical -- large hole in the front yard where someone could step in and hurt
themselves
2) Morale -- leaving a home with the doors unlocked and the windows opened
3) Moral -- embezzlement
,Insurance: List and define the 2 types of losses - ANSWER: 1) Direct loss -- damage
that is a direct result of a covered peril such as a fire destroying a home
2) Indirect loss -- consequential loss resulting indirectly from a direct loss due to a
covered peril such as loss of business income or loss of use
Claims Adjuster: What is a Staff/Company Adjuster? - ANSWER: work for the
insurance company such as State Farm and handle claims on behalf of the insurer;
they are paid a salary with benefits.
Claims Adjuster: What is an Independent Adjuster? - ANSWER: work for the
insurance companies to handle and evaluate certain claims on an as-needed basis;
they are paid a percentage of the claims they settle
Claims Adjuster: What is a Public Adjuster? - ANSWER: work for the insured to make
an evaluation of loss to be presented to the insurer; they are paid on a fee basis
(usually 10%) and are usually required to carry an adjuster bond
Claims Adjuster: CAT ( catastrophic) Adjusters - ANSWER: represent the insurance
company that hired the catastrophic adjusting company that you are doing claims for
Claims Adjuster: 11 things that a claims adjuster may do - ANSWER: 1) Determine
coverage
2) determine amount of damage
3) prepare report of findings
4) Try to work out a fair settlement
5) prepare a claim file
6) interview with insured and/or witnesses
7) inspect and estimate property damage or loss
8) consult police, fire dept. and medical reports
9) take pictures and draw diagrams
10) make advance settlement payments
11) attend court hearings if necessary
Claims Adjuster: 4 educational requirements that are suggested for adjusters to have
- ANSWER: 1) a combination of related education and on-the-job experience
2) at least a high school diploma
3) some post high school education is an asset
4) a valid driver's license
Claims Adjuster: Initial contact with the insured should be within __________ of
receiving the claim. - ANSWER: 24 hours
Claims Adjuster: The insurer has _________ to respond to a claim during non-
catastrophic situations. - ANSWER: 15 days
, Claims Adjuster: During catastrophic situations, the insurer has _________ to
respond to a claim. - ANSWER: 30 days
Claims Adjuster: Adjusters are __________________ for they act in the best interest
of the principle and not in their own best interest. - ANSWER: Fiduciary Agents
Claims Adjuster: Can adjusters be sued by the client/insured ? - ANSWER: Yes,
adjusters can be sued personally for unfair claims practices.
Claims Adjuster: Define Utmost Good Faith - ANSWER: When the adjuster and the
insured are working together with honesty and integrity
Claims Adjuster: Is it considered ethical for an adjuster to adjust for family members
and/or friends? - ANSWER: No -- this would be considered a conflict of interest
Licensing Requirements: Name the 6 licensing requirements according to the Texas
Statutes for a Texas Adjuster License? - ANSWER: 1) must be at least 18 years of age
or older
2) must be trustworthy
3) must reside in the state practicing in or in one that has reciprocity
4) must submit appropriate application and fees to the state of Texas
5) must complete an approved pre-licensing course
6) must successfully pass a state approved examination
Licensing Requirements: Persons holding which 2 designations are exempt from the
requirements of an adjuster's license examination? - ANSWER: chartered property
casualty underwriter or associate in claims
Licensing Requirements: list the 3 adjuster licenses available in Texas - ANSWER: 1)
all-lines adjuster 2) property & casualty adjuster 3) Worker's Compensation Adjuster
Licensing Requirements: How many CE hours are required every two years? -
ANSWER: 24 hours (at least 12 of them must be from classroom equivalent approved
courses)
Licensing Requirements: How many of the 24 CE hours have to be Ethics or
Consumer Protection? - ANSWER: 2 hours
Licensing Requirements: How often is the Texas Adjuster's License to be renewed? -
ANSWER: Every 2 years and the renewal date is the licensee's birthdate
Licensing Requirements: If you have an expired license of less than _________ then
you do not have to retake the exam or reapply for a new license. - ANSWER: 90 Days
Licensing Requirements: What is the fine per hour for deficient CE credits? -
ANSWER: $50/CE hour