Exam (elaborations)
Claims Adjuster Exam 2023 – Q’s & A’s
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Claims Adjuster Exam 2023 – Q’s & A’s
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Claims Adjuster Exam 2023 – Q’s & A’sInsurance ✔️Ans --an economic device used to protect against extreme
unforeseen loss
- the transfer of risk from one party to another
Premium ✔️Ans --the fee paid by the insured in exchange for insurance
Principle of Indemnity ✔️Ans --the insurer should be restored to where
they were before the incident
-no profit can be made
Idemnification ✔️Ans --to compensate for loss or damage; to provide
security for financial reimbursement to an individual in case of a specified loss
incurred by the person
4 Elements of a Legal Contract ✔️Ans --Agreement- signature or
handshake
-Consideration- money exchange
-Competent Parties-18 yrs. old, sober, sane
-Legal Purpose-no contracts for money laundering
Insured ✔️Ans -individual who pays premiums in exchange for protection
-can be a person, person's or an organization
- "You," "Your," or "Your's"
(if the insured is a group it is important to list the "first named insured,"-
because that is the only one that can authorize changes to the policy)
Insurer ✔️Ans --company or group offering insurance
-can be a government organization
-terms- "We," "Us," and "Our
6 Characteristics of a Contract:
Personal ✔️Ans --protects the person (insured) from loss
-does not protect property from becoming damaged
-coverage follows the person not the property
,6 Characteristics of a Contract:
Adhesion ✔️Ans --one party dictates terms
-the insured has no power to write the contract
-courses will favor the insured in a case of ambiguity
6 Characteristics of a Contract:
Utmost Good Faith ✔️Ans --applicants are expected not to withhold any
information or the contract can be voided
6 Characteristics of a Contract:
Aleatory ✔️Ans --depending on a unknown future event
-Insurer only has to pay in and when covered losses occur
6 Characteristics of a Contract:
Unilateral ✔️Ans --only the insurer make an obligation to pay for covered
losses
6 Characteristics of a Contract:
Conditional ✔️Ans --the insurer only has to perform if certain conditions
are met
Policy Sections
Declarations Page ✔️Ans --makes contract specific to the policy holder
Includes:
-Name of both parties
-Policy Number
-Location & Description of Item
-Value of Insured Item
-Value of item dates
- Amount & Limit of Coverage
-Deductible
-Premium
, Policy Sections
Definitions ✔️Ans --it is not technically essential
-need to know info. or language used in the contract
Policy Sections
Insuring Agreement ✔️Ans -summarizes:
-what is covered
-which losses are covered
-maximum limit of policy
-the core of the contract
-often one sentence
Policy Sections
Conditions ✔️Ans --the insurer specifies any limits or qualifications the
policy holder must meet
-will explain what procedure to follow in the event of a dispute
Policy Sections
Exclusions ✔️Ans -- what is not covered (excluded) under the contract
Policy Sections
Endorsements ✔️Ans --any additions to the policy
-can be added at anytime (could increase or decrease the price)
-aka: ryder, addendum, attachments
Types of Insurance
Government Insurance ✔️Ans --mandatory participation
-benefits prescribed by law
-designed to meet the needs of the general public
-government has a monopoly
-examples:
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