Florida 3-20 Public Adjuster Exam Outlines

Homeowners Coverage A

"Dwelling" covers the dwelling building and structures attached; also construction materials and supplies on or adjacent to the premises.

Homeowners Coverage C

(Actual Cash Value) Personal Property Coverage: Usually for 50% of coverage A (in addition)

Two types of Waivers

1.Explicit 2.Implied

Basic Extended Reporting Period for CGL

60 Days after expiration

626.854 (3)

A public adjuster may not give legal advice or act on behalf of or aid any person in negotiating or settling a claim relating to bodily injury, death, or noneconomic damages.

Why is it common to have the attorney's name on the settlement draft?

Because should the insurer pay over the money solely to the claimant, the attorney may sue the company for the fee

CGL Coverage A

Bodily Injury and Property Damage Insuring Agreement

Form SR-22

Drivers Convicted of DUI or a traffic felony over the prior 3 years are required to have 100/300/50 coverage or a certificate of self insurance of $350,000.

What must the Insured do if they wish to completely reject Windstorm Coverage?

Hand write "I DO NOT WANT THE INSURANCE ON MY (HOME/MOBILE HOME/CONDOMINIUM UNIT) TO PAY FOR DAMAGE FROM WINDSTORMS OR HURRICANES. I WILL PAY THOSE COSTS. MY INSURANCE WILL NOT."

Beginning statement of a liability insurance policy

Insurer agrees "to pay on behalf of the insured all sums the insured becomes legally obligated to pay as damages" or equivalent wording.

Homeowners Coverage D

Loss of Use-

HO-4 Policy

Renters policy. Personal property covered for broad perils.

What are the two main divisions of a Home Owners Form?

Section I-Property&Section II-Liability

Statute 627.409

Statute covering misrepresentation by the insured. Only a defense for the insurer if they didn't know and it would have affected the coverage offer.

accident

Sudden, unexpected event

Retro-Active Date

The date on which the coverage legally began.

Mediation Statute 627.7015

The department shall adopt by rule a property insurance mediation program to be administered by the department or its designee. The department may also adopt special rules which are applicable in cases of an emergency within the state. The rules shall be modeled after practices and procedures set forth in mediation rules of procedure adopted by the Supreme Court. The rules shall provide for:(a) Reasonable requirement for processing and scheduling of requests for mediation.(b) Qualifications, denial of application, suspension, revocation of approval, and other penalties for mediators as provided in s. 627.745 and the Florida Rules for Certified and Court-Appointed Mediators.(c) Provisions governing who may attend mediation conferences.(d) Selection of mediators.(e) Criteria for the conduct of mediation conferences.(f) Right to legal counsel. (5) All statements made and documents produced at a mediation conference shall be deemed to be settlement negotiations in anticipation of litigation within the scope of s. 90.408. All parties to the mediation must negotiate in good faith and must have the authority to immediately settle the claim. Mediators are deemed to be agents of the department and shall have the immunity from suit provided in s. 44.107. (6)(a) Mediation is nonbinding; however, if a written settlement is reached, the policyholder has 3 business days within which the policyholder may rescind the settlement unless the policyholder has cashed or deposited any check or draft disbursed to the policyholder for the disputed matters as a result of the conference. If a settlement agreement is reached and is not rescinded, it is binding and acts as a release of all specific claims that were presented in that mediation conference. (b) At the conclusion of the mediation, the mediator shall provide a written report of the results of mediation, including any settlement amount, to the insurer, the policyholder, and the policyholder's representative if the policyholder is represented at the mediation. (7) If the insurer fails to comply with subsection (2) by failing to notify a policyholder of its right to participate in the mediation program under this section or if the insurer requests the mediation, and the mediation results are rejected by either party, the policyholder is not required to submit to or participate in any contractual loss appraisal process of the property loss damage as a precondition to legal action for breach of contract against the insurer for its failure to pay the policyholder's claims covered by the policy. (8) The department may designate an entity or person to serve as administrator to carry out any of the provisions of this section and may take this action by means of a written contract or agreement. (9) For purposes of this section, the term "claim" refers to any dispute between an insurer and a policyholder relating to a material issue of fact other than a dispute:(a) With respect to which the insurer has a reasonable basis to suspect fraud;(b) When, based on agreed-upon facts as to the cause of loss, there is no coverage under the policy;(c) With respect to which the insurer has a reasonable basis to believe that the policyholder has intentionally made a material misrepresentation of fact which is relevant to the claim, and the entire request for payment of a loss has been denied on the basis of the material misrepresentation;(d) With respect to which the amount in controversy is less than $500, unless the parties agree to mediate a dispute involving a lesser amount; or(e) With respect to a windstorm or hurricane loss that does not comply with s. 627.70132.

626.854 (14) (b)

The insurer may not exclude the public adjuster from its in-person meetings with the insured. The insurer shall meet or communicate with the public adjuster in an effort to reach agreement as to the scope of the covered loss under the insurance policy. The public adjuster shall meet or communicate with the insurer in an effort to reach agree

DP-3 Special Form

covers the dwelling and other structures on an open perils basis, except for the perils specifically excluded.

Broad Form

covers the same 11 perils, but adds 6 more: Falling objects, Weight of ice, snow or sleet, accidental discharge or overflow of water or stream from within plumbing or related systems; does not include discharge or overflow of water from a sump, sudden and accidental rupture of heating, air conditioning, fire protective sprinkler, or hot water heating system. Freezing of plumbing or related systems. And Sudden and accidental damage from artificially generated electrical current.

Basic Form

covers these 11 "perils" or causes of loss: Fire or Lightning, Smoke, Windstorm or Hail, Explosion, Riot or Civil Commotion, Aircraft (striking the property), Vehicles (striking the property), Glass Breakage, Vandalism & Malicious Mischief, Theft, and Volcanic Eruption.

HO-8 Policy

form is a modified version that provides coverage for homeowners unable to attain an HO-3 policy for their older home — typically more than 40 years old. Under an HO-8 policy, the insured's dwelling, personal property, liability, and loss of use are covered. However, it should be noted this insurance policy will not go as far in covering your home and personal belongings as an HO-3 or HO-5 policy. An______ will at least provide certain key coverages against the most common perils (causes of loss)

HO-2 Policy

home insurance policy covers only your home and personal property against threats specifically named on the policy's declarations page. named peril policy — the covered threats are specifically listed. Below are the 16 named perils covered:. Lightning or fire Hail or windstorm Damage caused by aircraft Explosions Riots or civil disturbances Smoke damage Damage caused by vehicles Theft Vandalism Falling objects Volcanic eruption Damage from the weight of snow, ice, or sleet Water damage from plumbing, heating, or air conditioning overflow Water heater cracking, tearing, and burning Damage from electrical current Frozen pipes These policies are uncommon. Most insurance companies only write an_____ if they deem the risk presented by you and your property to be too great for a higher-level policy. An ____ policy can leave you and your belongings vulnerable to many unnamed perils.

HO-6 Policy

is home insurance for owners of co-ops or condominiums. It provides personal property coverage, liability coverage and specific coverage of improvements to the owner's unit. ... An HO-6 policy will cover interior damage to your unit, improvements, additions and alterations you've made and your personal property.

Valued Policy Law

requires payment of the face amount of insurance to the insured if a total loss to real property occurs from a peril specified in the law

Part D - Coverage for damage to your auto

the insurance company agrees to pay an amount in excess of your deductible for direct and accidental loss to your covered car or any other car specified in the agreement. Thus, it pays for damage or theft to your car.

627.70131 Insurer's duty to acknowledge communications regarding claims; investigation.

(1) Upon an insurer's receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgment. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer's claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. (2) Such acknowledgment shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment shall provide necessary claim forms, and instructions, including an appropriate telephone number. (3) Unless otherwise provided by the policy of insurance or by law, within 10 working days after an insurer receives proof of loss statements, the insurer shall begin such investigation as is reasonably necessary unless the failure to begin such investigation is caused by factors beyond the control of the insurer which reasonably prevent the commencement of such investigation. (4) For purposes of this section, the term "insurer" means any residential property insurer. (5)(a) Within 90 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. Any payment of an initial or supplemental claim or portion of such claim made 90 days after the insurer receives notice of the claim, or made more than 15 days after there are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured shall select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. (b) Notwithstanding subsection (4), for purposes of this subsection, the term "claim" means any of the following:1. A claim under an insurance policy providing residential coverage as defined in s. 627.4025(1);2. A claim for structural or contents coverage under a commercial property insurance policy if the insured structure is 10,000 square feet or less; or3. A claim for contents coverage under a commercial tenant policy if the insured premises is 10,000 square feet or less. (c) This subsection shall not apply to claims under an insurance policy covering nonresidential commercial structures or contents in more than one state.

Two main defenses against Negligence

1. Assumption of Risk 2.Comparative Negligence

Four Additional Homeowners Coverages

1. Claims Expense 2. First Aid Expenses 3. Damage to Property of Others 4. Loss Assessment

4 Subsections of Section I of a Property Coverage Policy

1. Coverage 2.Perils Insured Against 3.Exclusions 4.Conditions

4 Exceptions to Tort Exemption(Threshold of No-Fault)

1. Significant and Permanent loss of bodily function. 2.Permanent injury other than scarring and disfigurement. 3.Significant and Permanent scarring or disfigurement. 4.Death

4 Elements of a Valid Contract?

1.A manifestation of assent to its terms by parties who make the contract. 2.A sufficient consideration (value or payment) for each promise. 3.Legal Capacity of the parties to contract. 4.Legal Subject matter.

7 Common CGL Conditions

1.Cancellation(30 Days by insurer option, 10 Days By no payment). 2.Changes 3.Examination of Books 4.Inspections and Surveys 5.Premiums 6.Transfer 7.Nuclear Endorsement

What are the two broad classifications of damages that a plaintiff can seek in an action for money damages?

1.Compensatory 2.Punitive

A Homeowners Policy consists of(3 components):

1.Declarations 2.One of 6 Homeowners forms 3.Mandatory and optional endorsements

Contents of a CGL Contract

1.Declarations Form 2.Common Policy Conditions Form 3. One of:A.Occurrence Form B.Claims Made Form 4.Nuclear Energy Liability Exclusion Endorsement.

6 Responsibilities of the Public Adjuster

1.Evaluate 2.Substantiate 3.Determine values 4.Negotiate 5.Recommend(upgraded insurance) 6.Re-Open Claims

Declarations of a CGL Contract(4)

1.Named Insured(including address) 2.Policy Period 3.Premium 4.Limits of Coverage

2 Types of Tort Liability

1.Negligent Liability(Unintentional) 2.Strict Liability(Intentional)

The 3 Conditions that define work as "completed"

1.When all work called for in the contract is completed. 2.When all work to be done at the site has been completed if one contract calls for work at more than one site. 3.When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor.

Three Ways in which the limits to a liability insurance policy Insuring Agreement can be expressed?

1.single limit 2.split limit 3.Aggregate limit

How much notice must the insurer give the insured of non-renewal of a homeowner's Policy?

120 Days

What is the limit to the Public Adjuster's share of a re-opened claim

20% (626.854(10)(a)).

How long does the client have to cancel the Public Adjuster's Contract

3 Business Days 626.854 (6)

What is the standard limit of Homeowner's Coverage D for: HO-2, HO-3 & HO-5?

30% of Coverage A

How long must a Public Adjuster wait after an event that leads to a claim to contact the claimant?

48 hours. (626.854(13))

How long must the Public Adjuster keep his written estimate of the claimant's Loss.

5 years 626.854 (11)

Statute that requires that when Property is Insured for replacement cost is deemed a total loss, the full replacement cost without reservation or holdback of depreciation must be paid.

627.7011

How long does a residential property policy have to be in effect to hold the insured immune to 627.409(fraud by insured)

90 Days

626.854 (13)

A company employee adjuster, independent adjuster, attorney, investigator, or other persons acting on behalf of an insurer that needs access to an insured or claimant or to the insured property that is the subject of a claim must provide at least 48 hours' notice to the insured or claimant, public adjuster, or legal representative before scheduling a meeting with the claimant or an onsite inspection of the insured property. The insured or claimant may deny access to the property if the notice has not been provided. The insured or claimant may waive the 48-hour notice.

626.854 (15)

A licensed contractor under part I of chapter 489, or a subcontractor, may not adjust a claim on behalf of an insured unless licensed and compliant as a public adjuster under this chapter. However, the contractor may discuss or explain a bid for construction or repair of covered property with the residential property owner who has suffered loss or damage covered by a property insurance policy, or the insurer of such property, if the contractor is doing so for the usual and customary fees applicable to the work to be performed as stated in the contract between the contractor and the insured.

Coinsurance

A policy for less than the entire value of the insured property and cover pro-rata whether or not other insurance exists. 80% actually means (pro-rata share)/80%

626.854 (14) (c)

A public adjuster may not act or fail to reasonably act in any manner that obstructs or prevents an insurer or insurer's adjuster from timely conducting an inspection of any part of the insured property for which there is a claim for loss or damage. The public adjuster representing the insureds may be present for the insurer's inspection, but if the unavailability of the public adjuster otherwise delays the insurer's timely inspection of the property, the public adjuster or the insureds must allow the insurer to have access to the property without the participation or presence of the public adjuster or insureds in order to facilitate the insurer's prompt inspection of the loss or damage.

626.854 (10) (b)

A public adjuster may not charge, agree to, or accept from any source compensation, payment, commission, fee, or any other thing of value in excess of: 1. Ten percent of the amount of insurance claim payments made by the insurer for claims based on events that are the subject of a declaration of a state of emergency by the Governor. This provision applies to claims made during the year after the declaration of emergency. After that year, the limitations in subparagraph 2. apply. 2. Twenty percent of the amount of insurance claim payments made by the insurer for claims that are not based on events that are the subject of a declaration of a state of emergency by the Governor.

626.854 (5)

A public adjuster may not directly or indirectly through any other person or entity solicit an insured or claimant by any means except on Monday through Saturday of each week and only between the hours of 8 a.m. and 8 p.m. on those days.

626.854 (16)

A public adjuster shall not acquire any interest in salvaged property, except with the written consent and permission of the insured through a signed affidavit.

626.854 (17)

A public adjuster, a public adjuster apprentice, or a person acting on behalf of an adjuster or apprentice may not enter into a contract or accept a power of attorney that vests in the public adjuster, the public adjuster apprentice, or the person acting on behalf of the adjuster or apprentice the effective authority to choose the persons or entities that will perform repair work in a property insurance claim or provide goods or services that will require the insured or third-party claimant to expend funds in excess of those payable to the public adjuster under the terms of the contract for adjusting services.

626.854 (8)

A public adjuster, a public adjuster apprentice, or any person or entity acting on behalf of a public adjuster or public adjuster apprentice may not give or offer to give a monetary loan or advance to a client or prospective client.

626.854 (9)

A public adjuster, public adjuster apprentice, or any individual or entity acting on behalf of a public adjuster or public adjuster apprentice may not give or offer to give, directly or indirectly, any article of merchandise having a value in excess of $25 to any individual for the purpose of advertising or as an inducement to entering into a contract with a public adjuster.

626.854 (12)

A public adjuster, public adjuster apprentice, or any person acting on behalf of a public adjuster or apprentice may not accept referrals of business from any person with whom the public adjuster conducts business if there is any form or manner of agreement to compensate the person, directly or indirectly, for referring business to the public adjuster. A public adjuster may not compensate any person, except for another public adjuster, directly or indirectly, for the principal purpose of referring business to the public adjuster.

Occurance

An accident, including continuous or repeated exposure to substantially the same general harmful conditions.

Does Hurricane Coverage Occur on a Per Occurrence or an Annual Basis

An annual basis

626.854 (6)

An insured or claimant may cancel a public adjuster's contract to adjust a claim without penalty or obligation within 3 business days after the date on which the contract is executed or within 3 business days after the date on which the insured or claimant has notified the insurer of the claim, whichever is later. The public adjuster's contract must disclose to the insured or claimant his or her right to cancel the contract and advise the insured or claimant that notice of cancellation must be submitted in writing and sent by certified mail, return receipt requested, or other form of mailing that provides proof thereof, to the public adjuster at the address specified in the contract; provided, during any state of emergency as declared by the Governor and for 1 year after the date of loss, the insured or claimant has 5 business days after the date on which the contract is executed to cancel a public adjuster's contract.

626.854 (10) (d)

Any maneuver, shift, or device through which the limits on compensation set forth in this subsection are exceeded is a violation of this chapter punishable as provided under s. 626.8698.

Why is the term "Coverage Trigger" misleading?

Because it intends to refer to the time period during which the insurance contract is in effect.

The ______________ is intended for use by parties who are beginning the process of filing suit against an insurer, when a party feels they have been damaged by specific acts of the insurer. The Notice is intended to meet a portion of legal requirements set forth in Section 624.155, Florida Statutes, which requires a party to file Notice with both the insurer and the Department of Financial Services (DFS) at least 60 days prior to bringing an action against the insurer. The DFS does not involve itself in the pre-suit negotiations or communications related to Notices as such actions are not within the scope of its statutory authority.

Civil Remedies Notice

What is the difference between Common Law and Statute Law?

Common Law is based on stare decisis, whereas statutory law is explicit with a statute number.

Contracts wherein the parties are of unequal bargaining power are called?

Contracts of Adhesion

626.854 (11)

Each public adjuster must provide to the claimant or insured a written estimate of the loss to assist in the submission of a proof of loss or any other claim for payment of insurance proceeds. The public adjuster shall retain such written estimate for at least 5 years and shall make the estimate available to the claimant or insured, the insurer, and the department upon request.

626.854 (19)

Except as otherwise provided in this chapter, no person, except an attorney at law or a public adjuster, may for money, commission, or any other thing of value, directly or indirectly: (a) Prepare, complete, or file an insurance claim for an insured or a third-party claimant; (b) Act on behalf of or aid an insured or a third-party claimant in negotiating for or effecting the settlement of a claim for loss or damage covered by an insurance contract; (c) Advertise for employment as a public adjuster; or (d) Solicit, investigate, or adjust a claim on behalf of a public adjuster, an insured, or a third-party claimant.

What must Public Adjuster Contracts Contain regarding fraud by insured

Felony Warnings (626.8796) is the requirement for the Public Adjuster. 817.234 is the felony, 775.082, 775.083 & 775.084 are the punishments.

626.854 (7) (b)

For purposes of this paragraph, the term "written advertisement" includes only newspapers, magazines, flyers, and bulk mailers. The following disclaimer, which is not required to be printed on standard size business cards, must be added in bold print and capital letters in typeface no smaller than the typeface of the body of the text to all written advertisements by a public adjuster: "THIS IS A SOLICITATION FOR BUSINESS. IF YOU HAVE HAD A CLAIM FOR AN INSURED PROPERTY LOSS OR DAMAGE AND YOU ARE SATISFIED WITH THE PAYMENT BY YOUR INSURER, YOU MAY DISREGARD THIS ADVERTISEMENT."

HO-3 Policy

Homeowners Policy Special Form — part of the Insurance Services Office, Inc. (ISO), homeowners forms portfolio, the _____ insures the described owner-occupied dwelling, private structures in connection with the dwelling, unscheduled personal property on and away from the premises, and loss of use. Personal liability coverage and medical payments coverage are also provided by this policy. Coverage of the dwelling, related structures, and scheduled personal property is on an all risks basis, while coverage of unscheduled personal property is on a broad named perils basis. Losses to the dwelling and other structures are paid on a replacement cost basis, with no deduction for depreciation if certain conditions apply. Losses to personal property are paid on an actual cash value (ACV) basis, unless amended by endorsement.

626.854 (10) (a)

If a public adjuster enters into a contract with an insured or claimant to reopen a claim or file a supplemental claim that seeks additional payments for a claim that has been previously paid in part or in full or settled by the insurer, the public adjuster may not charge, agree to, or accept from any source compensation, payment, commission, fee, or any other thing of value based on a previous settlement or previous claim payments by the insurer for the same cause of loss. The charge, compensation, payment, commission, fee, or any other thing of value must be based only on the claim payments or settlement obtained through the work of the public adjuster after entering into the contract with the insured or claimant. Compensation for the reopened or supplemental claim may not exceed 20 percent of the reopened or supplemental claim payment. In no event shall the contracts described in this paragraph exceed the limitations in paragraph (b).

When might "Loss Settlement" cover buildings under Coverages A & B to Full Replacement Cost?

If the limit of Insurance at the time of Loss is equal to 80% or more of the replacement value of the building.

Valuation of Mobile/Manufactured Homes

If the manufactured home's homeowners' policy has a value on it, and you're in a valued policy state, the insurance company will pay up to the limit listed on the policy if the home is deemed a total loss. Some manufactured home policies will have a provision that allows for homes less than a certain age (10 years for example) to be valued at replacement cost. This has been done in part because some companies recognize that construction methods have changed over the years and that the home is newer. It's kind of like getting new car replacement on your auto policy, but only for late models.

626.854 (10) (c)

Insurance claim payments made by the insurer do not include policy deductibles, and public adjuster compensation may not be based on the deductible portion of a claim.

626.854 (7)

It is an unfair and deceptive insurance trade practice pursuant to s. 626.9541 for a public adjuster or any other person to circulate or disseminate any advertisement, announcement, or statement containing any assertion, representation, or statement with respect to the business of insurance which is untrue, deceptive, or misleading.

There are several important statutory requirements pertaining to contracts made by public adjusters:

Must state the type of claim, including an emergency claim, non-emergency claim or supplemental claim. Requires the signatures of all named insureds. If the signatures of all named insureds are not available, the public adjuster must submit an affidavit signed by the available named insureds attesting that they have authority to enter into the contract and settle all claim issues on behalf of the named insureds. An unaltered copy of the contract must be remitted to the insurer within 30 days after execution. This means the contract provided to the insurer must also contain the agreed upon fee percentage.

What does NFIP stand for?

National Flood Insurance Program

What if there is more than one applicable deductible?

Only the highest deductible applies.

Homeowners Coverage B

Other Structures or Appurtenant Structures (10% of Coverage A)

DP-1 Basic Form

Perils insured against are fire, lightning, and internal explosion.

626.8796

Public Adjuster Fraud Statement

626.854 (18)

Subsections 5-17 only apply to homeowners and condominium policies

Who determines how much HO-6 coverages a Condominium Owner needs?

The Association

The Difference between "Occurance" and "Claims Made" CGL Coverages

The Coverage Trigger:The Occurance Form applies to BI and PD regardless of any later time at which the claim is made.The Claims-Made Form applies only to BI and PD that occurs on or after the "Retro-Active date"

The Residential Property and Casualty Joint Underwriting Association originally created by this statute shall be known as the Citizens Property Insurance Corporation

The corporation shall provide insurance for residential and commercial property, for applicants who are entitled, but, in good faith, are unable to procure insurance through the voluntary market.

626.854 (7) (a)

The following statements, made in any public adjuster's advertisement or solicitation, are considered deceptive or misleading: 1. A statement or representation that invites an insured policyholder to submit a claim when the policyholder does not have covered damage to insured property. 2. A statement or representation that invites an insured policyholder to submit a claim by offering monetary or other valuable inducement. 3. A statement or representation that invites an insured policyholder to submit a claim by stating that there is "no risk" to the policyholder by submitting such claim. 4. A statement or representation, or use of a logo or shield, that implies or could mistakenly be construed to imply that the solicitation was issued or distributed by a governmental agency or is sanctioned or endorsed by a governmental agency.

626.854 (14) (a)

The insurer may not exclude the public adjuster from its in-person meetings with the insured. The insurer shall meet or communicate with the public adjuster in an effort to reach agreement as to the scope of the covered loss under the insurance policy. The public adjuster shall meet or communicate with the insurer in an effort to reach agreement as to the scope of the covered loss under the insurance policy. This section does not impair the terms and conditions of the insurance policy in effect at the time the claim is filed.

626.854 (14)

The public adjuster must ensure that prompt notice is given of the claim to the insurer, the public adjuster's contract is provided to the insurer, the property is available for inspection of the loss or damage by the insurer, and the insurer is given an opportunity to interview the insured directly about the loss and claim. The insurer must be allowed to obtain necessary information to investigate and respond to the claim.

Code of ethics (FAC 69B-220.201)

The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster's own interests in every instance. ... (b) An adjuster shall treat all claimants equally.

DP-2 Broad Form

This dwelling coverage form covers perils included under the DP-1 with ECE and optional VMM endorsement attached, plus: burglars; falling objects; weight of snow, ice, sleet; accidental discharge or overflow of water or steam; sudden and accidental tearing apart, cracking, burning or bulging of a steam or hot water heating system, or an air conditioning or automatic fire protective sprinkler system, or an appliance for heating water; freezing of a plumbing, heating, air conditioning, or automatic fire protective sprinkler system, or of a household appliance; and sudden and accidental damage from artificially generated electrical current.

Florida No-Fault Tort Exemption

Those who comply with the law are granted limited immunity from suits of others through PIP coverage.

What is the rule of law's attempt to counter balance a contract of Adhesion?

To have any ambiguities resolved in favor of the insured.

True or False: Both mediation and sinkhole neutral evaluation are non-binding. Neither the insured nor the insurance company is legally obligated to accept the outcome of the mediation conference.

True

Business auto coverage form Section 3 Physical Damage Coverage

We will pay for "loss" to a covered "auto" or its equipment under: a. Comprehensive Coverage From any cause except: (1) The covered "auto's" collision with another object; or (2) The covered "auto's" overturn. b. Specified Causes Of Loss Coverage Caused by: (1) Fire, lightning or explosion; (2) Theft; (3) Windstorm, hail or earthquake; (4) Flood; (5) Mischief or vandalism; or (6) The sinking, burning, collision or derailment of any conveyance transporting the covered "auto". c. Collision Coverage Caused by: (1) The covered "auto's" collision with another object; or (2) The covered "auto's" overturn.

Special Form

does not specifically list perils, rather it is "all risk" coverage unless otherwise specifically excluded.

Florida Insurance Guaranty Association

establishes and maintains a service-oriented operation for processing covered claims of insolvent members. FIGA is a nonprofit corporation created by the Florida Legislature in 1970. FIGA services pending claims by or against Florida policyholders of member insurance companies which become insolvent and are ordered liquidated.

HO-5 Policy

policies are written on open-perils forms, which means it lists the perils that your insurance doesn't cover. Common Exclusions: Earth movement Ordinance or law Water damage from flood, sewer backup, or water seepage Power failure War Nuclear hazard Intentional loss Government action Collapse Theft to a dwelling under construction Vandalism or malicious mischief if vacant more than 60 days Mold, fungus, or wet rot Neglect, wear and tear, and deterioration Mechanical breakdown Smog, rust, and corrosion Smoke from agricultural smudging and industrial operations Discharge, dispersal, or seepage of pollutants Settling, shrinking, bulging, or expanding of your home's foundation Infestation of birds, vermin, rodents, or insects Animals owned by insured