West Virginia Adjuster Exam 5

The Insurance Commissioner may, after notice of hearing, administer a fine of up to _________ for each violation of prohibited acts.

$1,000

The benefit limit for vocational rehabilitation is _______________ for each injured employee.

$20,000

Private dwellings are eligible for up to _______ in coverage under the FAIR Plan.

$200,000

Frank purchases a homeowners policy worth $700,000 with a 4% deductible. A few months later, a heavy hailstorm destroys his roof, porch, and windows, causing $50,000 in damages. Frank should expect __________ from the insurance company to pay for the damages.

$22,000

If you cause an accident in West Virginia, you must be able to prove that you have the financial means to cover the first _________ in bodily injury to one person.

$25,000

Kirsten makes $375 per week bagging groceries at her job in West Virginia until she trips over a customer's skateboard and breaks her ankle. How much will Kirsten's Temporary Total Disability benefits under workers' compensation insurance pay per week until she is able to return to work?

$250

Dragonfly Landscapers has one landscaper and one bookkeeper. The landscaper makes $25/hr, and the bookkeeper makes $15/hr. The landscaper worked 20 hours in 2014, so he made $500. The bookkeeper also worked 20 hours, so she made $300. So Dragonfly's entire payroll for 2014 was $800. Let's say that for every $100 of payroll, the WC rate for landscapers is $50 and the rate for bookkeepers is $5. How much did Dragonfly have to pay in workers' compensation premiums for 2014?

$265

Nancy borrows Drew's car so she can run to the grocery store to pick up some last minute items they forgot when they shopped earlier. While out, she rear-ends an SUV, injuring the driver and one passenger. The passenger suffers $40,000 in injuries, while the driver suffers $60,000. Assuming Drew has a liability policy with limits of 30/60/25, while Nancy carries minimum coverage for West Virginia, how much will Nancy's policy cover?

$35,000

Commercial properties are eligible for up to _______ in coverage under the FAIR Plan.

$500,000

XYZ Trucking Company has a franchise deductible policy with a deductible of $100,000. When a tornado rips through their lot, the company sustains $965,000 in damage. How much of the damage will XYZ Trucking Company be responsible for paying?

$965,000 XYZ Trucking will not be responsible for paying any of the loss, because they have a policy with a franchise deductible, and the loss exceeded the deductible. With a franchise deductible, the policyholder only pays for damages that are less than his deductible. If the cost of damages equals or exceeds his deductible, the insurer pays the full amount and the policyholder pays nothing.

In West Virginia civil cases, the sum of the percentages of the comparative fault of all parties must always equal:

0% or 100%

In West Virginia, every employer with ___ or more employees must provide workers compensation coverage for them., unless exempt from the requirement

1

An insurer or self-insured employer has _______ days to make a decision on all injury and occupational disease claims, except those involving occupational pneumoconiosis.

15

In West Virginia, the insurer must acknowledge receiving a claim within _____.

15 days

How many hours of continuing education are required in order to renew an adjuster license?

24

When fulfilling CE requirements, how many hours must an adjuster complete in ethics?

3 hours

If an insurer decides not to renew a Personal Auto policy, the insurer must provide written notice to the insured __________ in advance.

45 days

An injured employee can receive Temporary Partial Rehabilitation benefits under workers compensation insurance for up to ______ weeks, unless they are part of a vocational rehabilitation plan for retraining, in which case they can last up to _______ weeks.

52; 104

An injured worker who is eligible for Permanent Partial Disability benefits through workers compensation insurance cannot receive more than ___________________.

70% of the State Average Weekly Wage

Initial emergency adjuster appointments can last up to _____ days.

90

Which of the following drivers is MOST likely to purchase insurance through a residual market program?

A driver with a recent arrest for driving while intoxicated

Nancy's home was completely destroyed by a fire. Which of the following statements is TRUE?

According to the Valued Policy Law, Nancy can be indemnified for the full limit of coverage, even though she can rebuild for less.

Jasmine was receiving permanent total disability benefits when she died of a heart attack, which was unrelated to her original injury. How much will her two children receive in death benefits under workers' compensation?

An award equal to 104 times Jasmine's weekly PTD benefits at the time of her death, split between the two children

Benjamin's parents' home was recently flooded because of a hurricane. Benjamin lives at his parents' house and works as a company adjuster. His parent's insurer inadvertantly assigns their claim to Benjamin. Which of the following best describes what Benjamin should do in this situation?

Benjamin should not take the assignment, because he is not permitted to adjust claims in which he has a financial interest.

Bill has bought $175,000 in insurance coverage on his $300,000 home. Which of the following statements applies to Bill?

Bill is underinsured on his home.

Which of the following is often Coverage B in the Business Owners Policy?

Business Personal Property

Martin is Arnold's chauffeur. While driving Arnold to a meeting, Martin accidentally rear-ends Deana's car after she slammed on the breaks to avoid hitting Bob, who was jaywalking. Deana then sues Martin for her injuries and damage to her vehicle. Which of the following is FALSE, based on West Virginia's comparative negligence doctrine?

Deana will not be awarded any settlement if the judge determines she was at all responsible for her own damages.

All of the following are Unfair Claims Settlement Practices in West Virginia, EXCEPT:

Demanding verification of facts without explaining the reason for doing so

Which of the following employees must be covered under Workers' Compensation insurance?

Evangeline is 15 years old and works for her father's friend's architecture firm, shredding paper.

Under the FAIR Plan, which coverage for commercial property is NOT excluded due to vacancy?

Explosion

Which of the following is not true about Business Income from Dependent Properties, an Additional Coverage in a Business Owners Policy?

It is also known as Extended Business Operations Interruption coverage.

Which statement about the Jones Act is TRUE?

It protects injured seamen by allowing them to sue for damages and to choose a jury trial.

Which of the following statements about the West Virginia FAIR Plan is FALSE?

Its purpose is to provide coverage against earth movement caused by underground mines.

Jerry accidentally hit Bob with his car as Bob was running away from a bank he had just robbed. Bob's resulting medical expenses totaled $10,000. Bob sued Jerry for the damages after he was convicted of robbing the bank. Which of the following is true?

Jerry is not liable for any of Bob's medical expenses.

What does a declaratory judgment action seek?

Legal clarification of policy coverage

Which term refers to the date after which there is unlikely to be any further improvement or recovery to a person's injury, based on reasonable medical probability?

Maximum medical improvement

Omega Transports is a carrier that other companies hire to transport their goods from one location to another. What type of Inland Marine policy should Omega Transports purchase if they want protection against their liability for damages to goods in their custody during transport?

Motor Truck Cargo Policy

Which of the following activities would be a speculative risk?

Operating a crocodile racing ring

Which benefits are NOT available under WC?

Pain and suffering benefits

A lion at a zoo escaped when a zoo employee failed to follow protocol. The lion injured a zoo patron. In court, the injured patron's lawyer could invoke the doctrine of:

Res Ipsa Loquitur.

Frank has been in four accidents in the past three weeks and his insurer has given him notice of cancellation according to the provisions in his Personal Auto Policy. Since Frank is essentially uninsurable when it comes to auto insurance, where can he turn to find the coverage required by law?

Residual Market program

Ruby was caught driving her car without insurance. This is her first offense. Which of the following is TRUE?

Ruby faces a 30-day suspension of her driver's license.

Jenine is the victim of a hit-and-run. What must she do to get insurance to cover the damages?

She must establish that the damage was caused by the hit-and-run driver.

Marissa is a public adjuster. In which of the following activities is Marissa NOT violating the Standards of Conduct for Public Adjusters?

She refuses to accept power of attorney from the client that gives her authority to decide who will perform repair work on the damaged property.

Steadfast Insurance, Inc wants to cancel Orion's policy after it discovered that Orion had made a significant misrepresentation on his application. Which of the following is true?

Steadfast Insurance must notify Orion at least 30 days before ending the policy.

Every insurance policy will have at least four sections. Which of the following is NOT one of them?

Subrogation

While driving one winter day, April is surprised by a deer jumping into the road directly in front of her. She strikes the deer, overcorrects, and slides on the icy road. Her car skids off the road and plows through a barbed-wire fence. What is the proximate cause of the damage to the fence?

The deer strike

Who is responsible for paying the premiums on a workers' compensation policy?

The employer

Which of the following is NOT a valid reason for an insurer to leave mine subsidence coverage off of a policy?

The insured's current policy covers less than 80% of the value of the property.

Which of the following items would NOT be covered by an Inland Marine policy?

The truck being used to transport the property

Tom works for Home Improvement Corporation. One day Tom reports to work and is told to deliver a load of lumber to a customer in his truck. Tom loads up the lumber and heads off to the client's house. On the way, he runs a red light and causes an accident. Why might Tom's PAP liability insurance deny coverage to Tom?

Tom's accident occurred during employment related activities, so it would be covered by the employer's liability.

Which of the following counties requires insurers to provide mine subsidence coverage unless the policyholder waives it?

Wetzel county

Jane's shed burns to the ground during a tornado, when a tree falls on the roof and snaps a power line, which then ignites the structure. What is the proximate cause of the loss?

Wind

The West Virginia Mine Subsidence Fund offers coverage to:

all property owners the state.

In a third-party claim, the injured person has a duty to:

authorize the insurer to examine her medical records.

Sam is a company adjuster and believes that his insurer is encouraging fraudulent behavior among employees. Not wanting to lose his job, he never reports his suspicions, but the Insurance Fraud Unit discovers the fraud anyway. The commissioner __________ for failing to report.

can suspend or revoke Sam's license

Most states require businesses to purchase workers' compensation insurance to cover their employees. Workers' comp in those states is:

compulsory.

Under the Valued Law Policy, an insurer can only issue a fire insurance policy:

for a fixed and specific dollar amount.

A company adjuster MAY NOT:

give any legal advice to an insured, even if the insured asks for it.

Which of the following is excluded from liability insurance coverage?

intentional acts of tort or wrongdoing

A fidelity bond that provides coverage on a scheduled basis, covers:

named employees or named positions.

ABC Consulting has a CGL policy and an Umbrella policy, but the CGL runs from January 1 to December 31 and the Umbrella policy runs from June 1 to May 31. This difference in inception and expiration dates creates confusion when settling claims. This condition is known as:

nonconcurrency.

Gina was injured when she slipped and fell on a wet floor in ABC Department Store. She filed a lawsuit and was awarded $9,000 to cover her medical bills. Gina's monetary compensation is considered ____________.

special damages

If an insurer in West Virginia runs out of money and cannot pay settlements that it owes:

the West Virginia Insurance Guaranty Association will pay the claims.

An auto insurer has the right to sue anyone who has caused bodily injury or property damage for a policyholder, up to:

the amount that the insurer paid the policyholder.

All of the following are true of the West Virginia Insurance Guaranty Association, EXCEPT:

the association pays covered claims, but it is not required to defend claimants in court.

If an insurer is defending a claimant in court when it becomes insolvent:

the case will automatically be delayed 6 months to give the West Virginia Insurance Guaranty Association time to prepare to take over.

The commissioner will not reinstate a suspended, revoked, or refused license unless:

the cause for that suspension, revocation, or nonrenewal no longer exists.

When settling motor vehicle damage claims in West Virginia, in addition to whatever cash settlement the insurer and claimant agree to, the insurer must also pay:

the consumer sales tax on the settlement amount.

Part Four of a workers' compensation policy contains:

the employer's duties in the event of an accident.

After a loss, the Watercraft Policy will pay using:

the lowest of policy limit, actual cash value, or amount needed to repair or replace the property.

The comparative fault of a person that is not named in a lawsuit will be considered if,

the nonparty entered into a settlement agreement with the plaintiff.

According to West Virginia's Guest Passenger law:

the personal auto policy of a person test driving a vehicle for possible purchase provides secondary coverage, while the dealer's auto coverage is primary.

Jackie is adjusting a claim and finds a damaged chandelier that would work perfectly in her dining room. She knows someone who could fix it, so she privately offers the insured a good price for the chandelier. Jackie has:

violated the Adjuster Standards of Conduct.

If an auto insurer receives a written request for information from a claimant's attorney, it must respond:

within 30 days.