Free Hawaii Insurance Adjuster Practice Questions

Insurance only deals with pure risk: situations where there's a chance of loss or no loss, but no chance of gain (like your house burning down). Speculative risk involves a chance of loss, no loss, OR gain. That's gambling and investing, and insurers won't touch it. If there's an upside, it's not insurable.

Insurers like risks that are accidental (due to chance, not intentional) and definite and measurable (you can pin down when, where, and how much). Add in 'predictable for large groups,' 'not catastrophic to the insurer,' and 'affordable premium,' and you've got the recipe for an insurable risk. A loss someone causes on purpose? Not insurable.

Treaty reinsurance is the automatic, blanket deal: the reinsurer agrees in advance to take a whole category of risks. Facultative is the opposite, case-by-case, where the reinsurer can accept or decline each risk individually. Treaty equals automatic and broad; facultative equals optional and specific.

The law of large numbers needs lots of similar exposures to make predictions reliable. A big pool of comparable homes lets the insurer forecast losses; a handful of wildly different ones doesn't. And concentrating them all in one spot is actually bad: one hurricane could wipe out the whole pool at once.

A mutual insurer is owned by its policyholders, so a 'dividend' is really a return of overpaid premium, which is why it's generally not taxable. And it's never guaranteed; it depends on the company's results. Stock dividends, by contrast, go to stockholders and are taxable.

Participating policies 'participate' in the insurer's profits by paying policy dividends, and are typically issued by mutual companies. Nonparticipating policies don't pay dividends and are typically issued by stock companies. The word 'participate' is your tell.

A contract of adhesion is written by one party (the insurer) and accepted as-is by the other, with no line-by-line negotiating. The practical kicker: because the insured didn't get to write it, any ambiguity is interpreted in the insured's favor. That's a courtroom rule worth knowing.

Unilateral means only one side makes a legally enforceable promise, and it's the insurer, who promises to pay covered claims. The insured doesn't actually promise to keep paying premiums; they just won't get coverage if they stop. One enforceable promise equals unilateral.

Representations are statements the applicant believes are true, and they only need to be true to the best of the applicant's knowledge. A warranty is a stronger animal: it's guaranteed to be absolutely true. Concealment is hiding a material fact. For most applications, you're dealing with representations.

Concealment is staying silent about a material fact you know the insurer would want, and if it's intentional, it can void the policy. It's the sin-of-omission version of misrepresentation (which is an active false statement). Both turn on the fact being 'material,' meaning it would have affected the insurer's decision.

Depreciation is the loss in a property's value from age, use, and obsolescence. It's subtracted from replacement cost to arrive at actual cash value. Hook: depreciation is the wear-and-tear value the insurer subtracts under ACV.

With agreed value, the parties set the insured amount up front (often for hard-to-value items like fine art), and that agreed figure is paid for a total loss, with the coinsurance requirement waived. Hook: agreed value locks in the payout amount ahead of time, no coinsurance fight later.

Open perils coverage protects against all direct physical losses unless a peril is specifically excluded, making it broader than named perils. The exclusions list defines what's left out. Hook: open perils covers everything except what's specifically excluded.

A direct loss is the immediate physical damage a peril causes, like a fire burning a building. It contrasts with indirect (consequential) losses that follow from it. Hook: direct loss is the physical damage itself, the fire burning the house.

An indirect, or consequential, loss is the financial fallout that follows a direct loss, like the income a business loses while closed for repairs. Business income (interruption) coverage addresses it. Hook: indirect loss is the ripple effect, the income lost after the physical damage.

Required coverage is 80% of $200,000, or $160,000. The insurer pays the loss times the ratio of coverage carried to coverage required: ($120,000 / $160,000) times $50,000 equals 0.75 times $50,000, or $37,500. The owner absorbs the $12,500 coinsurance penalty for underinsuring. Hook: did-over-should times the loss, $120k over $160k times $50k equals $37,500.

Compensatory damages reimburse the victim's actual losses (special damages like medical bills and lost wages, plus general damages like pain and suffering). Punitive damages go beyond that to punish egregious conduct and deter others. Hook: compensatory makes the victim whole; punitive punishes the wrongdoer.

After paying the insured for a loss caused by someone else, the insurer steps into the insured's shoes (subrogation) and pursues the at-fault party to recover what it paid. It prevents the insured from collecting twice. Hook: subrogation lets the insurer go after whoever caused the loss to get its money back.

A physical hazard is a tangible condition of property or environment that increases risk, like icy steps, faulty wiring, or stored chemicals. It exists in the physical world, unlike moral or morale hazards. Hook: a physical hazard is a real-world condition you could point to.

A moral hazard arises from a person's character, a dishonest tendency that increases risk, such as someone who would intentionally cause or exaggerate a loss to collect. Hook: moral hazard is dishonesty, the intent to cheat the insurer.

Both forms cover the dwelling on open perils, but the HO-5 upgrades personal property to open perils as well, while the HO-3 keeps personal property on named perils. The HO-5 is the broadest standard homeowners form. Hook: HO-5 takes the HO-3 and upgrades the contents to open perils too.

Coverage A insures the dwelling itself, the house and structures attached to it. Hook: Coverage A is the dwelling, the house itself.

Coverage C usually equals about 50% of the Coverage A dwelling limit, though the percentage can be adjusted. It covers the insured's belongings. Hook: Coverage C, personal property, runs about 50% of the dwelling limit.

The dwelling under Coverage A is generally settled on a replacement cost basis, as long as the insured carries at least the required percentage, usually 80%, of replacement cost. Personal property defaults to actual cash value unless a replacement-cost endorsement is added. Hook: the dwelling is replacement cost if insured to value; contents default to ACV.

Coverage F is a no-fault, goodwill coverage that pays reasonable medical expenses for others accidentally injured on the insured's premises, regardless of fault, which often heads off a larger liability claim. Coverage E, by contrast, requires legal liability. Hook: Coverage F pays guests' medical bills no-fault; Coverage E needs you to be legally liable.

The base liability section covers bodily injury and property damage. A personal injury endorsement broadens it to cover offenses such as libel, slander, defamation, and invasion of privacy. Hook: the personal injury endorsement adds the reputation harms, libel and slander.

Items like jewelry, cash, furs, and firearms carry special low sublimits, especially for theft, because they are high in value, easily stolen, and hard to verify. To insure them fully, the owner schedules them. Hook: jewelry, cash, and guns hit special low sublimits, so schedule them for full value.

Underinsuring below 80% drops the insured to the larger of the actual cash value of the loss or a reduced amount figured by the loss-settlement proportion, but never the full replacement cost. Hook: under 80%, you fall back to the greater of ACV or the prorated amount, not full replacement.

Because the owner will not occupy it, a homeowners form does not fit. A dwelling policy insures the structure of a rental or non-owner-occupied home, and the tenant separately buys an HO-4 for their own contents. Hook: the rental structure goes on a dwelling policy; the tenant's belongings go on HO-4.

After a covered loss, current building codes may require costlier rebuilding than the original construction. An ordinance or law endorsement covers that added expense, which the base policy may limit or exclude. Hook: ordinance or law pays the code-upgrade costs when you rebuild.

Part C is Uninsured/Underinsured Motorist coverage, which protects the insured when an at-fault driver has no liability insurance or not enough of it. Hook: Part C covers you when the other driver Can't pay.

In split limits the first number is the per-person bodily injury cap, the second is the per-accident bodily injury cap, and the third is the property damage cap per accident. So 100/300/50 is 100,000 per person, 300,000 per accident, 50,000 for property. Hook: split limits read per person, per accident, then property damage.

Liability coverage includes the insurer's duty to defend the insured against covered claims, and those defense costs are usually paid in addition to the policy limits, not subtracted from them. Hook: liability buys you a lawyer, and the defense cost normally sits on top of your limit.

UM coverage steps in when an at-fault driver has no liability insurance (or cannot be identified, as in a hit-and-run), paying the insured for injuries the other driver should have covered. Hook: uninsured motorist covers you when the at-fault driver has zero insurance.

The newly acquired auto rule automatically extends the policy to a car the insured buys during the term, for a limited window (commonly up to 14 days), so the insured is not driving uninsured before reporting it. Hook: buy a new car and you get an automatic grace period to add it.

Towing and labor coverage, sometimes called roadside assistance, pays for towing and on-site labor costs after a disablement. It is a low-cost optional endorsement. Hook: towing and labor is the tow-truck and roadside endorsement.

After a total loss, physical damage pays only the ACV, which can be less than what the insured still owes. Gap coverage pays that shortfall between the ACV and the outstanding loan or lease balance. Hook: gap covers the gap between what the car is worth and what you still owe.

Rental reimbursement (transportation expense) coverage pays a daily amount for a rental car while the insured's vehicle is being repaired or replaced after a covered loss, usually subject to a daily and total cap. Hook: rental reimbursement keeps you on the road while your car is in the shop.

The PAP excludes vehicles used as a public or livery conveyance, meaning carrying people or property for a fee. Personal use, commuting, and vacations are fine; for-hire driving needs commercial or ride-share coverage. Hook: the PAP is personal use, driving for a fee needs a different policy.

The PAP excludes losses occurring while the auto is used in any prearranged or organized racing or speed contest, because that activity sharply increases the risk. Hook: take it to the track and the PAP taps out, racing is excluded.

The dwelling policy is built for residences that fall outside standard homeowners eligibility, especially rentals and non-owner-occupied homes, plus seasonal or older dwellings. Homeowners forms assume the owner lives there. Hook: the DP is the rental and non-owner-occupied house policy.

Among dwelling forms, the DP-3 gives the broadest protection on the structure by covering open perils. The DP-2 is broad but still named-perils, and the DP-1 is the narrowest. Hook: broadest dwelling form is the DP-3, open perils on the building.

In its base form the DP-1 covers fire, lightning, and internal explosion. Extended Coverage and optional endorsements broaden it from there. Hook: the bare DP-1 starts with fire, lightning, and internal explosion.

Extended Coverage adds the classic EC perils: windstorm, hail, explosion, riot and civil commotion, aircraft, vehicles, and smoke. Flood, earthquake, and war stay excluded. Hook: EC adds the WHARVES-style perils, wind, hail, aircraft, riot, vehicles, explosion, smoke.

The DP-1 settles dwelling losses at actual cash value, which deducts depreciation from replacement cost. The broader DP-2 and DP-3 can pay full replacement cost when the insured-to-value condition is met. Hook: DP-1 pays ACV; step up to DP-2 or DP-3 for replacement cost.

Like homeowners, dwelling policies exclude flood and earth movement (including earthquake). Flood is insured through the NFIP or a private flood policy, and earthquake can be added by endorsement or separate policy. Hook: DP and HO both exclude flood and earth movement, buy those separately.

The dwelling policy leaves out three things homeowners builds in: liability, theft, and medical payments. Each can be added by endorsement, but none is automatic. Hook: a DP skips liability, theft, and med pay unless you add them.

Seasonal and secondary residences often fail homeowners occupancy requirements, so they are written on a dwelling policy instead. Hook: the vacation or seasonal home usually lands on a dwelling policy.

Dwelling policies are flexible on occupancy: they can cover owner-occupied, tenant-occupied, or even vacant dwellings, with endorsements and conditions adjusting the coverage for each situation. Hook: a DP can insure owner-occupied, rented, or vacant homes.

The DP-2 keeps the named-perils approach but lengthens the peril list and, unlike the DP-1, settles the dwelling on a replacement cost basis. Open perils is the DP-3, not the DP-2. Hook: DP-2 adds perils and upgrades the dwelling to replacement cost, still named perils.

A CPP is a package because it bundles two or more commercial coverage parts, such as property and general liability, under one policy with shared declarations and conditions. Hook: package means two or more coverage parts in one policy.

Each coverage part is itself built from a declarations page, coverage form(s), a causes-of-loss form (for property), and applicable conditions, all sitting under the shared common declarations and common conditions. Hook: a coverage part stacks its own dec, coverage form, causes-of-loss, and conditions.

The common policy conditions, things like cancellation, changes, inspections, and transfer of rights, govern every coverage part in the package, while each part also has its own specific conditions. Hook: common conditions are common to all parts; specific conditions live in each part.

The BPP has a separate Personal Property of Others category for property of others in the insured's care, custody, or control, such as customers' goods left for service. Hook: customers' property in your care goes under Personal Property of Others.

Building coverage takes in the structure, completed additions, permanently installed fixtures and machinery, and equipment used to maintain or service the building (like heating and air conditioning). Movable contents and stock are business personal property instead. Hook: building is the structure plus what is bolted in to run it.

Extra expense pays the added costs of staying open or reopening sooner, such as renting a temporary location or leasing equipment, which can reduce the business income loss. Hook: extra expense is the money spent to keep the doors open after a loss.

The period of restoration runs from the date of the direct physical loss (after any waiting period) until the property is or should be repaired or replaced with reasonable speed. That window defines how long business income is paid. Hook: restoration runs from the loss to when repairs should be done.

CGL Coverage A is the core: bodily injury and property damage liability arising out of the insured's premises, operations, products, and completed operations. Hook: CGL Coverage A is bodily injury and property damage liability.

Coverage B covers personal and advertising injury offenses: libel, slander, false arrest, wrongful eviction, and infringing on copyright or slogans in the insured's advertising. Hook: Coverage B is the reputation and advertising offenses, libel and slander.

A CPP is built piece by piece from chosen coverage parts and suits a wide range of businesses, while a BOP is a standardized bundle of property and liability designed for eligible small to mid-size businesses. Hook: CPP is build-your-own; BOP is the prepackaged small-business bundle.

The BOP packages property and liability into one standardized policy built for eligible smaller businesses, simplifying coverage that would otherwise take several separate policies. Hook: a BOP is property plus liability, prepackaged for small business.

Every BOP bundles commercial property and commercial general liability into a single policy, which is the core of what makes it a businessowners policy. Hook: a BOP is property and liability in one package.

The BOP gives a small business broad, coordinated coverage at a lower bundled cost and with fewer gaps than juggling separate policies. It does not erase exclusions or premiums. Hook: the BOP wins on simplicity and price for the right-sized business.

Modern BOPs commonly insure property on an open-perils (special) basis, covering any cause of loss that is not specifically excluded, which is broader than named-perils. Hook: BOP property usually runs open perils, covered unless excluded.

A defining simplification of the BOP is that it usually has no coinsurance clause, so the insured is not penalized for underinsuring the way a coinsurance form would penalize them. Insuring to value is still wise but not enforced by a coinsurance penalty. Hook: the BOP drops the coinsurance clause, no did/should penalty.

The BOP builds in business income and extra expense automatically, so a covered shutdown is protected without the owner having to remember to add the coverage. That is a key BOP advantage for small businesses. Hook: business income comes built into the BOP, no add-on needed.

Like the CGL, BOP liability covers bodily injury and property damage, personal and advertising injury, and offers limited medical payments to others, with defense costs. Hook: BOP liability covers BI/PD, personal and advertising injury, and a little med pay.

Workers compensation is never part of a BOP; it is written on a separate workers comp policy. The BOP does include property, liability, and business income. Hook: a BOP has no workers comp, that is always a separate policy.

While the BOP is standardized, insurers offer optional coverages and endorsements (for example, equipment breakdown or hired and non-owned auto) to tailor it to a business's needs. Hook: tailor the BOP with optional coverages and endorsements.

Fire department service charge coverage reimburses charges a fire department bills the insured for responding to a covered fire, up to a stated limit. Debris removal and ordinance or law are different additional coverages. Hook: the fire department bill is paid by fire department service charge coverage.

Under workers compensation, an injured worker collects benefits without proving the employer was negligent, and benefits are generally owed even if the worker was careless. Fault is set aside. Hook: no-fault means benefits flow without proving blame.

The grand bargain of workers compensation: the worker gets prompt, certain benefits and in return gives up the right to sue the employer in court over the work injury. Hook: guaranteed benefits in, the right to sue the employer out, that is exclusive remedy.

Under the going-and-coming rule, an ordinary commute is normally not in the course of employment, so a commuting injury usually is not covered (special exceptions can apply, such as travel that is part of the job). Hook: the normal commute is off the clock for comp purposes.

Although comp is no-fault, most statutes still allow benefits to be reduced or denied where the injury results from the worker's intoxication or willful misconduct. No-fault does not mean no defenses. Hook: no-fault still has limits, intoxication and willful misconduct can cut benefits.

Workers compensation medical benefits generally cover the full reasonable cost of treating the job injury, with no deductible and no overall dollar cap, unlike most health plans. Hook: comp medical is usually first-dollar and unlimited for the work injury.

A fatal work injury triggers death benefits to the worker's surviving dependents (often a percentage of wages) along with a burial or funeral allowance set by statute. Hook: a fatal claim pays the dependents plus a burial allowance.

Part One promises to pay whatever benefits the listed states' workers compensation laws require, with no dollar limit, because the insurer is standing in for the employer's full statutory obligation. Hook: Part One pays the statute in full, no dollar limit.

The experience mod compares an employer's actual losses with those expected for its class. A mod above 1.0 raises premium, below 1.0 lowers it, rewarding good safety records. Hook: the experience mod credits or debits you for your own loss history.

Workers compensation rates are quoted as a dollar rate per $100 of payroll for each classification, so payroll drives the premium. Hook: comp rates are dollars per $100 of payroll.

The Jones Act gives seamen (crew members of vessels) the right to seek damages from their employer for job injuries. Railroad workers use FELA instead. Hook: seamen sail under the Jones Act; railroaders ride FELA.

Standard property forms exclude earth movement, but earthquake coverage can be added by endorsement or bought separately, commonly with a deductible expressed as a percentage of the dwelling limit rather than a flat dollar amount. The NFIP covers flood, not quake. Hook: earthquake is excluded but buy-back-able, usually with a percentage deductible.

Scheduling valuables like jewelry, furs, or fine arts is done on a personal articles floater, which is a personal inland marine form. Hook: the personal articles floater is inland marine for your valuables.

Protection and indemnity (P&I) is the liability portion of ocean marine, covering the owner's legal liability for bodily injury and property damage arising from the vessel, including crew injury and damage to other ships. Hull covers the vessel, cargo covers the goods, P&I covers the liability. Hook: P&I is the liability piece of ocean marine.

Aviation risks (hull and liability for aircraft) are excluded from standard personal lines and must be written on specialized aviation policies. Hook: planes need aviation insurance, never the home or auto policy.

A performance bond is a surety bond guaranteeing the contractor will complete the project according to the contract; if not, the surety makes the obligee whole. Hook: performance bonds guarantee the job gets finished.

FAIR Plans are state residual-market programs that make basic property insurance available to applicants who cannot get it in the voluntary market, often because of location or risk. Hook: FAIR Plans are the property safety net for hard-to-insure risks.

A DIC policy is written alongside basic property coverage to fill gaps, commonly adding catastrophic perils such as flood and earthquake that the underlying policy excludes. It supplements rather than replaces. Hook: DIC fills the holes, often adding flood and quake to a property program.

A farm policy blends personal and business exposures, covering the farm dwelling and personal property along with barns, equipment, livestock, and farm liability, because a farm is both a home and a business. Hook: farm coverage mixes the home and the business under one roof.

Mobile and manufactured homes have unique construction and transport exposures, so they are commonly written on a specialized mobile-homeowners form rather than a standard HO-3. Hook: mobile homes get their own mobile-homeowners policy.

Personal umbrellas typically start at $1,000,000 of additional liability and increase from there, giving high-net-worth and ordinary insureds a large cushion above their home and auto limits. Hook: personal umbrellas usually begin at a cool one million.