ACA 1 study

Under Mechanical Breakdown Coverage, new cars are eligible for service up to:

36 MONTHS/36,000 MILES

Liberalization states, "The insured gets the benefit of any broadened coverage if the company, within __________ days of inception, adopts a form revision that is broader and without increase in premium."

45

Under Commercial Property Policies, Florida law requires an insurer to give the insured at least __________days advance written notice of non-renewal.

45 DAYS

Number of months a licensee has to secure a new appointment after termination of all prior appointments, without re-applying for a license.

48

IF A LICENSEE HAS THEIR APPOINTMENT TERMINATED, HOW LONG DOES HE/SHE HAVE TO BE REAPPOINTED BEFORE THE LICENSE IS TERMINATED?

48 MONTHS

The Department may issue a nonrenewable temporary license authorizing the appointment of a general lines insurance agent, life agent, or an industrial fire or burglary agent, for a period not to exceed:

6 MONTHS

What is the timeframe for a Non-Renewable Temporary License

6 MONTHS

All of the following are eligible for a Homeowner's Policy, except?

A business condo owned by a local insurance company

Which of the following is not covered under Coverage C, Personal Property?

A fish dies because he has been left alone for a week without food

A LENDER HAS AN INSURABLE INTEREST IN AN AUTO, THE CLAUSE PROTECTING THE LENDER'S INSURABLE INTEREST IS DEFINED AS:

"Loss Payable Clause" or "Loss Payee"

Johnathon HAS A HONDA ACCORD COVERED UNDER HER PERSONAL AUTO POLICY WITH A $100 DEDUCTIBLE FOR OTHER THAN COLLISION AND A $500 DEDUCTIBLE FOR COLLISION. ON THE WAY HOME FROM WORK HIS VEHICLE COLLIDES WITH A MAILBOX, THE DAMAGE TO HIS VEHICLE IS $1,000. HOW MUCH WILL HIS POLICY PAY?

$1,000-$500 = $500 PAID

Jeremy has a not at fault accident. If he has PIP with a $1,000 deductible, how much can he expect his PIP coverage to pay toward his medical bills that total $3,000?

$1,600

Understand PIP and how it may apply to a given scenario (Review the PIP Activity).

$10,000 - $1,000 DEDUCTIBLE = $9,000 X 80% = $7,200 T = ($10,000 - DEDUCTIBLE) x .8 (20% NOT PAID BY PIP) SCENARIO: Jeremy has a not at fault accident. If he has PIP with a $1,000 deductible, how much can he expect his PIP coverage to pay toward his medical bills that total $3,000?

Under workers compensations, a rate is charged for every __________ of payroll to employees.

$100

SUSAN HAS $100,000 NON STACKED UNINSURED MOTORIST WITH 3 CARS. SHE FLIPS HER CAR AFTER BEING HIT BY A CAR THAT LEAVES THE SCENE OF THE ACCIDENT. WHAT IS THE MOST THAT SHE CAN COLLECT FROM HER UNINSURED MOTORIST?

$100,000

UNDER FLORIDA THE ADJUSTER SHOULD SETTLE A THIRD PARTY LIABILITY CLAIM FOR AN INJURED MINOR CHILD WITH BOTH PARENTS OF THE INJURED CHILD, PRESUMING THE SETTLEMENT IS FOR AN AMOUNT NOT IN EXCESS OF

$15,000

COINSURANCE PRACTICE ►For example, coverage limit on a property is $30,000, 80% coinsurance, and a loss of $20,000 occurs. If the value of the covered property is $50,000 at the time of loss, the insurer's loss payment responsibility is calculated:

$20,000 X $30,000 $40,000 ($50,000 * 80%) = $15,000 Loss Settlement

UNDER A COMMERCIAL GENERAL LIABILITY POLICY A BASIC LIMIT OF __________ PER PERSON APPLIES TO MEDICAL PAYMENTS.

$5,000

Under Inside The Premises - Robbery or Safe Burglary of Personal Property, a special limit of __________ per occurrence applies to articles whose principal value is precious metals, precious or semiprecious stones, pearls or furs, and to the physical or intrinsic value of manuscripts, drawings or records:

$5,000

Under a Commercial General Liability Policy, a basic limit of __________ per person applies to Medical Payments

$5,000

Understand the Basic Pip Benefits. DEATH

$5,000 IN ADDITION TO THE $10,000 IF THE EVENT RESULTS IN DEATH

Identify the Thresholds of the No-Fault Law.

(1) Significant and permanent loss of a bodily function, or (2) Permanent injury other than scarring and disfigurement, or (3) Significant and permanent scarring or disfigurement, or (4) Death.

What are the components that make up the Investigation process?

1. INQUIRY 2. VERIFICATION 3. COMPARISON

What are the components that make up the Investigation process?

1. INQUIRY: DIRECTED TOWARDS OBTAINING REQUIRED FACTS SURROUNDING A CLAIM 2. VERIFICATION: AS FACTS ARE OBTAINED, THEY ARE VERIFIED OR SUBJECT TO CHECK FOR ACCURACY 3. COMPARISON: DURING INVESTIGATION COMPARISON SHOULD BE MADE BETWEEN EVIDENCE, STATEMENTS, AND GATHERED/KNOWN FACTS

An applicant for a temporary license must be:

A. A natural person at least 18 years of age B. A US citizen or legal alien who possesses work authorization Both A&B

An applicant for a license as an adjuster may qualify as an adjuster in the following fields (but not limited to):

A. All lines of insurance except life and annuities B. Property and Casualty C. Workers Compensation Insurance D. All of the Above **ALL OF THE ABOVE**

Under Workers Compensation, Employers Liability includes:

A. Claims by others for the liabilities to insureds employees B. Claims by relatives of injured employees for consequential damages C. Claims made by employees that are not subject to Workers Compensation Laws D. All of the Above **ALL OF THE ABOVE***

The Commercial Property Contract includes all of the following, except:

A. Common Policy Conditions B. Commercial Property Conditions C. Coverage Form D. *COMMERCIAL LOSS SCHEDULE*

The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to:

A. Conduct B. Work Habits C. Claim Handling Activities D. All of the Above **ALL OF THE ABOVE**

When investigating liability insurance claims, which of the following three major elements are determined

A. Coverage B. Liability C. Damages D. All of the Above **ALL OF THE ABOVE**

When the basic liability limits provided by the policy are insufficient for an insureds needs, two coverage forms are used to provide the additional amounts of coverage:

A. Excess Liability B. Umbrella C. BOTH A AND B

Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices:

A. False Statements B. Unfair Discrimination C. Unlawful Rebates D. All of the Above **ALL OF THE ABOVE**

The adjusters basic activities in claims handling are:

A. Investigation B. Evaluation C. Negotiation D. All of the Above **ALL OF THE ABOVE**

Which of the following are reasons for refusal, suspension or revocation of a license or appointment?

A. Lack of Qualifications B. Failure to Pass State Examinations C. Fraudulent or Dishonest Practices D. All of the Above **ALL OF THE ABOVE**

Which of the following are parties to a Bond?

A. Principal B. Obligee C. Surety D. All of the Above *ALL OF THE ABOVE*

Which of the following are characteristics of Homeowner's Insurance?

A. Protects against economic loss to residences and household property, and legal liabilities B. Owner-occupants of 1-4 family dwellings C. Renters who maintain residential occupancy in any type of building

Under Workers Compensation, Part Four Your Duties if Injuries Occur, an employer is required to:

A. Provide the names and addresses of injured persons and witnesses B. Promptly provide any legal papers C. Cooperate and assist as the insurer requests D. All of the Above *****ALL OF THE ABOVE****

Employee Theft Coverage may be written in the following ways:

A. Scheduled Persons Coverage B. Scheduled Position Coverage C. Blanket Coverage D. All may apply **ALL MAY APPLY**

Characteristics of an HMO plan usually include:

A. Small or Non-existent Deductibles B. Fewer Exclusions C. Insurance services to members through employed physicians D. All of the Above **ALL OF THE ABOVE**

Under Crime Insurance, the insured is covered for loss by:

A. Theft B. Burglary C. Robbery D. All of the Above **ALL OF THE ABOVE**

A policy may contain a provision which states a period of time between issuance and acceptance before sickness benefits begin. This is defined as:

A. Waiting Period B. Elimination Period C. ***both and and B******

Property insurance policies usually contain a(n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value:

ABANDONMENT

Provides coverage for expenses, including loss of income, arising from an accident. This is defined as?

ACCIDENT INSURANCE

The process of disposing of an insurance claim is defined as:

ADJUSTING

Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as:

ADVANCED PAYMENT

Frank owned a home that was destroyed by a hurricane. Both ABC and XYZ Banks were listed as additional interests on his homeowner policy. The insurance company will make a payment to:

ALL LISTED INTERESTS

One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. This is defined as a(n):

AUTHORIZED

Which of the following is not one of the rating factors for a Homeowner's Policy?

Age & Gender of Insured

Understand the Basic Pip Benefits. BASIC

BASIC PIP $10,000 TOTAL LIMIT MAY CHOOSE COVERAGE FOR INSURED ONLY OR INSURED PLUS RELATIVE

THE FOLLOWING COVERAGE IS USED TO INSURE BUILDINGS IN THE COURSE OF CONSTRUCTION:

BUILDER'S RISK

THIS ENDORSEMENT COVERS THE INSURED FOR ENFORCEMENT OF LAWS WHICH REQUIRE DEMOLITION OF UNDAMAGED PORTIONS OF BUILDINGS (VALUE OF AND COST TO DEMOLISH) AND OR HIGHER COSTS OF REPAIR OR RECONSTRUCTION BASED ON BUILDING, ZONING, OR LAND USE LAWS.

BUILDING ORDINANCE COVERAGE

Protects against loss of business income that results from damage to covered property from a covered cause of loss.

BUSINESS INCOME INSURANCE COVERAGE

This form of bond is required to accompany a bid for a contract which will require that the successful bidder furnish further bond if awarded the job:

Bid

Used to cover buildings in the course of construction:

Builders Risk Policy

The authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf of an insurer or employer is defined as:

Appointment

Which of the following are NOT a type of bond?

Apprentice

The measure to determine disability benefits is the __________ of the employee at the time of injury:

Average Weekly Wage

ESTABLISHING A DOLLAR VALUE ON A CLAIMS IS DEFINED AS

EVALUATION PROCESS

Crime Insurance is _________ over any other Insurance coverage.

EXCESS

The Nuclear Energy Liability Exclusion endorsement, in general, __________ all hazards related to nuclear energy.

EXCLUDES

Establishing a dollar value on a claim is defined as:

Evaluation

Mandatory for risks exceeding certain annual premiums, recognizes the prior loss experience of the risk and applies either a debit for unfavorable experience or a credit for better-than-expected loss results. This is defined as:

Experience Rating Plan

Covers for all types of property, when surrendered away from the premises as a result of a threat to do bodily harm to the insured or an employee, or to a relative or invitee of either, who is (or allegedly is) being held captive. This is defined as:

Extortion

Established in 1973, this association was created for applicants who are unable to obtain insurance in the private market:

FAJUA

A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative.

FALSE

Once a Customer Representative 4-40 has been licensed and appointed for at least 3 years, he or she may transact insurance in the home of an existing customer.

FALSE

Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services.

FALSE

ANY PERSON ASSERTING RIGHT TO PAYMENT AS AN INSURED AS PROVIDED BY THE INSURANCE COMPANY ARISING OUT OF THE OCCURRENCE OF A CONTINGENCY OR LOSS COVERED BY THAT POLICY IS REFERRED TO AS A:

FIRST PARTY CLAIMANT

An Insurance Company which is formed under the laws of the State of Illinois, and has its Home Office there, is considered a:

FOREIGN

A SETTLEMENT RESULTING IN IMMEDIATE PAYMENT WHEN THE CLAIMANT SIGNS A RELEASE RELINQUISHING HIS/HER RIGHT TO SUE IS DEFINED AS:

FULL RELEASE SETTLEMENT

Passed during a legislative session in 1993, this association was created for employers who cannot obtain workers compensation insurance in the private market:

FWCJUA

A relationship that requires maintenance of a high degree of fidelity and loyalty to the interests of the principal, whether or not the adjuster is a direct employee is defined as:

Fiduciary

In 2002, the Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and the Florida Windstorm Joint Underwriting Association (FWUA), were combined to create:

CITIZENS

The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as:

CLAIM

Applies only to a BI or PD which occurs on or after the retroactive date, and for which the claim is received or recorded by an insured or the company during the policy period:

CLAIMS MADE

Sometimes referred to as commercial fire and allied lines, this is the form of insurance that covers direct and indirect losses related to properties other than one- to four-family dwellings and farm properties:

COMMERCIAL PROPERTY INSURANCE

This type of provision states the insurer can refuse to renew the policy only under certain conditions. The policy must state the conditions under which the policy will not be renewed. This is defined as?

CONDITIONALLY RENEWABLE

Used only for Commercial Condominiums, it covers the unit-owners business personal property and the personal property of others in the insured s care, custody or control:

CONDOMINIUM UNIT OWNERS FORM

THIS FORM OF BOND IS REQUIRED TO ACCOMPANY A BID FOR A CONTRACT WHICH WILL REQUIRE THAT THE SUCCESSFUL BIDDER FURNISH FURTHER BOND IF AWARDED THE JOB

CONTRACT BOND

Identify the characteristics of a Personal Automobile Policy Declaration Page.

COVERED AUTOS, LIABILITY COVERAGE, PHYSICAL DAMAGE COVERAGE, BUSINESS AUTO CONDITIONS, AND DEFINITIONS

One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as:

Claims Adjuster

The Core Value of Ethics.

Code of Ethics The Chief Financial Officer has adopted formal rules which impact on adjuster practices. Rule 4-220.201 of the Department of Financial Services Rules is entitled, Ethical Requirements. Following are the major requirements of this code: 1. Adjusters may not directly negotiate with a claimant who is represented by an attorney. 2. In interviewing witnesses, adjusters must avoid any actions tending to induce a suppression or deviation from the truth. A witness who requests a copy of a statement given must be provided with a copy. 3. Adjusters shall not give legal advice. 4. Adjusters shall not draft special releases; they are permitted only to fill in blanks of forms provided by the insurer. 5. Adjusters will not take advantage of an incapacitated claimant which would be to the detriment of the claimant. 6. Adjusters will not knowingly fail to advise claimants of their rights under contracts and laws of the state. 7. Adjusters will approach all aspects of the process with an unprejudiced and open mind, make truthful and unbiased reports, handle all processes with integrity and accept no remuneration other than that to which there is legal entitlement, and act with diligence and due dispatch in achieving proper disposition of claims.

First developed as an extension of Ocean Marine coverage, to provide coverage for cargo traveling over land, instead of by sea

Commercial Inland Marine Coverage

An adjuster who is a salaried employee under the supervision of the home, branch, or regional claims department of insurers is defined as a(n):

Company or Staff Adjusters

Understand the benefits under the Workers Compensation Law.: PERMANENT TOTAL

Compensated at 66-2/3% of the employees average weekly wage during the period of disability, without limit of time. Only claimants with catastrophic injuries are eligible for Permanent Total benefits. Catastrophic injury means a permanent impairment constituted by: a. Spinal cord injury involving severe paralysis of an arm, a leg, or the trunk; b. Amputation of an arm, a hand, a foot, or a leg involving the effective loss of use of that appendage; c. Severe brain or closed-head injury; d. Second-degree or third-degree burns of 25% or more of the total body surface or third-degree burns of 5% or more to the face and hands; e. Total or industrial blindness; or If one who is being compensated as permanent total becomes rehabilitated to the extent that earning capacity is restored, benefits are changed to those described below for wage loss.

Understand the benefits under the Workers Compensation Law.: TEMPORARY TOTAL

Compensated at 66-2/3% of the employees average weekly wage for a period not to exceed 104 weeks. However, the employee may receive as high as 80% of average weekly wage up to $700 per week for up to six months during a period of retraining and rehabilitation after certain defined injuries. If the employee is still disabled at the end of the 104 weeks, or at the date of maximum medical improvement, whichever comes first, Temporary Total Disability benefits end and a determination is made as to whether the worker qualifies for Permanent Impairment status benefits. Date of maximum medical improvement means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability.

Understand the benefits under the Workers Compensation Law.: Temporary Partial

Compensated under the wage loss formula, for a period of up to 104 weeks of impaired earnings. This benefit is computed weekly. As for Temporary Total, if the disability still exists at the end of 104 weeks, the employee is reviewed for Permanent Impairment benefits.

Insures a condominium association against direct physical loss or damage to buildings, business personal property and personal property of others in the care, custody or control of the association and located at the premises:

Condominium Association Form

Identify those who may have an insurable interest in a property.

For insurance to respond to or on behalf of someone, insurable interest must exist at the time the covered event takes place. You must have a reason for insurance. ►NO: Taking out an insurance policy on a neighbors home down the block from you ►YES: Being listed on your Mother's homeowners policy because you are listed jointly on the mortgage The Florida Statutes require insurable interest, define it, and state at least one of its purposes, in F.S. 627.405: (A) Persons must have an insurable interest in the things insured at the time of the loss. (B) Insurable Interest = Any actual, lawful and substantial economic interest in the safety or preservation of the subject of the insurance free from loss, destruction, or pecuniary damage or impairment. (C) Measure of Insurable Interest = Extent to which the insured might be indemnified by loss, injury, or impairment thereof.

An adjuster who is self employed and not affiliated with either insurers or bureaus is defined as a(n):

Independent Adjuster

What is an Insurance Contract?

Insurance is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies.

Toxic wastes escaped from a gas station disposal tank. The insured operator discovers the leak and cleans up the spill. Unfortunately, the waste quickly seeped into the ground and has caused illness among the residents of a neighboring community This is an example of?

Known loss

If financial responsibility doesnt exist at the time of an accident, which of the following things must happen to avoid penalties?

LEGALLY CALID CLAIMS OF OTHERS MUST BE SATISIFED UP TO 10/20/10 AND THE OWNER AND OPERATOR MUST PROVIDE CERTIFICATION OF FUTURE RESPONSIBILITY FOR FUTURE ACCIDENTS

ON A HOMEOWNER'S POLICY, THIS PROTECTS THE INSURED FROM LEGAL LIABILITY FOR BODILY INJURY OR PROPERTY DAMAGE TO OTHERS

LIABILITY COVERAGE

AN INDIVIDUAL REPRESENTING AN INSURER AS TO LIFE INSURANCE AND ANNUITY CONTRACTS INCLUDING AGENTS APPOINTED TO TRANSACT LIFE INSURANCE FIXED DOLLAR ANNUITIES OR VARIABLE CONTRACTS BY THE SAME INSURER IS DEFINED AS:

LIFE AGENT

An individual representing an insurer as to life insurance and annuity contracts, including agents appointed to transact life insurance, fixed-dollar annuities, or variable contracts by the same insurer is defined as:

LIFE AGENT

Must be licensed, appointed by a General Lines Agent and can transact AUTO insurance only in the Office Only.

LIMITED CUSTOMER REPRESENTATIVE

A WRITTEN STATEMENT, GIVEN BY THE INSURED TO THE INSURER, ACKNOWLEDGING THAT MONEY RECEIVED IN THE SETTLEMENT OF DAMAGES IS RECEIVED NOT AS A FINAL PAYMENT, BUT AS AN ADVANCE PENDING AN OUTCOME OF A CLAIM AGAINST THE PERSON RESPONSIBLE FOR THE DAMAGE. THIS IS DEFINED AS:

LOAN RECEIPT

A written statement given by the insured to the insurer acknowledging that money received in the settlement of damages is received, not as a final payment, but as an advance pending an outcome of a claim against the person responsible for the damage. This is defined as a(n):

LOAN RECEIPT

JUSTIN OWNS A HOME THAT IS RECENTLY DAMAGED DUE TO A HURRICANE. THE REPAIR ESTIMATE IS AVERAGED AT $13,000 AND HE DECIDES TO STAY IN A HOTEL BC MOST OF THE DAMAGE IS TO HIS ROOF AND KITCHEN. UNDER HOMEOWNER'S POLICY, WHAT COVERAGE WILL PAY FOR THE HOTEL CHARGE?

LOSS OF USE

Cover only losses that both occurred and were discovered during the policy period, or within one year of its expiration. This is defined as:

LOSS SUSTAINED

A customer representative appointed by a general lines agent or agency in transacting only the business of private passenger motor vehicle insurance from the office of that agent or agency is defined as:

Limited Customer Service Representative

COINSURANCE FORMULA

Loss X Limit of Insurance = Loss Settlement (Loss Settlement Value of Property x Coinsurance Percentage)

Jeremy owns a home that is recently damaged due to a hurricane. The repair estimate is averaged at $25,000 and Jeremy decides to stay in a hotel becuase most of the damage is to his bedroom and kitchen. Under a Homeowner's Policy, what coverage will pay for the hotel room bill?

Loss of Use

When a person has lost stock certificates, bonds or similar instruments, a bond is generally required by the issuing company to reissue the document. This is known as a:

Lost Instrument Bond

Understand the Basic Pip Benefits. MEDICAL

MED PAY: 80% OF REASONABLE EXPENSES ARE PAID FOR NECESSARY MEDICAL, SURGICAL, XRAY, DENTAL, AND REHABILITATIVE SERVICES INCLUDING PROSTHETIC DEVICES, NECESSARY AMBULANCE, HOSPITAL AND NURSING SERVICES, AND NECESSARY REMEDIAL TREATMENT AND SERVICES PERMITTED BY LAW FOR AN INJURED PERSON WHO RELIES ON SPIRITUAL MEANS THROUGH PRAYER ALONE FOR HEALING IN ACCORDANCE WITH RELIGIOUS BELIEFS.

The coverage that is intended to afford protection against catastrophic losses is defined as

Major Medical

Samantha eats uncooked chicken at a local barbecue joint and becomes violently ill. Which of the following workers compensation benefits would pay for this occurrence?

None of the above

An individual appointed by a general lines or agency to assist that agent or agency in transacting the business of insurance from the office of that agent or agency is defined as:

Customer Representative

Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made:

OCCURENCE FORM

WHICH OF THE FOLLOWING HAS PRIMARY RESPONSIBILITY FOR EXAMINING THE QUALIFICATIONS OF INSURANCE COMPANIES SEEKING TO DO BUSINESS IN THIS STATE AND ADMITTING SUCH COMPANIES WHEN THEY HAVE MET THE NECESSARY QUALIFICATIONS

OIR (OFFICE OF INSURANCE REGULATION)

ON A HOMEOWNER'S POLICY, ITEMS THAT ARE NOT PERMANENTLY ATTACHED TO THE DWELLING ARE DEFINED AS:

OTHER STRUCTURES

Parties associated with a Bond.

Principal: One who undertakes to perform, to fulfill a contract or to meet an obligation. Obligee: One who is to be guaranteed that the principal will perform. Surety: As known as the Bonding Company - It Guarantees the performance.

The Commercial General Liability __________ identifies the named insured and address, states the policy period and premium and miscellaneous information about the insured, and specifies the limits of coverage that apply.

DECLARATIONS

Any material which is or may have been a motor vehicle or mobile home, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or for its component parts, or a combination of the two. This is defined as:

DERELICT

The Financial Responsibility Law is administered by?

DMV - DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

The __________ states that when there is an unbroken connection between an occurrence and damage that grows out of the occurrence, then the resultant damage is all a part of the occurrence.

DOCTRINE OF PROXIMATE CAUSE

WHICH FORMS IS ALL RISK ON THE DWELLING POLICY?

DP-3, or the Special form

Which of the following forms is "all-risk" on the dwelling policy?

DP-3, or the Special form

Under the Florida Unfair Insurance Trade Practices Act, penalties are provided for misrepresentation of business practices, which include all of the following except:

Denying claims with reasonable investigation

Any loss discovered during the policy period or within 60 days after its expiration (one year after expiration for losses connected with employee benefit plans) is covered regardless of when it occurred. This is defined as:

Discovery

When a business s personal property values fluctuate, a single, fixed amount of insurance could produce either over- or under-insurance at any given time. With this option, the limit of coverage is set at an amount somewhat higher than expected peak values.

VALUE REPORTING

When a business' personal property values fluctuate, a single, fixed amount of insurance could produce either over- or under-insurance at any given time. With this option, the limit of coverage is set at an amount somewhat higher than expected peak values.

VALUE REPORTING

THE VOLUNTARY OR INTENTIONAL RELINQUISHMENT OF A KNOWN RIGHT IS DEFINED AS A(N)

WAIVER

The voluntary or intentional relinquishment of a known right is defined as a(n):

WAIVER

This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force:

WAIVER OF PREMIUM

Understand the Basic Pip Benefits. WORK LOSS

WORK LOSS: 60% OF ANY LOSS OF GROSS INCOME AND LOSS OF EARNING CAPACITY PER INDIVIDUAL FROM INABILITY TO WORK PROXIMATECAUSED BY THE INJURIES SUSTAINED BY THE INJURED PERSON, PLUS ALL EXPENSES REASONABLY OCCURRED IN OBTAINING FROM OTHERS ORDINARY AND NECESSARY SERVICES IN LIEU OF THOSE THAT, BUT FOR THE INJURY, THE INJURED PERSON WOULD HAVE PERFORMED WITHOUT INCOME FOR THE BENEFIT OF HIS OR HER HOUSEHOLD ALL DISABILITY BENEFITS PAYABLE UNDER THIS PROVISION SHALL BE PAID NOT LESS THAN 2 WEEKS.

Website for the Florida Department of Financial Services.

WWW.FLDFS.COM

A policy condition, either based on information in the insured s application or inserted by the insurer, is defined as:

Warranty

The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10

Split

Guarantees the performance between the principle and the obligee:

Surety

Which of the following is not one of the "Thresholds" in the "No-Fault" law?

TEMPORARY INJURY OF THE INSURED

Under Crime Insurance, losses must be discovered within 1 year. This is defined as:

THE DISCOVERY PERIOD

What are the Minimum Requirements for the Financial Responsibility Law? (There are 2)

THE LEGAL VALID CLAIMS OF OTHERS MUST BE SATISFIED UP TO THE 10/20/10 REQUIREMENTS THE OWNER/OPERATOR MUST PROVIDE CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR FUTURE ACCIDENTS

ALL OF THE FOLLOWING ARE "THRESHOLDS" OF THE "NO-FAULT" LAW, EXCEPT?

THRESHOLDS ARE: (1) Significant and permanent loss of a bodily function, or (2) Permanent injury other than scarring and disfigurement, or (3) Significant and permanent scarring or disfigurement, or (4) Death.

Defaming a competitor company or agent is not only unprofessional, it can also result in a license suspension.

TRUE

HOW MANY CARRIERS MUST A RISK BE REFUSED BEFORE IT CAN BE WRITTEN WITH THE FWCJUA?

TWO

The following are classes of disability, except

Temporary Full

Three full-time employees from a local furniture company are horsing around and one is pushed into a machine that cut his foot. How will the company's General Liability respond?

The GL policy will not pay

The Business Automobile Policy includes all of the following coverage forms except:

The Trailer Interchange Coverage Form

Understand the Coinsurance Clause and how it may apply to a given scenario.

The coinsurance clause on a property policy requires that the policyholder carry, as a minimum, a specified percent of the dwelling's replacement cost. Failure to do so results in a monetary penalty at the time of a loss. The percentage is 80%, used almost without exception in the coinsurance clause of a Homeowner policy. This means that the insured SHOULD carry 80% of the replacement cost, if they don't want to be penalized by the coinsurance clause at the time of a loss.

ACTUAL CASH VALUE OR ACV IS DEFINED AS?

REPLACEMENT COST MINUS DEPRECIATION

Duties and functions of the Department of Financial Services include all of the following except:

Rating and underwriting rules

Identify the perils covered by comprehensive coverage - Does the deductible apply to them all?

Referred to as "Other than Collision." Damage to Your Vehicle not caused by Collision. For example, an animal that runs out into your vehicle, hail damage on the hood, glass claims (windshields are replaced for free in Florida, you are not responsible for paying the deductible), etc. Deductible if it is not a windshield.

An optional alternative providing for adjustment of premium after expiration, based on a guaranteed basic premium to the insurer to which is added the actual losses incurred by the insured. This is defined as:

Retrospective Rating Plan

A motor vehicle or mobile home which is a total loss is defined as:

SALVAGE

Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as:

SALVAGE

Insurance applies separately to each insured as if other insureds did not exist. This is defined as:

SEVERABILITY

Charging an applicant for a specific ancillary coverage or product, in addition to the cost of the insurance coverage provided for, without the informed consent of the applicant is a practice of:

SLIDING

While selling an Automobile policy to a customer, an agent tells them that they are also required to purchase an Emergency Road Service Plan, even though that is not true. This is an example of:

SLIDING

Identify examples of Transacting Insurance.

SOLICITATION OF INSURANCE, NEGOTIATION OF INSURANCE, EFFECTING COVERAGE (BINDING INSURANCE COVERAGE). TRANSACTING INSURANCE MATTERS (DURING AND AFTER INSURANCE IS BOUND ONE CANNOT TRANSACT INSURANCE WITHOUT THE PROPER LICENSE)

Identify examples of a Peril. ►Fire and theft are common examples.

SOMETHING THAT CAUSES A LOSS. INCLUDING FIRE, WINDSTORM, FLOOD AFTER HURRICANE, ETC

Understand what the Declarations of a policy outlines.

STATES: THE INSURED(S) AND PROPERTY COVERED, THE LIMITS OF INSURANCE, DEDUCTIBLES, INCEPTION AND EXPIRATION DATES OF COVERAGE, IDENTIFY FORMS AND ENDORSEMENTS THAT APPLY, CONTAINS CERTAIN OTHER INFO RELEVANT TO RISK SUCH AS IDENTIFICATION OF MORTGAGE HOLDERS.

This type of bond covers streets, sidealks, sewers, etc.:

SUBDIVISION

What payment covers several areas of costs related to claims, and are payable in addition to the policy limits?

SUPPLEMENTARY

Taking, or attempted taking of property from within a locked safe or vault, by unlawful entry, with visible marks of forcible entry, or taking of the safe or vault from inside the premises. This is defined as:

Safe Burglary

All of the following are components of Workers Compensation, except:

Up to $750,000 in Death Benefits

The Loss Settlement Valuation that subtracts an allowance for depreciation is defined as?

actual cash value

Which of the following are characteristics of a License Bond?

Which of the following are characteristics of a License Bond? A. To guarantee the licensee will act according to the laws B. Protect the public from unfair business practice C. Proper collection and payment of taxes D. All of the Above *ALL OF THE ABOVE**

Which of the following can be found in a Commercial General Liability Contract?

Which of the following can be found in a Commercial General Liability Contract? A. Declarations B. Common Policy Conditions C. Two Forms: Occurence & Claims-Made D. ALL OF THE ABOVE

A(n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject:

insurable interest

States that if the insurer adopts a revision which would broaden coverage without additional premium within some period of time prior to the policy period or during the policy period, the insured receives the benefit of such broadened coverage.

liberalization

The following are basic characteristics of a property or liability insurance contract, except:

loss settlement contract

EMPLOYEE THEFT COVERAGE MAY BE WRITTEN IN WHICH WAY?

coverage may be written in three ways: -Scheduled Persons coverage: covers loss only from scheduled individual employees. -Scheduled Position coverage: covers loss only from persons who fill scheduled positions. -Blanket coverage: covers loss caused by any employee.

AN INSURED WHO WISHES TO HAVE FLOOD INSURANCE COVERAGE, BUT IS NOT LOCATED IN A FLOOD ZONE MAY DO SO BY PURCHASING A

Preferred Risk Flood Policy

An insured who wishes to purchase flood insurance, but is not located in a flood zone may do so by purchasing a:

Preferred Risk Flood Policy

After pleading guilty or no contest to a felony, a licensed individual has _________ days to inform the Department?

30

Every licensee shall notify the department, in writing, after a change of name, residence address, principal business street address and/or mailing address within how many days?

30 DAYS

How long does one have to notify the Department of Financial Services for a Name and/or Address Change?

30 DAYS

IF A LICENSEE HAS A CHANGE IN NAME OR ADDRESS, HOW LONG DOES HE OR SHE HAVE TO NOTIFY THE DEPT OF FINANCIAL SERVICES?

30 DAYS

How does PIP apply to Pedestrians - In and out of the State?

) If the person is a Florida resident, if struck by the insured's motor vehicle while not occupying a self-propelled vehicle (For Example, while a pedestrian). An analysis of persons entitlement to PIP benefits reveals the general approach intended by the law: (1) One who owns a motor vehicle is expected to fund PIP for oneself and all residing family members provided the family members are not themselves owners of a motor vehicle (rather than looking to others who may have caused injury). (2) Those who do not own motor vehicles or belong to a family which owns a motor vehicle are entitled to the PIP benefits of the owner of the motor vehicle they were occupying or by which they were struck. In those situations wherein PIP does not apply, named insured and relatives occupying or struck by others vehicles out-of-state; nonresident passengers out-of-state; and nonresidents as pedestrians in Florida - The No-Fault Law has no applicability and usual legal remedies and other insurance coverage's are to be relied upon.

FAJUA

- FLORIDA AUTOMOBILE JOINT UNDERWRITING ASSOCIATION

FRPCJUA

- FLORIDA RESIDENTIAL PROPERTY AND CASUALTY JOINT UNDERWRITING ASSOCIATION (PART OF CITIZENS)

What associations are Citizens Property and Insurance made up of?

- FLORIDA RESIDENTIAL PROPERTY AND CASUALTY JOINT UNDERWRITING ASSOCIATION (PART OF CITIZENS) - FLORIDA WINDSTORM UNDERWRITING ASSOCIATION (PART OF CITIZENS)

FWUA

- FLORIDA WINDSTORM UNDERWRITING ASSOCIATION (PART OF CITIZENS)

FWCJUA

- FLORIDA WORKER'S COMPENSATION JOINT UNDERWRITING ASSOCIATION

Define the characteristics of a Homeowners Policy.

-Protects against economic loss to residences and household personal property, and legal liabilities -Personal, non-business risk, no more than two roomers/boarders -Owner-occupants of 1-4 family dwellings -Renters who maintain residential occupancy in any type of building -Condominium unit owners and cooperative apartment occupants -Homeowners may not be used to cover property located on a farm premises, but light farming that is purely incidental to occupancy of a dwelling is permitted.

Frank has a not-at-fault accident, he has basic PIP, no deductible and Med pay of $5,000. How much will his Med Pay contribute to medical bills of $15,000?

. $5,000

All of the following are requirements for the "Code of Ethics," except:

. Adjusters may negotiate with a claimant who is represented by an attorney

The Insurer s responsibility to pay for a property loss may be conditioned on the insured having used reasonable means to avoid the loss, to protect the property against further loss, and to give the insurer proof of the loss is defined as?

. Conditional Contract

There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions:

0%

What are some reasons for suspension, revocation or termination of a license?

1. Transacting insurance outside of scope of one's license ►For example, an individual cannot sell life insurance if he or she has a Customer Service license but has not obtained a life license. 2. Misrepresentation or Fraud. 3. Participating in unfair methods of competition. ►Using discriminatory practices, making false entries on an insurance application or defaming others. 4. Sliding: Selling an item and stating that it is required by law (when it is not). 5. Demonstration of unworthiness or lack of fitness. 6. Misappropriation of funds. 7. Failure to inform Department of Financial Services, within 30 days, after pleading guilty or no contest to a felony.

Personal Injury Protection, or PIP, has a __________ per person, per accident limit.

10,000

Understand the Basic Pip Benefits. REPLACEMENT SERVICES

100% OF REASONABLE EXPENSES ARE PAID INCURRED FOR ORDINARY AND NECESSARY SERVICES YOU WOULD'VE PERFORMED EXCEPT THE INJURY FOR THE BENEFIT OF YOUR HOUSEHOLD DURING THE TIME YOU'RE UNABLE TO WORK.

Under Employer's Liability, the minimum limits of liability are:

100/100/500

AN INSURANCE CLAIM'S ADJUSTER IS REQUIRED TO COMPLY WITH 24 HOURS OF CONTINUING EDUCATION EVERY

2 YEARS

HOW MANY CALENDAR DAYS DOES AN INSURER HAVE TO FURNISH THE DEPT OF INSURANCE A RESPONSE CONCERNING A CLAIM?

21 CALENDAR DAYS

A licensed General Lines Claim Adjuster is required to complete how many hours of continuing education every two years?

24

How many continuing education hours must an insurance adjuster complete every 2 years?

24

Continuing Education requirements for a 6-20 License.

24 EVERY 2 YEARS

As to required proof for future accidents by purchase of auto liability insurance, the insurer must make a filing (Form SR-22) certifying that coverage is in effect, and this certification must remain on file for __________ years:

3

Which of the following are not considered to be an adjuster:

GENERAL LINES ADJUSTER

An agent who transacts any one or more of the following types of insurance: Property, Casualty, Surety, Marine, and Health is defined as a(n):

GENERAL LINES AGENT

Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles:

Garage Coverage Form

What types of Insurance licenses are offered by the Department and how do they differ?

General Lines Agent 2-20 Licensed to write property/casualty, surety or health insurance. Customer Representative 4-40 Must be licensed, appointed by a General Lines Agent and may assist in transactions. in the OFFICE ONLY Limited Customer Representative 4-42 Must be licensed, appointed by a General Lines Agent and transact AUTO insurance in the OFFICE ONLY. Claim Adjuster Licenses All Lines Claims Adjuster 6-20 Investigates, Evaluates and Negotiates Claims. The 3-20 License is a Public Adjuster License. Public Adjusters do not represent insurance companies but policyholders. They are subject to an entirely different set of requirements.

A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium.

HMO

The District of Columbia and any state or territory of the United States in which an insurance agent maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance agent. This is defined as:

HOME STATE

Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance:

HOSPITAL INDEMNITY

Identify examples of when Other than Collision (also referred to as Comprehensive Coverage) is used.

Hail Storm damages hood, animal runs into car and windshield replacement are common examples of when this coverage is used Identify the penalties for not complying with the No-Fault Law.

An agent representing a health maintenance organization , or as to health insurance only, an insurer transacting health insurance is defined as a(n):

Health Agent

Provides indemnification to the insured for basic hospitalization of room and board in the hospital, nursing care, laboratory fees, operating room, medical supplies, etc. This is defined as?

Hospitalization Expense

THIS WAIVER IS A RESULT FROM SOME ACT OF NEGLECT ON THE PART OF THE ADJUSTER:

IMPLIED WAIVER

May act as part of the bonding party and agrees to reimburse the surety for any loss it may suffer from having bonded the principal:

INDEMNITOR

Understand the benefits under the Workers Compensation Law.: PERMANENT IMPAIRMENT

Impairment benefits are based upon a medical impairment rating schedule approved by the Division of Workers Compensation. Once the rating (based upon the degree of injury) is assigned, the benefits are paid weekly at the rate of 75% of the employees average weekly Temporary Total Disability benefit, and continue until the earlier of either (1) two weeks for each percentage of the impairment up to 10%; three weeks for each percentage of impairment from 11% to 15%; four weeks for each percentage of impairment from 16% to 20%; six weeks for each percent of impairment from 21% and higher; or (2) the death of the employee.

Understand the features of Major Medical Insurance.

Major medical coverage is intended to afford protection against catastrophic losses. Some forms are designed to supplement basic hospital/surgical policies; others intend to provide both basic and catastrophic illness coverage. The policy is generally characterized by a deductible, a high maximum limit, and a percentage participation, or coinsurance. In addition, it may contain internal limits for hospital daily room charges (or state, for example, it will pay the hospital's customary semi-private room rate) and for surgical services. Major Medical policies may include maximum limits of $10,000 to $1,000,000 or more, deductibles of up to 10% of the maximum limit and coinsurance percentages of 20 or 25%.

A lender has an insurable interest in a home and finds protection in the:

Mortgagee Clause

On a Homeowner's Policy, covers items that are not permanately attached to the dwelling. This is defined as:

Other Structures

Provides for loss of money and securities outside the premises in the care, custody and control of a messenger or armored car service resulting from theft, disappearance or destruction. This is defined as:

Outside the Premises

This bond guarantees indemnification to the obligee for any losses resulting from the principal s failure to complete the contract work in accord with specifications:

PERFORMANCE

PIP Versus Workers Compensation - Which is excess?

PIP IS PRIMARY AGAINST ALL OTHER FORMS OF MEDICAL AND DISABILITY, EXCEPT WORKER'S COMP WORKER'S COMP = PRIMARY PIP = EXCESS

The adjuster's investigation may include all of the following except:

POLICY CANCELLATION

__________ is a selected group of hospitals and medical practitioners in a given area who have joined together in an effort to reduce medical costs.

PPO

THE PROGRAM WHICH IS A SELECTED GROUP OF HOSPITALS AND MEDICAL PRACTITIONERS IN A GIVEN AREA THAT HAVE JOINED TOGETHER IN AN EFFORT TO REDUCE MEDICAL COST IS DEFINED AS:

PPO - preferred provider organization

One who undertakes to perform, to fulfill a contract or to meet an obligation is known as:

PRINCIPAL

An adjuster who represents the financial interests of the insured named in the policy is defined as a(n):

PUBLIC ADJUSTER

Compare and contrast the different types of adjusters.

There are various titles for claim adjusters: employee or staff adjusters, independent adjusters, bureau adjusters, public adjusters and fee adjusters. Company or staff adjusters are salaried employees under the supervision of the home, branch or regional claims department of insurers. Fee adjusters are those who offer their services on a fee-for-service basis. They represent many insurers. Bureau and independent adjusters are examples of fee adjusters. A bureau adjuster is an employee or agent of an adjustment bureau which serves multiple company clients, such as the GAB Business Services, Inc. and Underwriters Adjusting Company, both national firms. An independent adjuster, like the bureau adjuster, is in the "fee adjuster" category. As the name implies, however, independent adjusters are self-employed and are not affiliated with either insurers or bureaus. They serve as adjuster representatives of insurers, and their services are compensated on a fee-plus-expenses basis for each loss handled. Rather than staff, bureau or independent adjusters, many insurers still utilize "state and special agents" in the adjusting of some claims, especially in property insurance. In addition, local agents may serve as adjusters, although usually only in regard to small losses under property insurance contracts. A public adjuster is a claims adjuster who is an advocate for the policyholder in appraising and negotiating an insurance claim. Aside from attorneys, public adjusters licensed by the Department of Financial Services are the only type of claims adjuster that can legally represent the rights of an insured during an insurance claim process. A public adjuster will offer the most benefit when it is clear that the insurer will pay the claim and the only issue is the proper identification and valuation of the loss. Most public adjusters charge a percentage of the settlement. Primarily they appraise the damage, prepare a claim and negotiate with the insurance company adjuster.

When making any payment for damage to an automobile for a partial loss, the insurer shall have printed on the loss settlement, "Failure to use the insurance proceeds in accordance with the security agreement, if any, could be a violation of s.812.014, Florida Statutes." This is payment for a(n):

Third Party Claim

Understand the Florida Unfair Insurance Trade Practices Act

This law, Florida Statutes 626.9541, describes certain practices which are prohibited. In the area of claim practices, penalties are provided for misrepresentation to insureds and claimants, and business practices, such as: 1. Failing to act promptly. 2. Failure to affirm or deny a claim when an insured is entitled thereto. 3. Failure to explain claim denials in writing. 4. Failure to maintain complaint-handling procedures, such as keeping accurate records of complaints. It is important for an adjuster to avoid violations of the Unfair Trade Practices Act. The insurer, in whose behalf the adjuster performs, may be subjected to administrative penalties if the adjuster commits an infraction.

A General Lines Agent instructs a licensed Customer Representative 4-40 to thoroughly cover the details of a new life insurance product with every Homeowner customer who calls or visits the office. The agent provides training on the new product. Although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested. Which of the following is true?

This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license.