Exam (elaborations)
NC CLAIMS ADJUSTER EXAM STUDY
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NC CLAIMS ADJUSTER EXAM STUDY
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NC CLAIMS ADJUSTER EXAM STUDYLiability Insurance PAP (Part A) - Answers -Pays all the sums and insured must legally
pay as damage due to BI/PD caused by an accident and resulting from the ownership,
maintenance or use of a covered auto.
Coverage Part A through F of a PAP - Answers -A. Liability
B. Medical Payments
C. UM/UIM
D. Physical Damage
E. Insured Duties
F. General Provisions
Certificate of Insurance (COI) - Answers -A document that proves the existence of
insurance coverage
Occurrence - Answers -Something that continue to happen and may cause injury later
on.
Accident - Answers -A sudden unforseen and unintended one time event
Assumption of risk - Answers -An individual who is aware of the potential risk involved
and chose to expose themselves to it.
Comparative negligence - Answers -Measures the amount of negligence contributed to
each party. The injured party will not cover damages equal to the percentage of
negligence they contribute.
Contributory Negligence - Answers -If an insured party contributed to their injury in
anyway due to their own negligence, we will not pay anything.
What state is a contributory state? - Answers -North Carolina
Negligence - Answers -Failure to do (or not do) what a reasonable prudent person
would or would not have done in a similar instance.
Temporary Substitute Automobile - Answers -Not owned by the named insured but used
temporarily as a substitute for the owned auto that is not currently being used.
What is an example of a Temporary substitute Automobile? - Answers -A dealership
loans an insured a vehicle to drive while their car is getting fixed.
Non Owned Automobile - Answers -Not owned by the named insured or any relative.
What is an example of an Non Owned Automobile? - Answers -An insured borrows a
neighbors car.
,If an additional vehicle is not reported to the insurer within 30 days: - Answers -No
coverage will apply to the added vehicle.
If a vehicle is added to an existing policy (In addition to): - Answers -It will have the
broadest coverage if insured within 30 days of becoming the owner.
If a replacement vehicle is not reported within 30 days: - Answers -Part D
(Comprehensive and Collision Coverage) will not apply to the replacement vehicle.
A new vehicle that replaces another vehicle will: - Answers -Have the same coverages
as the old vehicle if the named insured request to insure it within 30 days of becoming
the owners.
What does the Federal Emergency Management Agency (FEMA) Do? - Answers -Sets
program standards for the National Flood Insurance Program.
How many roomers and boarders can a dwelling policy insure? - Answers -Up to 5
roomers and boarders
How many roomers and boarders can a homeowners policy insure? - Answers -Up to 2
roomers and boarders.
What is probability? - Answers -Measuring the chance of an event occuring
What is a risk? - Answers -The uncertainty of a loss
What is a pure risk? - Answers -A chance of loss only
What is speculative risk? - Answers -When there is a chance of gain and a chance of
loss
What is a broker? - Answers -A person who represents the insurED. They also must be
able to post a bond more than or equal to $15,000 in favor of the state of NC.
What is the characteristics of insurable risk? - Answers -A low probability of a loss
occurring
Less than catastrophic results
Lost must be measurable
The loss must be significant
The loss must be accidental and unintended
What is insurable risk? - Answers -A risk an insurance company is willing to accept.
A transfer of risk - Answers -Insurance
, What is the 1st way to prevent adverse selection? - Answers -Rate up marginal risk
What is the 2nd way to prevent adverse selection? - Answers -Insurability standards
What is adverse selection (Bad Risk)? - Answers -When an insured with a high risk of
loss attempt to purchase insurance and are successful in getting the insurance.
Law of Large Numbers - Answers -As a larger number of events are included, the
difference between actual and expected results become smaller.
Who are competent parties? - Answers -1. Minors
2. The mentally infirm
3. Persons under the influence of drugs or alcohol.
What is a legal object? - Answers -A legal purpose in order to be enforced
what is a peril? - Answers -A cause of loss.
What is a hazard? - Answers -Something that increases the probability of a peril
occurring.
What is the Principle of indemnity? - Answers -Restoring you to where you were before
a loss but you will not make any money off of the loss.
What is a direct loss? - Answers -Actual damage to tangible property. There is a
deductible for this type of loss
(i.e.) house, detached garage and contents
What is an indirect loss? (Consequential loss)? - Answers -The money or income lost as
a result of a direct loss.
Offer and acceptance agreement - Answers -An offer is made by the proposed insured.
Acceptance occurs when the policy is issued.
What is consideration? - Answers -The exchange of something of value by both parties
What is an Agent? - Answers -A person who represents the insurER. They can bind
coverage.
What is the declarations page? - Answers -The personalized part of a policy.
What are the parts of the declarations page? - Answers -The parties of the contract
The policy term
The amount of insurance purchased
The amount of the premium
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