What is the failure to use that degree of care which n ordinary person of reasonable
prudence would use under similar circumstances? – ANSWER- Negligence
What is a situation involving a person other than an insured? – ANSWER- Third
Party Loss
What is the responsibility to another for one’s negligence? – ANSWER- Liability
Mary has a homeowner’s policy. Her Coverage A limit of liability is $250,000 and
her Coverage B limit of liability is $125,000. Her policy has a 2% deductible.
What is her deductible? – ANSWER- $5,000
The part of the insurance policy that details the rights and duties of the insured and
the insurance company in the policy? – ANSWER- Conditions
What is a partial legal defense that reduces the amount of damages that a person
can recover based upon the amount that this person’s own negligence contributed
to the loss? – ANSWER- Comparative Negligence
Value of property based on the current cost to replace it minus depreciation? –
ANSWER- Actual Cash Vale
This type of Auto Coverage pays for your damages if you were involved in a hit
and run: – ANSWER- Uninsured Motorist
What is the cost associated with replacing property at current market prices? –
ANSWER- Replacement Cost
The process when an insurer and insured have a dispute regarding the amount of
the damage: – ANSWER- Appraisal
The intentional misrepresentation of a material fact that may void a contract? –
ANSWER- Fraud
What is the type of negotiation that is also sometimes called positional or hardbargaining? – ANSWER- Distributive
An event that results in an insured loss and damages? – ANSWER- Occurrence
What is the period a policy is in force, from the beginning or effective date? –
ANSWER- Policy Period
The amount the insured must pay in a loss before any payment is due? –
ANSWER- Deductible
The insurer must review the claim and accept or reject within how many days? –
ANSWER- 15 calendar
Oral or written false statement that is malicious – ANSWER- Defamation
Time requirements does the policy holder have to complete the requirements that
the insurer has requested? – ANSWER- No requirements
Days for insurer to pay the claim – ANSWER- 5 business
Insurer must acknowledge the claim begin the investigation, and request all the
information needed in what time frame? – ANSWER- 15 Calendar days
What must an insurer provide for the declination, cancellation, or nonrenewal of an
insurance policy? – ANSWER- Written Statement
Established in 1991 to ensure prompt payment of insurance claims? – ANSWERArticle 21.55
An insurer may not consider a as a basis for declination? – ANSWERCustomer Inquiry
An insurer may refuse to renew a policy if the insurer has mailed notice of
nonrenewal to the insured at least____ days before the policy’s expiration date? –
ANSWER- 30
If the insurer needs additional time to evaluate and investigate a claim, they can
request how many additional days? – ANSWER- 45 Calendar Days
Under the Texas HO-B, the structure is covered for what type of losses? –
ANSWER- All risk of physical loss, unless excluded
Under the Texas HO-B, jewelry, watches, and furs are limited to? – ANSWER-
$500 for losses caused by theft
Under the Texas HO-B policy, the most paid for a tree? – ANSWER- $250
The Special Limit of Liability for Bullion/ Valuable Papers is? – ANSWER- $500
HO-B policy, you would choose the Deductible Clause 1 for losses caused by? –
ANSWER- Windstorm, Hurricane, Hail
Trees, shrubs, plants, and lawns are not covered for losses caused by? – ANSWERWindstorm
If your policyholder has a percentage deductible, how do you determine what the
deductible amount is? – ANSWER- Apply the percentage to Coverage A limit of
liability
What is a crucial element to the adjustment process? – ANSWER- Claim
investigation
The adjuster must set appointment _ to meet both the needs of the adjuster and the policyholder? – ANSWER- At reasonable times What should adjusters do to obtain a fair and equitable settlement? – ANSWERWork in Good Faith What should you do to make sure your policyholder always stays informed? – ANSWER- Timely Follow Up The claim activit log must be clear, concise, factual, and always? – ANSWER- Up to date Adjuster should make initial contact within – ANSWER- 24 hours 3 / 4 Adjusters should remain… – ANSWER- calm and professional The employee has to report injury in days – ANSWER- 30 days
Two examples of compensation provided by worker’s compensation? – ANSWERPaying for medical bills and replacing bills
How many types of worker’ comp disability? – ANSWER- 4
Workers Compensation provides income and medical if they are? – ANSWERInjured on the job?
An employee of Office of Injured Employee Counsel is known as? – ANSWEROmbudsman
Employer must report injuries within? – ANSWER- 8 days
Four Categories of Workers Compensation laws? – ANSWER- Disability, Medical,
Survivor, Rehab
Disability lasts a short period and employee is fully able to return. – ANSWERTemporary Total
Temporary disablement that allows employee to return but reduced capability? –
ANSWER- Temporary partial
Adjuster – ANSWER- an individual license under Insurance Code Article 21.07-4
All lines, Property & Casualty, Workers Compensation – ANSWER- Types of
Texas adjusters
CPCU designated, Associat in claims (AIC) designation, completed course or
exam with 12 months, expired license 91-364 days – ANSWER- Exempt from
licensing exam
License expires on – ANSWER- 2nd anniversary of issue date
Must apply after – ANSWER- 90 days expired
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