TX ADJUSTER TEST
Subrogate Subrogation is the right for an insurer to legally pursue a third party that caused an insurance
loss to the insured. This is done as a means of recovering the amount of the claim paid by the insurance
carrier to the insured for the loss. - correct answer While investigating a claim, you determine that the
loss was caused by a defective mechanism in the dishwasher. You would attempt
to_________________________?
Appraisal - correct answer What is the process when an insurer and an insured have a dispute regarding
the amount of damage?
Material Misrepresentation - correct answer
__________________________________________________is a significant misstatement in an
application form. If a company had access to the correct information at the time of application, the
company might not have agreed to accept the application.
Age, Condition and Life Expectancy - correct answer As an adjuster, you should base depreciation on
these three factors?
Umpire - correct answer An_________________ is a person hired by the property owner to settle the
claim with insurance company on their behalf.
HO-A - correct answer This type of policy provides coverage only for those perils that are listed in the
policy?
Additional Living Expenses - correct answer _________________________ are extra charges covered by
homeowner's policies over and above the policyholder's customary living expenses.
Occurrence - correct answer _______________________is an event that results in an insured
loss/damages?
,Actual Cash Value - correct answer What is value of your property, based on the current cost to replace
it, minus depreciation?
Incurred Expenses - correct answer Expenses that have already sustained and that have not yet been
paid are known as ____________________________________.
Declarations Page - correct answer ________________________________is the part of the written
insurance policy that states all the policy's specific's, including the name of the policyholder, the type of
property insured, the premiums, and the term limits for the coverage.
Negligence - correct answer What is the failure to use that degree of care which an ordinary person of
reasonable prudence would use under similar circumstances?
Overhead and Profit - correct answer ______________________________is the amount of money
dedicated to a general contractor's cost of doing a business and earning a profit.
Third Party Loss - correct answer ____________________________is a situation involving a person
other than an insurer and the insured.
Reserves - correct answer What is the amount representing actual or potential liabilities kept by and
insurer to cover debts to policyholder?
First Party Loss - correct answer This loss involves only the insurer and the insured?
Liability - correct answer What is the responsibility to another for one's negligence?
Severity - correct answer _____________________ is the size of a loss, the extent of damages.
Premium - correct answer ___________________________ is the amount paid by an insured to an
insurance company to obtain or maintain an insurance policy
,Replacement Cost - correct answer __________________________________is the cost associated with
replacing property at the current market price.
Policy Period - correct answer The period of a policy is in force, from the beginning or effective date to
the expiration date is the ________________________________?
deductible - correct answer The amount the insured must pay in a loss before any payment is due is
known as the ____________________________________.
Adjuster - correct answer A person who investigates and settles insurance claims is the
______________________?
$5000.00 - correct answer Mary Johnson has an HO-B policy. Her coverage A limit of liability is $250,000
and her coverage B limit is $125,000. Her policy has a 2% deductible. What is her deductible?
Coverage A - correct answer If your policyholder has a 1% deductible, this percentage would be taken
from what coverage?
10% of COV B - correct answer The Homeowner's policy provides coverage's for Personal Property that
is away from the residence premises. The total limit of liability for off premises losses is
______________________________?
at the residence or elsewhere - correct answer When handing a homeowner's content claim, you should
establish if the loss happened __________________________________________ to help determine the
total limit of liability that will apply to the claim.
$14,220 - correct answer Your policyholder has a Homeowner's Policy with the following limits on it COV
A limit is $158,000 COV B limit is $90,000 His home has a detached garage. His home and detached
garage were completely destroyed in a fire loss. What is the maximum that he can receive for his
detached garage? $15,800 MINUS A 1% DEDUCTIBLE=
Total Loss is $4950.00 less 1% deductible OF $85,000 = $850.00 = $4100.00 - correct answer COV A limit
is $85,000 COV B limit is $ 46,000Your policyholder lives in Houston, Texas. While on vacation in Detroit,
Michigan someone steals the following
,items from his house in Houston. How much will you pay for this loss? Electronics $1,600, Clothing $850,
Golf Clubs $1,500, Shoes $600, Luggage $400,
Loss is $7850 is the total loss. 1% of COV A =$750.00 Amount to be paid is $7100.00 - correct answer
COV A limit is $75,000 COV B limit is $36,000 Your policyholder lives in Houston, Texas. While on
vacation in Detroit, Michigan someone steals the following items from his house in Houston. How much
will you pay for this loss? Electronics $1,600, Clothing $850, Business Laptop $3000 ONLY PAYS $2500,
Music CD's $500, Golf Clubs $1,500, Shoes $900
1. Money or Bank Cards 2. Valuable Papers, deeds, stamps BULLIONS etc. 3. Jewelry Watches or furs -
correct answer Name 3 things that are subject to "Special Limits of Liability" under the HO-B
Coverage A - correct answer Under a HO-B policy, the dwelling/structure is covered for what types of
losses?
Coverage B - correct answer Under a HO-B policy, the contents are covered under what Coverage?
1)Fire and Lightening, 2) Sudden and Accidental Damage from Smoke, 3) Windstorm , Hurricanes and
Hail, 4)Explosion 5) Aircraft 6) Vandalism and Malicious Mischief 7) Riot and Civil Commotion 8) Collapse
of a building, or part of a building 9) accidental discharge overflow of water or Steam form plumbing,
heating, air conditioning, system or household appliance 10) Falling objects, 11) Freezing, 12) theft or
attempted theft - correct answer List the 12 named perils that contents are covered for under the HO-B?
$250 - correct answer What is the maximum amount for coverage for a covered loss to a tree?
Not Covered Found on HO-B PG 2 Under Property - correct answer Your policyholder sustained a theft
loss. His roommate's personal laptop, plasma television and
Sony stereo were all stolen. What are you going to tell him regarding his roommate's property?
(Explain your answer and cite where you found it in the policy)
personal property contained in a building unless
direct force of wind or hail makes an opening in a roof or wall and rain, snow, sand or dust enters
,through this opening and causes the damage. - correct answer Under Section I Exclusions, what does
Exclusions c. (3). Say?
NO. She is OVER 21. - correct answer Your aunt is caring for a 22 year old female. Is this 22 year old
female an Insured under the
HO-B policy?
$0 not covered - correct answer Your policyholder misplaced his watch somewhere in his house. The
watch costs $800. How
much are you going to pay him?
Floods are not covered - correct answer During the storm, your policyholder's dwelling sustained 12ft of
flood water. He provides you
with receipts for his Additional Living Expenses. The expenses are all reasonable. What do you tell
the policyholder?
$0 not covered Found in SECTION 1 Exclusions
C1 - correct answer During a recent windstorm, your policyholder's cloth awning sustains damage. The
damage to
the cloth awning is $400. How much can you pay for the cloth awning?
Not GO!! - correct answer While working on a claim with an approved vendor, he invites you to the
Cowboys game.
What should you do?
Professionally - correct answer When dealing with a customer, you should always
behave_________________?
Timely Follow Up - correct answer ________________________is critical to keep your Policy holder
informed during the claims process.
,Show them where it is in the policy. - correct answer While handling an auto claim, your policyholder
seems confused about your coverage
determination. At this time, what should you do?
To organize the claims so you know dates, times and facts for each claim. - correct answer Why should
you keep a chronological detailed log of all the activity on a claim?
done in Writing - correct answer Full or partial denial of claims must be __________________________.
Customer Service - correct answer Claim adjusting is what type of profession:
Adjuster Me and Insured - correct answer When setting appointments, getting an agreed time should be
a balance between what?
own Merits - correct answer You should always handle claims based on their
_____________________________?
Perceived! - correct answer Your actions do matter, you should always be aware of how you are
Safe, Secure and Sanitary - correct answer To what standard will FEMA repair a home to?
Dwelling, Contents, Debris Removal and ICC (Increased Cost of Compliance) - correct answer What are
the 4 sections of the Flood Policy?
80% of the Replacement Cost - correct answer In order for a building to apply for Replacement Cost, it
must be at least be insured for_______________________?
$250,000 - correct answer What is the maximum amount of coverage you can get on a building under
the Flood policy?
$0 - correct answer What is the maximum amount a person can receive for Additional Living Expenses
(ALE) under the Flood Policy?
,No - correct answer Stevens Jones has excess continuing education hours in a reporting period. Can he
carry the
hours over?
False 30 Hours - correct answer True OR False?Licensees must obtain 40 hours of Continuing Education
every 3 years?
a. Consumer Protection
b. Adjuster Ethics - correct answer The Texas Department of Insurance specifically requires the adjuster
applicants complete at
least two hours of continuing education in:
Go online and renew. - correct answer Mike's license expires in two weeks. What should he do to renew
his license?
a. All Lines
b. Property
c. Property and Casualty
d. Surety
e. Workers Compensation - correct answer What are the types of adjusters licenses approved for
insurance in Texas?
NO - correct answer Do you have to be a resident of Texas to obtain a Texas Adjuster's License?
Complete and comply
audited by TDI - correct answer The Texas Department of Insurance does not track completion of
continuing educations hours,
but you must ---------------------------- in the event you are _______________________________.
,18 years - correct answer To qualify to become an adjuster in Texas, you must be at least
_____________________ of age.
$50.00 - correct answer In the event you do not complete the adjuster CE requirements, you will be
fined __________________ per hour.
False 24hours - correct answer True or False: As an adjuster, you have up to 48 hours to make
reasonable contact with your
insured?
If Homeowner has 3 or more non-weather related claims w/in a 3 year period. - correct answer An
insurance company can refuse to renew a policyholder under what circumstances?
False - correct answer True OR False? Is it a violation of the Unfair Claim Settlement Practices Act to
provide the policyholder with the
pertinent information regarding their claim
Issue a full denial of the claim within 5 days. Promptly! - correct answer If you deny a claim you must?
a. Acknowledge the Claim
b. Begin the Investigation
c. Request all items needed to evaluate the claim. - correct answer Within 15 days after we receive
written notice of your claim we must:
5 Days - correct answer Once you have accepted or rejected an insurance claim, you
have_____________ to issue the payment or issue the written denial letter.
?You need type of specialist to assist with the investigation. ie structural engineer - correct answer
During the course of your investigation, you may request an additional 45 calendar days to complete
your investigation under what circumstances?
,False - correct answer True OR False? Failing to settle claims when liability is reasonably clear is an
accepted claim handling practice?
False - correct answer True OR False? As an adjuster, you should advise a claimant as to their legal
rights.
True - correct answer True OR False? As an adjuster, you should not contact a claimant represented by
an attorney.
False - correct answer True OR False? As an adjuster, you should advise a claimant against seeking legal
advice.
NO - correct answer Jacob was participating in the company softball tournament. During the game, he
twists his
ankle trying to run to 3rd base. Is this covered under Texas Worker's Compensation?
YES - correct answer . Donyalle disagrees with the coverage determination of her Worker's
Compensation claim;
can she hire an attorney and take the matter to court to get resolved?
a. if they 'are injured on the job
b. have a work related injury or illness. - correct answer Worker's Compensation benefits will pay under
what circumstances?
a. You were intoxicated at-the time of the injury
b. You injured yourself on purpose at while trying to injure- someone else
c. You were injured by another person for personal reasons;
d. You were injured by an act of God
e. Your injury occurred during horseplay; or Your injury occurred while voluntarily participating in an off-
work activity. - correct answer You cannot receive Worker's Compensation benefits if:
, Be on the approved DRs. List kept by the Division of Worker's Comp - correct answer You have the right
to an initial choice of Doctor. The Doctor you choose must?
30 Days - correct answer You must tell your employer within _________________of the date you were
injured.
8 days - correct answer An employer must report the injuries within ______________ of the injury.
Underwriting - correct answer The process an insurance company uses to decide whether to accept or
reject an application for a policy.
Staff Adjuster - correct answer Employee of the insurance company's claim department
is__________________
Reserves - correct answer A company's best estimate of what it will pay for claims. The amount that
represents actual potential liabilities kept by an insurer to cover debts to the policyholders.
Loss History Companies view "loss history" as an indication of an insured's propensity for a claim in the
future. - correct answer Refers to an insured's history of losses (claims) with other companies, or the
company they are currently with. A company will consider "loss history" when underwriting a new policy
or considering a renewal of an existing policy.
Insurer - correct answer The insurance company
Insured - correct answer The party to an insurance arrangement whom the insurer agrees to indemnify
for losses, provide benefits for, or render services to.
HO-B - correct answer A type of Homeowner's policy that provides coverage to Coverage A Structure for
All Risks of Physical Loss, unless specifically excluded from Coverage B personal Property on a Named
Peril basis.
Public Adjuster - correct answer A person hired by the insured to settle the claim with the insurance
company on their behalf is?
