Claims and Loss Settlement Flashcards
6 cards from real Property And Casualty Insurance License practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Claims and Loss Settlement flashcards as text
What is an 'independent adjuster' (IA)?
Answer: A freelance claims professional hired by insurers on a per-claim basis
Independent adjusters are self-employed or work for IA firms and are contracted by insurers to handle claims, particularly during catastrophes when staff adjusters are overwhelmed.
What is a 'first-party' claim?
Answer: A claim filed by the policyholder against their own insurance policy
A first-party claim is made by the insured directly to their own insurer, such as a collision claim or a homeowners contents claim.
What is 'comparative negligence' and how does it affect claims?
Answer: Damages are reduced proportionally based on each party's percentage of fault
Under comparative negligence, a claimant's recovery is reduced by their percentage of fault; for example, if 20% at fault, they recover 80% of their damages.
What is a 'coverage opinion' letter in liability claims?
Answer: A legal analysis by coverage counsel determining whether a policy covers a specific claim
A coverage opinion is a formal written analysis, typically prepared by an attorney, that evaluates whether a liability policy's terms apply to a specific claim or lawsuit.
What does 'excess judgment' mean in liability insurance?
Answer: A court judgment against the insured that exceeds the policy's liability limits
An excess judgment is a court verdict against the insured for an amount greater than the policy's liability limit, leaving the insured personally responsible for the difference.
What is the 'right and duty to defend' in a liability policy?
Answer: The insurer's obligation to provide legal defense for covered claims, even if groundless
Liability policies obligate the insurer to defend the insured against covered claims, including paying attorney fees, and this duty applies even to frivolous lawsuits.