N.C. Claims Adjuster Exam Questions and
Correct Answers/ Latest Update / Already
Graded
Inception/Expiration Date
Ans: an insurance policy covers the insured starting at 12:01am
on the day on which coverage begins and expires at 12:01am on
the expiration day of the policy.
Occurrence Date
Ans: Date of which the loss occurred
Identification of parties involved
Ans: The loss report should include the names and addresses of
the parties involved in the loss, the names and addresses of any
injured person(s) and the names and addresses of any
witness(s).
Policy Form/Number
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Ans: Identifies the type of coverage purchased (policy form)
and the policy number for the particular policy purchased by the
insured.
Description of the Loss
Ans: Information concerning how, when and where the
accident or loss happened is an essential element in any loss
report.
Coverage
Ans: Shows the type of coverage(s) purchased as well as the
limits of coverage purchased.
Damages - Special Compensatory damages
Ans: Are amounts paid to compensate the plaintiff for direct
expenses such as medical treatment, lost wages (both past and
future), funeral expenses and rehabilitation ex penses required
because of bodily injury. Special damages are paid for losses
that can be determined and documented. They are often
referred to as "out-of-pocket" expenses.
Damages - General Compensatory Damages
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Ans: Are paid for losses that cannot be specifically measured
and itemized in order to compensate the plaintiff for things
such as pain and suffering, loss of the use of an arm or leg, loss
of vision, physical disfigurement and/or loss of consortium.
Damages - Punitive Damages
Ans: Are typically awarded to the plaintiff in addition to
compensatory damages when the defendants conduct has been
especially malicious. Punitive damages are awarded to punish
the defendant and to deter others from engaging in similar
actions.
Unfair Claims Settlement Practices
Ans: 1. Knowingly misrepresenting relevant facts or policy
provisions relating to the coverage at issue. 2. Failing to
acknowledge with reasonable promptness communications
pertaining to claims. 3. Failing to adopt and implement
reasonable standards for the prompt investigation of claims. 4.
Arbitrary and unreasonable refusal to pay claims. 5. Failing to
affirm or deny coverage of claims within a reasonable time after
proof of loss has been completed. 6. Not attempting in good
faith to make prompt, fair and equitable claims settlement
when the insurer's liability has become reasonably clear. 7.
Compelling insureds to institute suits to recover amounts due
under a policy by offering substantially less to settle
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immediately. 8. Attempting to settle claims for less than the
amount for which a reasonable person would believe one was
entitled based on written or printed advertising material
accompanying or made a part of an application. I. Attem pting
settlement of claims on the basis of applications that were
altered without notice to knowledge of or consent of insureds.
Total Losses on Motor Vehicles/Miscellaneous Provisions
Ans: 1. If the insurer and the claimant are unable to reach an
agreement as to the value of the vehicle, the insurer shall base
any further settlement offer not only on the published regional
average value of similar vehicles, but also on the value of the
vehicle in the local market. 2. Local market value shall be
determined by using either the local price of a comparable
vehicle or if no comparable vehicle can be found, quotations
from at least two qualified dealers within the local market area.
Additionally, if the claimant represents that the vehicle was in
better than average condition, the insurer shall give due
consideration to the condition of the claimant's vehicle prior to
the accident. 3. When a motor vehicle is damaged in an amount
which equals or exceeds 75 percent of the preaccident actual
cash value, an insurer shall "total loss" the vehicle by paying the
claimant the preaccident value and in return, receiving
possession of the legal title for salvage purposes. 4. The insurer
will be responsible for all reasonable towing and storage
charges until three days after the owner and the storage facility
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