study material
For which perils does the standard HO-3 coverage form provide protection?
"All Risk" coverage for Coverages A and B, which includes all perils, including windstorm, unless excluded.
The rule under workers' compensation law that applies when an injury aggravates a pre-existing condition is:
"You take 'em as you find 'em"...meaning you must pay for the aggravation until the injury returns to its pre-injury state.
Which of the following is excluded under a Personal Articles Floater with "all risk" coverage? 1) A guitar player's electric guitar, amplifier and all associated cordage is destroyed by rats 2) An art collector's antique painting collection is stolen 3) A wedding dress passed down through 5 generations is kept in the attic for years. When the insured pulls it out to make alterations, she finds that all of the lace has yellowed and deteriorated
#1 and #3 only
Your insured runs a red light and hits another vehicle. Damage to the insured car is $7,600 and your policy has a $500 collision deductible. Damage to the other vehicle is $6,550 and is undriveable. Repair takes 3 weeks and the claimant incurs $757.00 in rental car charges. Fortunately the claimant was not injured seriously and has not seen a doctor. You think that if you handle the PD claim promptly and fairly, no injury claim will be made. How much will you pay for the property damage claim?
$ 7,307
Kate and Toby own and run a bed and breakfast in historic St. Augustine. The Bed and Breakfast is covered under a commercial Building and Personal Property coverage form with a $500 deductible and a Replacement Cost Endorsement for all coverages. They closed the bed and breakfast in June to go on a Mediterranean cruise. They had only planned to be gone for two weeks but they loved their stop in Italy so much that they decided to extend their vacation and stay for another couple of months to tour the country. When they returned to St. Augustine in late September, they find that someone had broken into and vandalized the bed and breakfast, stolen their computer system, video security system, and the televisions from each room. The total damages to the property came to $17860 and the value of the stolen items came to $12350. Is the loss covered and, if so, what would you pay?
$-0-. Because the property was vacant for more than 60 consecutive days, the theft and vandalism coverage is suspended. The loss is not covered.
Jack carries Mechanical Breakdown Insurance on his vehicle with a $250 deductible. One day while driving home from work the engine simply stops and he has to have the car towed to a garage for repair. The mechanic finds the crankcase has no oil in it and the engine has frozen up. The mechanic can find no oil leak. It just appears that no one has checked the oil in a long time. The engine block must be replaced at a total repair cost of $4,950.00. Jack gets a bill from the garage for $85.00 for towing and $75 for the inspection/diagnosis. How much can you pay him?
$0
Big Joe's Auto Sales & Service has a Garage Policy with a $100,000 Liability (Symbol #21) policy. They also have Garagekeepers coverage with a $40,000 limit and a $100 Comprehensive deductible and a $500 Collision deductible. One night a customer brings a car in for repairs and leaves it parked and locked outside the repair shop as part of its "Night Owl" drop off service. An unknown driver loses control of his car, hits the customer's car and leaves the scene. Damage to the customer's car is $1,500. What, if anything, would be payable by the Garage Policy for this claim?
$1,000 from the Garagekeepers coverage
While on a trip for a family reunion, your insured's hotel room is burglarized. The thief steals her wedding ring and a diamond necklace. The total value of the jewelry is $13,600. The insured's HO-3 homeowner's policy carries $150,000 in personal property coverage with a $500 deductible. How much could you pay for the loss of your insured's jewelry?
$1,500 (the maximum limit available for jewelry)
David and his best friend Trevor are involved in an accident in David's vehicle. The vehicle carries Basic PIP limits of $10,000, Additional PIP of $25,000, Extended PIP coverage, and a $1,000 deductible. Trevor's injuries result in medical expenses of $16,850 and lost wages of $5,250. If you were handling Trevor's (hint!) PIP claim, how much would you be willing to pay under David's PIP coverage?
$10,000
Tom rear ends a vehicle in front of him at high speed. The impact is severe and the air bag deploys, protecting him from injury. The BI/PD liability claim for the car in front is referred to a Casualty adjuster. You are assigned the auto PD claim. Unfortunately, the entire front end is crushed. You arrange for a field inspection and appraisal. The vehicle is a total loss valued at an ACV of $15,264.00. The insured has a Personal Auto Policy with a $500 Collision deductible and a no Comprehensive deductible. How much would you pay the insured?
$14,764.00
A homeowner has an HO-3 policy with $250,000 of Coverage A, $15,000 of Coverage B, $80,000 of Coverage C, and a $500 deductible. If a tree falls on the homeowner's detached work shed and the cost to repair the work shed is $18,620. How much would you pay the homeowner under his HO-3 policy?
$15,000
Michele has a home valued at $300,000 and an HO-3 policy with $275,000 in Coverage A limits and a $1,000 deductible. She has Other Structures coverage of $25,000 and $150,000 in Contents coverage. One night, during a violent summer storm, Michele heard a news report of a tornado warning in her area. The next morning, she found that her "She-Shed" was gone with only the slab remaining. The large pine tree next to her bedroom had snapped and fallen on the roof of the house, leaving a large hole. The RCV of the shed was determined to be $18,750.00. Damage to the home was estimated at $23,805.00 and Michele had an estimate from a tree service to remove the fallen pine tree for $1,050.00. Michele told the adjuster that she spent $35 on a tarp and paid her neighbor $50.00 to cover the hole in her roof. After settling the claim for the damage to the home, much would you pay for the damage to shed?
$18,750.00
Sam paid $1,300 to get his old car painted and is quite proud of how it looks. Two weeks later, while driving to Tallahassee, he runs through a severe thunder and hail storm. When he arrives he finds the entire surface of his car hood, top and trunk to be pitted and scratched. He is furious. He calls his agent to report the damage and file a claim under this insurance. He has a Personal Auto Policy with Collision with a deductible of $500 and Comprehensive with a deductible of $100. The repair estimate comes to $2,165.00. How much would you pay Sam?
$2,065.00
Connie purchases a previously owned 2018 Toyota Camry on 10/1/2018. She adds the car to her PAP with 100000 Liability limits Collision with a 500 deductible Comprehensive with a 250 deductible, Towing and Labor with a maximum limit of 75 + Mechanical Breakdown coverage with 100 deductible good for 12 months or 1000 miles whichever comes first. On 9/25/2019 Connie's car breaks down while on her way in to work, leaving her stranded on the interstate. On 10/5/2019, after Connie returns home, she calls the local repair shop and has the vehicle towed in for diagnosis and repair. After repairs are complete, the repair shop gives Connie a bill for $2462 in repairs $200 for the tune-up she authorized while it was there, and a bill for $50 for towing. Connie reports the claim and turns over the repair bill to her carrier. How much will her policy pay for repair of the vehicle?
$2,362.00
Sally is rear ended while stopping for a school bus. You are assigned the auto PD claim. Sally has a Personal Auto Policy with Collision coverage and a $500.00 deductible, Other than Collision coverage with a $250 deductible and Rental Reimbursement of $30/day, $900 total. Sally brings the car to the drive-in and the appraisal reflects damages of $3,276.00 to the rear end, with an estimated repair time of 4 days once parts are received. You advise Sally that she has a $500.00 deductible. She agrees to take the car to the body shop when the parts arrive. 2 days later, after the parts arrive, she drops the car off and picks up a rental you have arranged. You send her a check for $2,776.00 with a copy of the appraisal. When repairs are completed, Sally picks up her car and returns the rental. You receive a rental bill for $24.95 per day (includes tax) for 5 days, or $124.75. How much will be total payout on this claim?
$2,900.75
If an insured has the Basic $10,000 in PIP coverage and no deductible, and after an automobile accident incurs $2,300 in medical expenses, $1,300 in lost wages, and $300 in expense for general housekeeping services, how much would you pay in response to a claim filed for PIP?
$2,920
Greg has an HO-3 policy for his home with Coverage A limits of $300,000, Additional Structures Coverage of $25,000, Contents Coverage of $100,000 and a $1,000 deductible. The policy carries an 80% coinsurance requirement. One day Greg woke up to find that his master bathroom was flooded due to a pipe that had burst overnight. The water traveled from the bathroom into the master closet and the master bedroom. Several items in the closet as well as a few pieces of bedroom furniture were ruined by the water damage. Greg immediately reports the claim, to which you are assigned. The damages to his master bathroom, closet, and master bedroom came to $18,765. The damaged personal property came to $9,865. Your appraiser notes on the estimate that the current value of the home is $325,000. How much would you pay for the loss?
$27,630.00
Joe has a Dwelling "DP-3" policy covering one of his rental properties, with Coverage A limits of $100,000 and a deductible of $500. A tornado severely damages the house and it takes 4 months for repairs, during which time Joe loses his tenant and monthly rental income of $925.00. How much, if any, will Joe's policy pay for the lost rents under Fair Rental Value coverage?
$3,700
An insured has physical damage insurance with your company with a $250 deductible for Comprehensive and a $500 deductible for Collision. A rock breaks his windshield and the cost for repair is $325.00. How much will you pay under his policy?
$325.00
The Ocean Grill has a Business Auto policy with Liability limits of $100,000 (Symbol 1), Collision coverage with a $500 deductible (Symbol 2 - Owned Autos Only) and Comprehensive coverage with a $250 deductible (Symbol 2 - Owned Autos Only). Last week the owner went to work only to find the company's F-150 delivery truck had been stolen. He immediately reported the theft to the police, and three days later it was found in a parking lot on the other side of town with $4,300 worth of damage. If you were assigned the claim how much would you pay on the claim?
$4,050.00
Brittany drives 2017 Honda Odyssey and carries a Personal Auto Policy with a $500 deductible for Collision and Other-Than-Collision coverage, a Towing and Labor endorsement with a maximum benefit of $75 and Mechanical Breakdown coverage with a $100 deductible. One day, while waiting in the car line to drop her daughter off at school, the vehicle's engine simply stopped and would not restart. Brittany had the vehicle towed to from the school to her local auto repair shop. The mechanic finds that an oil pan scew was loose and all the oil had leaked from the vehicle, causing the engine to freeze up. A review of the vehicle maintenance records reflected that the oil had just been changed at a Jiffy Lube the week before. The engine block must be replaced at a total repair cost of $4,225.00. Brittany also receives a bill from the garage for $65.00 for tow to the shop. How much can you pay her?
$4,190.00
John has an Auto policy with Basic PIP coverage, a deductible of $500 and Property Damage limits of $10,000. He hits a bicyclist who is riding on the right side of the road and veers into the lane in front of him. He tries to avoid him, but there is traffic coming from the opposite direction and he hits him, causing a total loss of the bicycle valued at $425.00 and injuries to the bicyclist resulting in $3,500 in medical expenses and $827.00 in lost wages. You receive a phone call from the claimant asking if you will pay for his bicycle. He also says that his personal insurance paid for his medical except for $785 in deductible and co-pays and asks if you will pay his out of pocket medical bills and his lost wages. Disregarding arguments about liability, how much could you pay for property damage under John's policy?
$425.00
Donnie and Marie are driving through the countryside one lazy Sunday afternoon when a cow stumbles out into the road right in front of them. Donnie can't avoid the animal and hits it square on, killing the cow and severely damaging the front end of his car. His Personal Auto Policy has a $250 Collision deductible and no deductible for Other than Collision. The repair estimate is $5,270.00. How much will Donnie's policy pay for repair to the car and under what coverage?
$5,270.00 under Donnie's Other than Collision coverage
Brenda is driving her 2016 Lexus 3300 when she gets into an accident with another vehicle. Both drivers report the accident to their carriers but each claims the other is at fault. Brenda can't afford to wait for resolution of the property damage claim with the other carrier so she files a collision claim with her own insurance company. Her Personal Auto Policy provides Collision with a $500 deductible and Comprehensive with a $250 deductible. The appraisal for damage to the front bumper, right front fender and side panel totals $5,732.00. During repairs the body shop finds some hidden damage and requests a supplemental repair authorization of $625.00. How much would you pay?
$5,857.00
Jerry's house caught fire. Repair costs to the house, appliances, and fixtures totaled $76,380. His Coverage A limits were $175,000. At the time of the fire, the replacement cost value of his home was $250,000, and he had an 80% coinsurance requirement. If Jerry's policy had a $1,000 deductible, what would the policy pay?
$66,334.40
While driving his 2012 Honda Pilot, Terry is rear ended while he is stopped at a red light. The at-fault driver's insurance carrier has informed Terry that, although their insured was at fault, there may be a coverage issue and they need time to investigate. Terry elects to file the claim under his own collision coverage to expedite his repairs and allow his insurance carrier to subrogate against the at-fault party. The policy provides a rental reimbursement at $30/day for a maximum of 30 days, or $900 total. Damage to the rear bumper, rear door and right side quarter panel totaled $7432. Two days after the accident, John went out on his own, without discussing it with the adjuster, and rented a Cadillac Escalade at a rate of $85/day. He incurred 22 days of rental expense for a total of $1870. John presented the bill to the insurance company. How much would you pay?
$660.00
While parked at the grocery store, Connor's 2016 Jeep Wrangler is hit by another vehicle that was backing out of its parking space. Connor files the claim under his own collision coverage to expedite his repairs. The policy on his 2016 Jeep Wrangler provides Collision with a $500 deductible, Comprehensive with a $250 deductible and rental reimbursement at $20/day or $600 total. He drops the Jeep off at a body shop and goes out on his own, without discussing it with the adjuster, and rents new model Jeep Wrangler at a rate of $65.00/day. He incurred 12 days of rental expense of $834.60. While the Jeep is in the shop, the at-fault driver's insurance carrier is able to confirm coverage and accepts the shop's damage appraisal. After Connor picks up his Jeep, he presents the bill for $834.60 to the 3rd party liability carrier. If you were the 3rd party PD liability adjuster, what would you pay?
$834.60
Temporary total disability benefits are calculated by taking:
.6667 of the employee's pre-injury Average Weekly Wage (AWW).
A new adjuster must acquire how many CE hours of "Elective"?
20
An new adjuster's continuing education requirement is:
24 hours in every 24 month license period
An adjuster must notify the Department of any change of name, residence address, principal business street address, mailing address, contact telephone numbers, AND email addresses within how many days?
30 days
Chris' truck was stolen from his driveway overnight. Upon discovery of his missing truck, he immediately reports the theft to the police and to his insurance company. John has a PAP with Other than Collision coverage and no deductible. After two days, his adjuster arranges for him to pick up a rental car and arranges to have it direct billed to the company after its return. Four days later the truck is found wrecked...a total loss valued at $12,685.00. The adjuster calls Chris and agrees to pay him the full total loss amount. When must the rental be returned?
72 hours after the company issues the total loss settlement check.
For Florida licensed adjusters, resident and non-resident, the only mandatory CE course requirement is:
A 4-Hour Law & Ethics Update course
A controverted case is:
A claim for which the employer or carrier has denied compensability (liability) for all workers' compensation benefits.
Maximum medical improvement (MMI) means:
A date in time when an employee's recuperation from injury is as good as it is going to get.
How are adjustments under commercial property coverages initially valued?
Actual Cash Value
You are assigned a claim for severe storm damage to your insured's home. You learn that, during the storm, a tree fell on the house and crashed through the roof, leaving a massive opening. You advise your insured that you will have a field adjuster come by to inspect the damage within 48 hours. The insured asks you if it would be all right if someone were to remove the tree limb that's piercing the roof so she can cover the hole. How would you respond?
Advise her that her policy will cover any reasonable expense she incurs to protect further damage to her property, and that she will be fully reimbursed as part of the appraisal.
Which of the following would result in a denial of workers' compensation benefits?
An employee who intentionally injures himself in order to collect disability benefits.
A lost time case is defined as:
An injury that results in more than seven (7) days of work, or for which indemnity benefits would otherwise be due, such as a medical only claim that results in a permanent impairment.
"An accident, including continuous and repeated exposure to the same generally harmful conditions" is a trigger of coverage, known as:
An occurrence
John (your insured) is a roofing contractor. John is is putting a new flat roof on a building and one of the John's employees accidentally tips a bucket of tar off of the side of the roof. It falls thirty feet onto a car that is parked on the side of the building below. When the claim for property damage comes in, what kind of claim is it, and what kind of policy will respond?
An operations claim to be addressed by the insured's General Liability policy.
Auto Experts Company has a Business Auto policy with Symbol #1 indicated for Liability coverage. Which autos are covered under the policy?
Any auto
If an employee is to be eligible for workers' compensation benefits, the following is required:
As long as the injury resulted from an accident while at work, the injury is covered by workers' compensation regardless of fault.
Which of the following is NOT one of the supplementary payments provided by the CGL?
Bail bond costs arising out of an automobile accident while on company business
A theft of money and securities from a cash register or safe, as well as clear evidence of forced entry into the insured's premises, is known as:
Burglary inside the premises
The Wiener Schnitzel German Restaurant has a loyal clientele and has a consistently busy dinner crowd. It has a commercial property insurance policy with your company. One day an elderly motorist accidentally runs through the plate glass window and into the store. The damage is extensive and the business must close for a month while repairs are completed. The owner of the Wiender Schnitzel asks you if the policy covers the revenue he lost while his business is closed. For what kind of coverage would you look to go about reimbursing him for the business's lost income?
Business Income coverage
A shipper wants to obtain insurance coverage on both outgoing and incoming shipments while in transit. This type of coverage is called:
Cargo coverage
All of the following can be done through the MyProfile portal except:
Change your legal name
What is the residual market choice for consumers unable to secure residential property coverage in the voluntary insurance market?
Citizens
Damage to a windshield by a bird would be covered under:
Comprehensive
Jerry has an HO-3 policy with $100,000 in Liability coverage and $1,000 in Med Pay carried by Citizens Property Insurance Corporation. He also has two vehicles that are insured under a GEICO Personal Auto Policy with 100/300/100 limits, Basic PIP, no UM rejection, and $1,000 in Medical Payments coverage. Jerry and his wife, Diane are listed as the primary drivers on both vehicles. One day Jerry's 17-year old son and his girlfriend are washing the family car so they can use it to go on a date that evening. He accidentally smashes her fingers in the car door, causing two finger fractures and overall bruising. You work as an adjuster for Citizens and receive a claim under the Citizens homeowner's policy for $1,350.00 in medical expenses for treatment. Which of the following actions is the proper one for a good adjuster to take?
Contact Jerry and advise him that although this claim is not covered by his homeowners' policy, it would likely be covered under his auto insurance policy's Med Pay coverage and refer him to his auto carrier.
A homeowner enjoys restoring old classic cars in his spare time. He has created a workshop in his 12 x 22 detached garage. One day, while the insured was doing some welding on his old 1937 Chevy, sparks landed on a pile of nearby papers, causing a fire to break out. The fire spread quickly and caused severe damage to the garage. Under what part of the HO-3 policy would this damage be covered?
Coverage B - Other Structures
East Coast Auto Sales has a standard Garage Policy with Symbol 21 for Liability coverage. All of the following claims would be covered under East Coast's policy except:
David (owns his own fully insured car) is test-driving a new car when he side-swipes another car and hurts the driver, Mary. Mary sues David. David tenders the claim to East Coast claiming he is covered under their policy and that East Coast should provide his defense. He does not want to use his carrier for fear of a premium increase.
The provision in an accident insurance policy that doubles the death benefit otherwise applicable for an accident is called:
Double Indemnity
Which of the following would NOT be covered under a standard homeowner's policy?
During a storm a transformer two miles from the Insured's residence explodes, causing widespread power loss. The insured suffers no damage but loses $275 worth of food in their refrigerator due to the loss of power.
Over a period of time, one of the insured's cashiers steals over $1,500 from cash purchases not processed through the register, which of the following coverages would reimburse the insured for such a loss?
Employee theft or dishonesty
Which of the following perils are typically covered under a homeowner's policy?
Fire, lightning, windstorm, and explosion
Denying claims without conducting reasonable investigations based upon available information is a violation of what Florida law:
Florida Statute §624.9541(i), Unfair Claim Settlement Practices
A traveling employee's business trip includes an overnight stay, the employee is injured in an accident while traveling to dinner that evening. Are the injuries compensable under W/C?
For traveling employees, the law considers the conduct of business to include, not just literal work activities, but also while so engaged, such normal and necessary "essential" activities as eating, sleeping, and other reasonable "personal comforts". Therefore, the injury is compensable.
In general, an employee who suffers an occupational injury and collects workers' compensation benefits during recuperation:
Gives up the right to sue the employer for personal injury and pain and suffering and can sue only for workers' compensation benefits
Which type of organization provides comprehensive health services to its members for a prepaid fixed fee with the goal of preventative care and requires the selection of a primary care physician?
HMO
According to Florida law, once successfully licensed by the Department, no person may be, act as, or hold himself or herself out to be a licensed insurance adjuster until and unless he or she:
Has been appointed by an appropriate appointing entity or person
Which of the following is a TRUE statement concerning auto physical damage coverage under a Personal or Business Auto policy?
In Florida, there is no deductible applied to windshield damage claims as long as the policy carries comprehensive coverage.
According the Florida's Code of Ethics, which of the following statements is NOT true?
In an effort to protect an insured's or claimant's interests, an adjuster may advise the insured or claimant to refrain from seeking legal advice, or advise against the retention of counsel.
Your business owns a five year old copy machine that breaks down. It's worked so well over the years, and new machines are so expensive, that you decide to have it repaired. A local vendor takes the machine to their shop. A severe thunderstorm spawns a tornado that severely damages the vendor's shop, and your copy machine is destroyed. A new machine of its type would cost you $17,250 and your old machine was valued at $8,600. You file a claim under your commercial property policy where your deductible is $500. What can you expect?
In the absence of an RCV endorsement, you would receive $8,100 (the ACV of your machine less the $500 deductible) under Property Off-Premises coverage.
All of the following are true of Florida workers' compensation EXCEPT:
In the event of accidental death, maximum compensation benefits of $100,000 and funeral expenses of $7,500 are owed.
Dwelling coverages are intended for:
Individuals and companies seeking only to protect their financial interests in the property.
During its trip from China to the US, a cargo ship accidentally navigates into a tropical storm. Some of the cargo is thrown overboard to save the ship. What is this action called?
Jettison
Bay Breeze Grill wants to add a bar and sell alcoholic beverages. To protect themselves from the risk of over-serving customers and getting dragged into lawsuits rising from intoxicated customers or drivers, what kind of coverage should it make sure it has?
Liquor Liability coverage endorsed onto its General Liability policy
You are involved in an automobile accident on your way to work one morning. Is your injury covered by W/C?
No. Traveling to from work is considered a personal risk and injuries that occur during this period are not covered by workers' compensation.
The type of health provision that provides the greatest degree of policy continuation protection to an insured without any change in benefits or rates is:
Non-cancelable
While driving through the country, an insured hits a deer crossing the road. Where would the insured look in the PAP to determine if coverage applied?
Other than Collision (aka Comprehensive) coverage
Part I: Coverage A of the Workers' Compensation policy provides for:
Payment of all benefits required of the employer under the law of the state in which an employee is injured.
An "injury" is defined to mean:
Personal injury or death by "accident", arising out of work performed in the course of employment.
Bobby owns and operates a convenience store that also sells gasoline. One day a customer pulls away from the pump while the gas is still pumping, breaks the pump line and causes gasoline to escape all over the parking lot and into the storm drain. Bobby files a claim under his commercial property policy. Damage to repair the pump totals $675.00 and $230.00 worth of gasoline was pumped out before anyone noticed the accident and was able to stop the pump. The local HazMat team was called out by the authorities to clean up the parking lot and the storm drain. Bobby received a bill from the County for $10,620.00 for the clean up. He sends the bill to you to pay. What kind of coverage under Bobby's policy would pay this loss?
Pollution Clean Up and Removal
A container of salt falls and spills on the floor at a local convenience store. An elderly customer is shopping and slips on the spilled salt, injuring her hip. What kind of claim will be filed under the convenience store's CGL policy?
Premises Liability
Bay Breeze Grill is known for it's oysters. A customer eats some of the oysters and falls extremely ill. Where would the coverage lie for such an event?
Premises and Operations
The definition of Actual Cash Value is:
Replacement cost less depreciation.
Peggy owns a boutique cake shop in the historic district of downtown Lakeland. A fire breaks out at the warehouse next door and spreads to Peggy's cake shop, causing severe damage to the building. The fire loss results in a repair appraisal of $190,625 on a building that has a replacement cost value of $300,000. The building has been condemned by the County and must be totally demolished. Clean up and removal of existing fire debris will cost $18,000. Peggy has a Commercial Property policy with $325,000 in dwelling coverage, a special "All Risks" coverage form and a $1,000 deductible. How much will the policy pay?
Since the location is condemned, the building is a total loss, and the valued policy law will require payment of $325,000 for the dwelling. An additional $10,000 is also available for debris removal.
A shopper hits her head on a low hanging shelf in a grocery store. You've been asked to handle the claim. After talking to both her and your insured on the telephone, you really don't think there is any liability, but you think the best way to handle the case is to pay her medical bills without admitting liability and try a walk-away settlement. How would you do it?
Tell her you'll pay her bills and wish her well. Ask her to call you if she has any questions. When they arrive, pay the bills under the CGL's Medical Payments coverage.
Capital Mortgage has an insurable interest in your policyholder's covered property. Under what clause would Capital Mortgage's interests be protected in the event of a loss?
The Mortgage or Mortgagee clause
What did the Florida legislature create to provide Florida consumers with availability and affordability of insurance coverages that are no longer available through normal channels?
The Residual Marketplace
A policyholder insures his home for $350,000. After being totally destroyed during Hurricane Wilma, his insurance company issued payment for the full $350,000, even though the replacement cost of the house was only $290,000. The reason for this payment was based on:
The Valued Policy Law
Jackson Ellis is CEO of Puzzles Brews. He operates three different craft breweries, each with its own unique selection of brews. Jackson decides to add a 4th brewery and purchases the perfect building. Two weeks later, and before he has an opportunity to contact his insurance agent, a fire breaks out next door and spreads to his building. Before the fire is extinguished more than half of it is destroyed. Jackson reports the claim and it is assigned to you. You make contact with Jackson at which time he asks if the new location will be covered under the Puzzles policy. The initial step in your investigation is to review the Puzzles policy. It is a Commercial Property policy with $300,000 in dwelling coverage on each of its three locations, a special "All Risks" coverage form and a $1,000 deductible. How would you respond to Jackson?
The commercial Building and Personal Property form provides coverage for newly acquired locations for 30 days for up to $250,000 on the dwelling and $100,000 on the business personal property. Thus, the new location is covered.
Heart attacks and strokes aren't compensable under workers' comp unless
The employee is doing extraordinarily heavy or exerting work immediately prior to the attack.
Which of the following would NOT be covered under Coverage C, Personal Property?
The insured's dog that was killed after being bitten by a rattlesnake on the property.
Sharon has taken in her elderly mother to live with her so that she can care for her in her old age. Unfortunately, a thief breaks into Sharon's house while they are out to lunch. Sharon's mother's jewelry and television set are stolen. How Sharon's HO-3 policy respond?
The policy will cover the loss under Coverage C of the HO-3 policy, subject to the policy limits, the $1,500 sub-limit on jewelry and the applicable deductible.
After a weekend getaway, Barbara and John return home to find that their house had been broken into. Their family computer, flat-screen television, rare gun collection and some jewelry were stolen. In what way would their HO-3 policy respond?
The theft loss would be covered within the Coverage C limits of the HO-3.
Florida's Code of Ethics under 69B-220.201(3) begins with an important statement that provides a basis for the very sensitive nature of what an adjuster does. Select that statement from below:
The work of adjusting engages the public trust.
An insured's employee is injured in an automobile accident. A claim for injuries is submitted to the General Liability carrier. How should they respond?
There is no coverage as injuries to employees are excluded under the GL. They are covered under the employer's Workers' Compensation policy.
In Florida, what is the deductible for windshield claims?
There is no deductible in Florida for windshield claims
During a severe windstorm, a large oak tree falls on your house and through your roof, pulling the electricity line away from your home. You are without power for 4 days before power is restored, resulting in the loss of hundreds of dollars of frozen beef from your deep freezer. The loss of the food would be covered because:
There was an unbroken connection between the windstorm, the fallen tree, and the electrical line damage that led to the loss of electricity, therefore windstorm is the "proximate cause" and resulting damage is covered.
To which of the following does Florida's Valued Policy Law apply?
Total loss of any building, structure, mobile or manufactured home resulting from any covered peril
In Florida, when is a vehicle considered to be a "total loss"?
When the cost of repair is 80% of the cost to replace it with one of like kind and quality (or the value of the auto)
Casual labor is defined as:
Work that requires less than 10 days to complete, at a total labor cost of less than $500, and is not work that is part of the employer's normal business.
Stud Cutz Barber Shop has a commercial property policy with your company. An employee dropped a cigarette into a waste basket without putting it completely out and a fire destroyed half the store before it was extinguished. The local fire department sends the laundry a bill for $725.00 for their response to put out the fire. Will the policy cover this expense and how much?
Yes. Fire Department Service Charge is included up to $1,000, thus covering the entire bill.
Assume your home caught fire due to a faulty electrical device, and one month after the fire you receive a bill from the fire department for $450.00 for responding to the fire. Would this be paid under your homeowner's policy?
Yes. It is called Fire Department Service Charge and is an Additional Coverage provided under the policy, limited to $500.
Jack's Body Shop owns two tow trucks, one with a standard tow package and one with a lift bed for cars that can't be towed. Jack has purchased a Business Auto Garagekeepers Policy with the following: - Symbol #1 is listed next to "Liability" coverage.- Symbol #7 is listed next to "Physical Damage: Collision" coverage, with only Jack's personal vehicle listed.- Symbol #1 is listed next to "Garagekeepers". While enroute in the company tow truck to an accident to pick up a wrecked car, Jack's employee/driver, Mel, is talking on his cell phone getting directions to the pickup location and swerves over into the adjacent lane and sideswipes another vehicle. He quickly stops, gives the other driver his name, the name and phone number of the company and his insurance information, and then proceeds on to the pickup. The 3rd party claim is later assigned to you for handling. Is there coverage for this claim?
Yes. Liability coverage is provided for "Any Auto", which includes Jack's tow trucks.
Danielle (your insured) invites a group of ladies over to her home for a Pampered Chef party. After the party was over and everyone was leaving, one of her elderly guests fell when she stepped off of the front porch and fell on the sidewalk. She sprained her ankle and skinned her knee. Her medical expenses were $1430 for ER treatment, medications and a couple of follow-up visits with her doctor. Danielle has an HO-3 Homeowner's policy with $300000 Liability limit and a $5000 Med Pay limit. Your investigation reveals that the edge of Danielle's front porch was about ¼" higher than building code requirements and the step-down was not well lit. You believe that the facts will support that the guest was just not watching her step, but also assess Danielle's potential for liability at about 40%. Under what coverage would you be protected and how much would be paid under that coverage?
Your insured's Medical Payments coverage would pay 100% of the guest's medical expenses incurred as a result of her injury on your insured's premises, up to $5,000.
The most basic premise of a General, Homeowners or Personal Liability insuring agreement states that:
the policy will respond if an insured person or entity is legally liable for bodily injury or property damage that occurs within the policy period and is not otherwise excluded from coverage.
