Free Maine Insurance Adjuster Practice Questions

Morale hazard is the 'eh, I'm covered' attitude: indifference or carelessness that creeps in because insurance exists. It's not dishonesty (that's moral hazard) and it's not a physical condition (physical hazard). Trick to remember: moralE hazard is about a person's lazy attitudE.

Reinsurance is insurance for insurance companies. The original insurer (the ceding company) hands off part of its risk to a reinsurer so one giant loss doesn't sink it. Individuals never deal with reinsurers directly; it all happens behind the scenes between carriers.

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 reciprocal (an unincorporated group of members who insure each other) is run by an attorney-in-fact. The members are both insureds and insurers to one another. Niche, but the exam likes the 'attorney-in-fact' detail, so tuck it away.

A captive (or exclusive) agent represents a single insurer, and that insurer owns the book of business. An independent agent represents multiple companies and owns their own expirations (the renewal rights). The ownership-of-expirations detail is the classic distinguisher.

Apparent authority is about appearances: what a reasonable customer believes the agent can do based on how the insurer let the agent act (business cards, signage, company applications). Express authority is spelled out in the contract; implied is what's needed to carry out the express. Apparent is the 'looks legit' bucket.

A broker works for the insured, shopping the market on the client's behalf, while an agent works for the insurer. Same exam, different masters: keep them straight. Broker equals the buyer's side; agent equals the company's side.

Aleatory means the exchange of value can be lopsided and depends on chance. You might pay $600 in premium and collect $200,000 on a claim, or pay for years and never file one. That built-in inequality, hinging on whether a loss happens, is what makes the contract aleatory.

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.

The four elements are agreement (offer and acceptance), consideration, competent parties, and legal purpose. A notarized signature isn't on the list, so it's the odd one out. Consideration, by the way, is what each side brings to the table: the insured's premium and the insurer's promise to pay.

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.

Under named perils, the insured must show the loss was caused by a listed peril. Under open perils (all-risk or special form), coverage is presumed unless the insurer proves an exclusion applies, so the burden shifts to the insurer. Open perils is the broader coverage. Hook: named perils, the insured proves it's covered; open perils, the insurer proves it's excluded.

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.

The deductible is the amount the insured absorbs on each loss, which screens out small, frequent claims and reduces the premium. Hook: the deductible knocks out the small stuff and trims your premium.

The limit of insurance is the most the insurer will pay for a covered loss; amounts above it are the insured's responsibility. Hook: the limit is the ceiling on what the insurer pays.

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.

Comparative negligence reduces the claimant's award by their percentage of fault, so someone 30% responsible recovers 70% of their damages. It's more forgiving than the older contributory negligence rule, which could bar recovery entirely for any fault at all. Hook: comparative negligence trims your recovery by your share of the blame.

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.

When an insurer pays for a loss, it generally gains rights to the salvage, the damaged property, which it can then sell to recover part of what it paid. Hook: salvage is the leftover the insurer can sell after paying the claim.

A morale hazard is an attitude of carelessness: a person takes fewer precautions simply because they know insurance will cover any loss (the why-worry-I'm-insured mindset). It differs from a moral hazard, which involves outright dishonesty. Hook: morale hazard is carelessness from having coverage; moral hazard is dishonesty.

Coverage E pays sums the insured is legally liable for when they cause bodily injury or property damage to others, and it also pays the cost of legal defense. It is third-party coverage. Hook: Coverage E covers what you owe others when you are legally liable.

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.

Medical Payments covers others, not the named insured or regular household residents. Their own injuries fall outside this coverage and would be handled by their own health insurance. Hook: Coverage F is for others, never the insured or household members.

Raising Coverage C does not lift the special jewelry theft sublimit. Scheduling the ring on a personal articles floater (scheduled personal property endorsement) insures it for its full appraised value, usually on an open-perils basis and often with no deductible. Hook: beat the jewelry sublimit by scheduling the item, not by raising Coverage C.

By default, Coverage C pays actual cash value, replacement cost minus depreciation, for personal property. A replacement-cost-on-contents endorsement upgrades it to pay full replacement with no depreciation. Hook: contents default to ACV; add the endorsement to get replacement cost.

The loss settlement condition usually requires carrying at least 80% of the dwelling's replacement cost to be paid full replacement cost on partial losses. Carry less and the payout is reduced. Hook: insure the dwelling to at least 80% of replacement cost to get full replacement on partial losses.

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.

Coverage D responds when a covered peril renders the home unfit to live in, paying the additional living expenses incurred while it is repaired or rebuilt. A voluntary remodel does not trigger it. Hook: Loss of Use kicks in when a covered loss forces you out, not when you choose to leave.

Earth movement, including earthquake, is excluded by the standard homeowners policy, but the insured can usually add earthquake coverage by endorsement or buy a separate earthquake policy. Hook: earthquake is excluded but can be bought back by endorsement.

Standard policies exclude water that backs up through sewers or drains, but a water backup endorsement adds that coverage up to a selected limit. It is separate from flood, which is surface water. Hook: sewer backup needs the water backup endorsement; surface flooding needs NFIP.

Liability coverage responds when the insured is legally responsible for injuring someone else or damaging their property, and it also pays the cost of defending the insured. It does not pay for the insured's own car. Hook: liability pays the other guy, both his injuries and his property.

Medical Payments is a no-fault coverage that pays reasonable and necessary medical (and sometimes funeral) expenses for the insured and occupants of the covered auto, no matter who caused the accident. Hook: Med Pay pays your people's medical bills, fault not required.

For the named insured and resident family members, Med Pay follows the person: it applies when they are struck by a vehicle as pedestrians or while riding in other autos, not only in the insured's car. Other passengers are covered while occupying the insured auto. Hook: for you and your family, Med Pay follows the person, not just the car.

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.

UM bodily injury pays for the insured's injuries caused by an at-fault driver who is uninsured or who flees the scene. Whether UM also covers property damage varies by state. Hook: UM-BI is for your injuries when the other driver is uninsured or a hit-and-run.

A deductible is the insured's share of each physical damage loss, paid before the insurer pays the remainder. Choosing a higher deductible lowers the premium. Hook: the deductible is your slice of the loss you pay first.

Auto physical damage is normally paid on an actual cash value basis, which is replacement cost minus depreciation, reflecting the car's worth at the moment of loss. Vehicles lose value over time, so ACV is usually less than what was paid. Hook: cars are paid ACV, depreciated value, not what you paid for them.

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.

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 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.

Unlike the homeowners policy, the dwelling policy is primarily a property form and does not build in personal liability. An insured who wants it adds a liability endorsement. Hook: the DP is property-only out of the box; liability is a bolt-on.

Dwelling policies fill the gap for properties homeowners forms will not write: rentals, seasonal or secondary homes, vacant dwellings, and older homes. The DP is narrower, not richer, than homeowners. Hook: the DP is the answer when the home does not qualify for homeowners.

The dwelling program has three standard forms: DP-1 Basic, DP-2 Broad, and DP-3 Special, in increasing order of coverage breadth. The HO numbers belong to the homeowners program. Hook: dwelling forms are 1 Basic, 2 Broad, 3 Special.

The DP-1 is the narrowest form: it insures a short list of named perils and generally pays losses on an actual cash value basis (replacement cost minus depreciation). Hook: DP-1 is basic, named perils paid at ACV.

Coverage E is Additional Living Expense, paying the extra costs an owner-occupant runs up living elsewhere while a covered loss is repaired. Coverage D, by contrast, is for lost rent on a rented dwelling. Hook: Coverage E is ALE for the owner who lives there; Coverage D is lost rent for a rental.

Coverage B is Other Structures, covering detached structures on the premises like a freestanding garage, shed, or fence, just as it does on a homeowners form. Hook: Coverage B is the detached structures, the same in DP and HO.

Like the HO-3, the DP-3 splits its basis: the dwelling and other structures get open perils, but personal property is covered on a named-perils basis. Hook: DP-3 is open perils on the building, named perils on the contents, just like HO-3.

Settlement basis is a major dividing line: the DP-1 pays ACV on the dwelling, while the broader DP-2 and DP-3 pay replacement cost when the insured carries enough coverage. Hook: DP-1 means ACV; DP-2 and DP-3 mean replacement cost.

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-1 Basic Form sits at the bottom of the ladder, with the fewest perils and ACV settlement. The DP-2 is broader and the DP-3 is broadest. Hook: DP-1 is the floor, the narrowest dwelling form.

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 first named insured may cancel by mailing or delivering notice, and the insurer may cancel by sending advance written notice (the number of days is set by the condition and state law). The first named insured acts on behalf of all insureds. Hook: the first named insured cancels by notice; the insurer cancels with advance written notice.

The BPP is the workhorse coverage form of the commercial property coverage part, insuring buildings and business personal property. Hook: the BPP is the heart of the commercial property part.

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.

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 C is goodwill medical payments: it pays reasonable medical bills for others injured on the premises or by the insured's operations, no fault required, which can prevent a larger liability claim. Hook: CGL Coverage C pays small injury bills no-fault, just like home med pay.

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.

Inland marine covers property that moves or is hard to value at a fixed location: contractors' equipment, fine arts, goods in transit, and similar floating risks. Despite the name, it is largely land-based. Hook: inland marine insures property on the move and hard-to-rate items.

Classic eligible BOP classes include small offices, retail and mercantile stores, and apartment buildings. Auto dealers, financial institutions, and heavy manufacturers fall outside the eligible classes. Hook: offices, shops, and apartments are bread-and-butter BOP risks.

BOP programs cap eligibility by size, commonly using floor area and annual gross sales or receipts for the class. Exceed the thresholds and the risk must move to a CPP. Hook: square footage and sales are eligibility gates, too big and it is a CPP.

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.

BOPs bundle several automatic additional coverages, such as debris removal and limited money and securities coverage. Workers comp, professional liability, and auto are not part of the BOP. Hook: BOP throws in extras like debris removal and a little money and securities.

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.

BOP medical payments is a no-fault goodwill coverage that pays modest medical bills for others injured on the premises, which can head off a larger liability claim. Hook: BOP med pay covers others' small injury bills no-fault.

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.

BOPs do not cover professional liability; a business needing errors and omissions protection buys a separate professional liability policy or specific endorsement. Hook: E&O is not in the BOP, that needs its own professional liability policy.

Business personal property is the contents the business owns and uses, furniture, fixtures, machinery, equipment, and stock, at the described premises. The building is separate, and licensed autos are excluded. Hook: BPP is the contents, furniture, fixtures, machinery, and stock.

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.

Permanent partial disability (PPD) applies when the worker is left with a lasting impairment, such as the loss of use of a limb, but retains some ability to work. Benefits often follow a statutory schedule. Hook: permanent partial means a lasting impairment, but still able to work somewhat.

Vocational rehabilitation helps a worker who cannot return to the old job get back to gainful work, through retraining, job placement, or similar services. Hook: voc rehab is about getting the worker back to work, retrain and replace the income.

Part Two protects the employer against lawsuits for work-related injuries that escape the exclusive-remedy bar, such as a third-party-over action or a consequential injury claim by a family member. It backstops the gaps Part One does not address. Hook: Part Two catches the work-injury suits that slip past exclusive remedy.

Workers compensation premium is driven by payroll and the job classifications of the workers, since riskier classes carry higher rates. Premium is typically a rate applied to payroll. Hook: comp premium rides on payroll and job classification.

Because workers compensation covers employees, a true independent contractor is normally not covered by the hiring firm's policy and is expected to carry their own. Misclassifying employees as contractors is a common compliance problem. Hook: real independent contractors are not on the hiring firm's comp.

The Longshore and Harbor Workers Compensation Act (USL&H) covers maritime workers such as longshoremen and harbor workers who fall outside state workers comp. The Jones Act covers seamen and FELA covers railroad workers. Hook: dockworkers fall under USL&H, the Longshore act.

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.

Second Injury Funds limit an employer's liability when a new work injury combines with a worker's prior impairment to cause a greater disability, removing a disincentive to hire workers with pre-existing conditions. Hook: second injury funds make it safer to hire workers with prior impairments.

The core bargain is certainty for the worker (guaranteed no-fault benefits) traded for giving up the right to sue the employer, which also caps the employer's exposure. Hook: certain benefits for the worker, no lawsuit for the employer, that is the deal.

When a loss is covered by the umbrella but not the underlying policy, the insured pays a self-insured retention (much like a deductible) and the umbrella covers the rest. Hook: no underlying coverage means the umbrella kicks in after your self-insured retention.

The NFIP is a federal program run through FEMA, offering flood insurance in communities that adopt and enforce floodplain management rules. Private insurers may sell and service it under write-your-own arrangements. Hook: NFIP is federal flood insurance, available where the community participates.

NFIP flood coverage typically does not take effect until about 30 days after purchase, which discourages buying only when a flood is imminent. Limited exceptions apply (such as loan-related purchases). Hook: NFIP usually makes you wait about 30 days, no buying ahead of the storm.

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.

Homeowners policies give limited coverage for small, low-powered watercraft, but larger or faster boats require a dedicated boatowners or yacht policy. Hook: little boats may ride on the homeowners; real boats need their own policy.

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 surety bond is a three-party guarantee: the surety guarantees to the obligee that the principal will perform an obligation. Insurance, by contrast, is a two-party contract covering accidental loss. Hook: surety is three parties and a guarantee; insurance is two parties and a loss.

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.

The residual or shared market is the insurer of last resort, providing coverage (auto through assigned risk plans, property through FAIR Plans) to applicants the voluntary market turns down. Hook: the residual market is the last resort for risks no one else will write.