Adjusting - C

Which of the following shows a correct sequence of activities for an adjuster when negotiating a claim? a) determine the cost to repair or replace, then check for coverage under the policy b) determining the amount of damage,, then check the policy coverage c) acknowledging the claim, then opening a line of communication with the insured or claimant d) negotiating the settlement, then completing the investigation

c) acknowledging the claim, then opening a line of communication with the insured or claimant

Which of the following would not be determined by a court when an insurer has filed a declaratory judgment action? a) if a particular insuring agreement would provide coverage for the claim that is the subject of the action b) they type and amount of damages that will be paid to a plaintiff for the claim that is being disputed c) if a particular exclusion would apply to the claim that is the sibject of the action d) the amount of other insurance that would apply ot a claim if other policies cover the loss

b) the type and amount of damages that will be paid to a plaintiff for the claim that is being disputed

Which of the following is NOT a reason that proper claim reserving techniques should be used? a) To ensure that the company has enough reserve on hand to meet the company's current claim obligations b) to permit the insurer to present a better financial picture to regulatory officials that is accurate c) to prevent the necessity of raising premium rates d) to prevent underwriters from making inaccurate coverage decisions on data prior to claims

b) to permit the insurer to present a better financial picture to regulatory official than is accurate

The most common reason an insurer issues a reservation of right notice to an insured is

because the insured failed to provide prompt notice of the loss

Which of the following most closely describes a claim reserve? a) an estimate of all losses paid to date on claims b) an amount set aside to pay a claimant's attorney c) an expectation of losses incurred but not yet reported d) an amount expected to be ultimately paid on an open claim

d) an amount expected to be ultimately paid on an open claim

a disadvantage to using the "formula method" to set claim reserves is

it does not take into consideration the specific circumstances of a claim

A loss reserving method that establishes aggregate reserves for all claims for a single line of insurance is known as:

loss ratio method

Selena is a claims representative. She has reviewed and set the reserves for a claim. She asks her friend and fellow claims representative, Orville, to independently evaluate and set the reserve on the same claim file. Selena is using which of the methods to set her claim reserves?

roundtable method

An adjuster has uncovered a potential coverage issue in matters pertaining to a claim and is unable to contact the insured to discuss these matters. What should the adjuster do in this situation?

send a reservation of rights letter to the insured's last known address

a method of setting claim reserves based on the claim's circumstances and the claim reps experience in handling similar claims is known as

the individual case method