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University of Southern California (Risk
Management and Insurance Program)
State Insurance Claims Adjusters Certification
California C.A Claims Adjuster Exam
Course Title and Number: Claims Adjuster Exam Exam Title: Board Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructor’s Name] Student Name: [Insert Student’s Name] Student ID: [Insert Student ID]
Examination
180 minutes
Instructions:
**1. Read each question carefully.
- Answer all questions.
- Use the provided answer sheet to mark your responses.
- Ensure all answers are final before submitting the exam.
- Please answer each question below and click Submit when you have** **completed the Exam.
- This test has a time limit, The test will save and submit automatically** **when the time expires
- This is Exam which will assess your knowledge on the course Learning** Resources.
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State Insurance Claims Adjusters Certification 2024- California C.A Adjuster License Exam Review Questions and Correct Answers | 100% Pass Guaranteed | Graded A+ | Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - An agent has altered an auto application for a customer. He struck through the higher limits of auto coverage for underinsured motorist coverage and inserted a lower limit. Neither the insured nor the agent initialed the change. The insured signed the application. The policy was renewed for three years with the lower limit. The insured was involved in a hit and run accident and was killed. What should the insurer do? Pay the lower limit of coverage Deny the claim because of the vagueness of intent Pay the higher limit Refuse to adjust the claim on the basis of an altered application = The =Answer>> is: Pay the higher limit. EXPLANATION: This is an actual case and the insurer paid the higher limit that had been struck through on the application without any acknowledgment on the part of the applicant. Unfair claims practice laws forbid the adjuster to adjust claims on the basis of an altered application. It was determined by the insurer's legal counsel that the higher limit should be paid. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Homeowner policies require that the named insured reside at the described premises while dwelling policies do not. Homeowner policies are only for actual home owners while dwelling policies can be written only for tenants. Homeowner and dwelling policies have the same eligibility requirements. Dwelling policies can be written on duplexes while homeowner policies are only for single-family dwellings. = The =Answer>> is: Homeowner policies require that the named insured reside at the described premises while dwelling policies do not. EXPLANATION: The name d insured must be a resident of the insured premises under the HO program. An accident reconstructionist is an expert used by insurance companies and plaintiff lawyers to: Determine what type of mechanical defect caused an accident. Determine how much the at-fault driver had been drinking. Determine which way the vehicles were traveling prior to impact. Thoroughly examine the accident scene and conduct the appropriate tests to reach a reasonable conclusion as to causative factors. = The =Answer>> is: Thoroughly examine the accident scene and conduct the appropriate tests to reach a reasonable conclusion as to causative factors. EXPLANATION: Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Reconstr uctionists thoroughly examine the accident scene and conduct the appropriate tests to reach a reasonable conclusion as to the cause of an accident. Supplementary payments under the liability section of a commercial auto policy include reasonable expenses incurred by the insured including loss of earnings up to ___ per day. $ $ $ $500 = The =Answer>> is: $250. EXPLANATION: Reasonab le expenses including loss of earnings up to $ per day. The insured carries an Equipment Breakdown policy with a limit of $300,000. A boiler has exploded and caused extensive damage to the building and its contents. As a result of the explosion a fire ensues causing $100,000 in damages. How much will the Equipment Breakdown policy pay for the fire damage? $50, $25, $100, $0 = The =Answer>> is: $0. EXPLANATION: The Equi pment Breakdown policy excludes fire damage. The loss would be covered under a commercial property form. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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property, the Motor Carrier form should be used. The Truckers Form was withdrawn by ISO in 2005 and it has been replaced by the Motor Carrier form. The circumstances under which a consumer reporting agency may furnish a consumer report include: I. A credit transaction involving the consumer. II. For employment purposes. III. With the underwriting of insurance. I, II and III I only I and II only I and III only = The =Answer>> is: I, II and III EXPLANATION: All of t hese are circumstances under which an investigative consumer report may be ordered. However, a person may not procure or cause to be prepared an investigative consumer report on any consumer unless it is clearly and accurately disclosed to the consumer that an investigative consumer report may be made. This disclosure must be made in writing and mailed, or otherwise delivered to the consumer, no later than three days after the date on which the report was first requested. The manager of a grocery store has checked out the cash register and places the checks and money in a night depository bank bag. He places the bag on the desk and goes to the rear of the store to check the back door. When he returns the money bag is missing. This is an example of: Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Forcible entry Burglary. Robbery. Theft. = The =Answer>> is: Theft. EXPLANATION: This is an example of the presumption of theft. Property is missing from a known place where the property should be. This would be the case because theft has the broadest definition of criminal activity. Which of the following is not an implied warranty under an ocean marine policy? Seaworthiness of the vessel Legality No deviation in the voyage Protection and indemnity = The =Answer>> is: Protection and indemnity. EXPLANATION: Protecti on and indemnity is a form of ocean marine liability coverage and is not an implied warranty. In commercial auto liability, which of the following would not be covered? A third party claim occurred a week after products were finally delivered to a customer. A third party claim that occurred in a warehouse as an employee was using a hand truck to load a delivery truck. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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A customer injured in a department store when a sign falls on her and sues the store for medical costs and pain and suffering An employee injured lifting a heavy carton sues his employer for costs An individual fired from her job sues her employer for unemployment benefits = The =Answer>> is: A tenant evicted by his landlord sues the landlord for invasion of privacy and wrongful eviction. EXPLANATION: Invasion of privacy and wrongful evictions are part of the personal injury coverage. Which of the following is not considered to be a consequential loss coverage? Replacement Cost Coverage Business Income Coverage Leasehold Interest Coverage Extra Expense Coverage = The =Answer>> is: Replacement Cost Coverage. EXPLANATION: A conseq uential loss occurs as the result of a direct loss to the insured property. Replacement cost coverage is used to determine the amount of the loss. If replacement cost coverage is not selected then actual cash value applies. An adjuster's report that contains all the facts, evidence and disposition of the claim and is considered to be the final report is known as the: Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Full Report. Field Report. Interim Report. Settlement Report. = The =Answer>> is: Full Report. EXPLANATION: The "ful l report" is the third and final report containing all the information gathered. Which of the following should be insured by an HO-6? The owners of condominiums and townhouses A tenant who rents an apartment in a high-rise building The owner of a ranch-style house A person who wishes to schedule their valuable jewelry separately on a policy = The =Answer>> is: The owners of condominiums and townhouses. EXPLANATION: The HO-6 is for owners of condominiums and townhouses. Which of the following losses would be paid under a garage policy with garage keeper's legal liability coverage, but without dealers physical damage coverage? I. Hail damage to a 4-door van held for sale. II. Damage when paint is accidentally spilled on a customer's truck by the dealer's body shop. III. Fender damage when a mechanic drives the customer's sports car into a steel post. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Law laid down in the decisions of courts = The =Answer>> is: Law based on new trials yet to be decided. EXPLANATION: Case law is law based on prior cases that have been previously decided. It would not apply to new trials yet to be decided. Horace Timm has a general liability policy with the Marvel Insurance Company. The policy's limit of liability is $25, per occurrence. In the course of one policy year, Mr. Timm becomes liable for the following amounts as a result of three separate occurrences: Occurrence #1 $35, Occurrence #2 $10, Occurrence #3 $25, The total amount Marvel will pay as result of these three occurrences is: $25, $60, $70, $75,000 = The =Answer>> is: $60,000. EXPLANATION: The CGL policy has two limits. The first is the aggregate limit and the second is a per occurrence limit. The per occurrence limit is the most that can be paid on any one single claim. Therefore the policy can only pay $25,000 on occurrence 1 and pay the total claimed on the others. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Who of the following people would be considered as "family members" under a personal umbrella liability policy? A parent of the insured who resides in another state The divorced wife of the insured who no longer resides with the insured The insured's father-in-law who lives next door A foster child who lives with the insured = The =Answer>> is: A foster child who lives with the insured. EXPLANATION: Only the foster child would be considered a family member since the child resides with the insured. Which of the following would NOT be covered by a flood insurance policy? Overflow of water from a pond on the insured property Mudslides from recent heavy rain. Collapse of land along the shore of a body of water Inundation and overflow of surface waters = The =Answer>> is: Mudslides from recent heavy rain. EXPLANATION: Damage c aused by mudflow is covered under the policy. Mudslides are not. Which of the following coverages can be included under a Commercial Package Policy? All of the responses listed are correct Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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The claim would be excluded due to concurrent causation. The insured would need the earthquake endorsement to be covered for any of this damage. Only the explosion damage would be covered. Only the resulting fire and explosion damage would be covered. = The =Answer>> is: Only the resulting fire and explosion damage would be covered. EXPLANATION: The prox imate cause of loss is apparently earth movement, but the insured does NOT need the earthquake endorsement to cover the fire and explosion. In the HO forms, the earth movement exclusion states that there IS coverage. If fire or explosion ensues the insurer will pay only for the ensuing loss. (Similarly, the water damage exclusion states that direct loss by fire, explosion, and theft resulting from water damage is covered.) Which of the following would be eligible for the Businessowners Policy? A family pub A funeral home An auto repair service station A credit union = The =Answer>> is: A funeral home. EXPLANATION: There ar e many classes that are not eligible for the businessowners program. Businesses connected with the auto business, such as repair or service stations, dealerships, or parking lots or garages are not eligible unless one of these is incidental to an eligible business. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Bars and pubs are ineligible for coverage as well. A funeral home would be eligible. A credit union would not be eligible. In case of a Workers Compensation injury, generally the _______ is responsible for arranging medical treatment for the first 30 days from the date of the injury or illness is reported. The employer The employee The HMO The worker's compensation commission = The =Answer>> is: The employer. EXPLANATION: This is generally the employer's responsibility. After 30 days the employee is then free to select any treating physician or facility. A settlement in which the claimant receives payment in installments over a period of time instead of a lump sum is: A Structured Settlement. Scheduled Payment Release. Full Release Settlement. Open-Ended Release. = The =Answer>> is: A Structured Settlement. EXPLANATION: Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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EXPLANATION:
Sometime s it takes time for damage or an injury to become evident. Previously, all liability policies were based on the concept of "accident" in which all damage is immediately evident. The courts ruled this concept too restrictive and for that reason, liability policies cover claims on an "occurrence" basis. Your insurance company pays for the damages to your auto and for your bodily injury after your car is struck by a hit and run driver. The accident is witnessed by several individuals who can describe the car and its driver but who failed to get a license number. A year after the accident, the owner of the hit and run vehicle turns himself in. It is determined that he was fully insured at the time of the accident but fled because he had been drinking. Pursuant to the California Insurance Regulations, your insurance company can: Do nothing as a full year has passed since the accident occurred Subrogate against the other insurance company to recover only for the damages to your vehicle Subrogate against the other driver to recover all sums paid for your vehicle repair and your bodily injury File a lawsuit to waive the statute of limitations then proceed with subrogation = The =Answer>> is: Subrogate against the other driver to recover all sums paid for your vehicle repair and your bodily injury. EXPLANATION: Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Payments made under both your Uninsured Motorist Bodily Injury and Uninsured Motorist Property Damage coverages can be recovered from the responsible party by subrogation if his/her identity is later confirmed. The insured has sustained a loss of income loss from a covered peril under his Businessowners Policy. What deductible applies to loss of income coverage? A 72 hour waiting period before the policy pays The same deductible that applies to the building or contents coverage A $500 deductible No deductible = The =Answer>> is: A 72 hour waiting period before the policy pays. EXPLANATION: Business income coverage is triggered by physical loss or damage, from a covered cause of loss, to property at the described premises. This loss must result in a suspension (now defined within the coverage) of the business's operations—that is, the business activities—during the period of restoration. The period of restoration begins seventy-two hours after the time of the direct physical loss or damage. Thus, there is a time deductible. What is not covered by "extra expense" coverage in commercial property insurance? Rent Payments at a Temporary Location Moving Expenses Overtime Pay Required to Make Repairs Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
