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Texas Claims Adjuster Questions and Correct Answers the Latest Update
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Texas Claims Adjuster Questions and Correct Answers the Latest Update
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Texas Claims Adjuster Questions
and Correct Answers the Latest
Update
Basic Cause of Loss
✓ Normal Peril form that specifies the perils insured against.
Broad Cause of Loss Form
✓ Named peril form and provides coverage for the perils named in the basic form, but
adds additional perils and names them on the form.
Special Cause of Loss Form
✓ The special form is an "open peril" or "all risk" form that provides coverage for all
risks of loss, except for those excluded in the policy
Appraisal Clause
✓ allows either the insured or the insurance company to demand a binding appraisal of
the loss.
Principle of Indemnity
✓ An insured who has suffered a loss, should only be restored to the approximate
financial condition that existed prior to the loss, no better and no worse.
Insurable Interest
✓ The "person" must have a lawful, substantial, and economic interest in the health,
property or object being covered under the insurance.
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Risk
✓ uncertainty concerning the occurrence of a loss
Pure Risk
✓ There is only the possibility of a loss or no-loss.
Speculative Risk
✓ There is a possibility of both profit and loss
Peril
✓ cause of loss
Hazard
✓ Increases the chance of loss
Physical hazard
✓ The material, structural, or operational features of the risk itself, apart from the
morale or moral hazards of persons owning or managing it.
Moral Hazard
✓ A condition that increases the likelihood that a person will intentionally cause or
exaggerate a loss.
Morale Hazard
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✓ A condition of inattention to, or disregard for, one's own life, health, property or
behavior, that increases the frequency or severity of a loss.
Five Methods of Risk Management
✓ 1. Risk Avoidance
✓ 2. Transfer of Risk
✓ 3. Sharing a Risk
✓ 4. Assumption of Risk
✓ 5. Risk Reduction or Risk Control
Underwriting
✓ Process of selecting certain types of risks and rejecting others so the insurance
company will have a book of business that will produce the company's desired
results. (they want a favorable loss ratio)
Contracts must contain these 4 elements
✓ 1. Capacity of Contract/Competent Parties
✓ 2. Legal Purposes
✓ 3. Offer and Acceptance
✓ 4. Consideration
Parts of an Insurance Contract
✓ 1. Declarations
✓ 2. Insuring agreement
✓ 3. Exclusions
✓ 4. Conditions
The two broad principles that form the legal foundations of all insurance policies
are:
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