Free New Mexico Insurance Adjuster Practice Questions

Moral hazard equals dishonesty. It's the risk that someone deliberately causes or exaggerates a loss to profit, like torching a failing business for the payout. Don't mix it up with morale hazard (carelessness, choice B) or physical hazard (the actual physical conditions in A and D).

A physical hazard is a tangible condition that increases the likelihood or severity of a loss: gasoline in the garage, a slippery floor, frayed wiring. You can see or touch it. If it's an attitude problem it's morale; if it's dishonesty it's moral; if it's a physical thing sitting there raising the odds, it's physical.

Buying insurance is the classic risk transfer: you hand the financial consequences of a loss to the insurer in exchange for a premium. Avoidance means not doing the risky thing at all, retention means keeping the risk yourself (like a deductible), and reduction means lowering the odds or severity (smoke detectors). Insurance equals transfer.

Adverse selection is the insurer's headache: the people most likely to have a loss are also the most eager to buy and keep coverage. If underwriting didn't push back, the risk pool would fill up with bad risks and the math would collapse. It's exactly why underwriting and exclusions exist.

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.

An agent represents the insurer (the principal); that's the cornerstone of agency law. A broker, by contrast, represents the insured. So when an agent acts within their authority, the insurer is on the hook for what they do. Agent equals the insurer's rep.

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.

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.

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.

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.

ACV pays what the damaged property was actually worth at the time of loss: replacement cost minus depreciation for age and wear. It leaves the insured to absorb the depreciation. Hook: ACV equals replacement cost minus depreciation, today's worn-down value.

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.

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.

If the insured met the coinsurance requirement, carrying at least the required percentage of value, no penalty applies and the loss is paid in full up to the limit. The penalty only bites when coverage falls short. Hook: meet the coinsurance requirement and there's no penalty.

The four elements of negligence are a duty owed, a breach of that duty, the breach being the proximate cause, and actual damages. Intent is not required; in fact, negligence is unintentional, which separates it from an intentional tort. Hook: duty, breach, causation, damages, but never intent for negligence.

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.

An excess provision makes that policy pay only after other primary coverage has been used up; it sits on top as a second layer. Hook: excess coverage waits its turn, paying only after the primary is exhausted.

Property policies typically prohibit abandonment: the insured can't simply dump damaged property on the insurer and demand the full amount. The insurer decides whether to repair, replace, or pay. Hook: you can't abandon the wreck to the insurer and demand a full check.

A peril is what actually causes a loss (fire, theft, windstorm), while a hazard is a condition that makes a loss more likely or more severe, like oily rags raising the chance of fire. Hook: peril is the cause; hazard is what makes the cause more likely.

HO-3 insures the dwelling and other structures on an open-perils basis (covered unless excluded) but covers personal property on a named-perils basis. That split is the reason it is the go-to homeowners form. Hook: HO-3 is open perils on the house, named perils on the stuff inside.

HO-4, the Contents Broad Form, is the renters or tenants policy. It covers the tenant's personal property and liability but not the building, which the landlord insures. Hook: HO-4 is the renters form, contents and liability, no building.

HO-6 covers condominium and co-op unit owners. It insures personal property and provides limited building coverage for improvements inside the unit, since the association's master policy covers the structure itself. Hook: HO-6 is the condo form, your belongings plus the walls-in.

The HO-2 Broad Form covers both the dwelling and personal property on a named-perils basis, using the broad list of covered perils. It is narrower than the HO-3, which opens the dwelling up to open perils. Hook: HO-2 is named perils on everything, the broad list applied to both house and contents.

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.

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.

Coverage E follows the insured, applying worldwide to liability arising out of personal, non-business activities, not just incidents on the residence premises. Hook: your personal liability travels with you worldwide, not just at home.

Standard homeowners forms require the dwelling to be owner-occupied, meaning it is the insured's residence. Non-owner-occupied or rental dwellings are insured under a dwelling policy instead. Hook: homeowners forms are for owner-occupied homes; rentals go on a dwelling policy.

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.

A combined single limit gives one pool of money per accident that can be used for bodily injury and property damage in any combination, instead of separate per-person and per-accident caps. It offers more flexibility on large losses. Hook: combined single limit is one bucket for everything per accident.

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.

UIM fills the gap when the at-fault driver does carry liability insurance but the limits run out before the insured's injuries are fully paid. It picks up where the other driver's insufficient coverage stops. Hook: underinsured means they had some coverage, just not enough, and UIM bridges the shortfall.

Other-than-collision, often called comprehensive, covers the non-crash perils: theft, fire, hail, falling objects, vandalism, glass breakage, and animal strikes. Crashing or overturning is collision, not comprehensive. Hook: comprehensive is everything but the crash, fire, theft, hail, and Bambi.

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.

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.

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 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.

The DP-3 Special Form insures the dwelling and other structures on an open-perils basis, meaning all causes of loss are covered except those specifically excluded. It is the broadest of the dwelling forms. Hook: DP-3 is special, open perils on the structure.

Coverage C is personal property belonging to the named insured. On a rental dwelling it covers the owner's property at the location, not the tenant's belongings, which the tenant insures separately. Hook: Coverage C is personal property, the insured's stuff.

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.

Because the dwelling policy is property-focused, liability and medical payments are not built in; they are added through a personal liability supplement or endorsement when the insured wants them. Hook: want liability and med pay on a DP, add the liability endorsement.

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 monoline policy covers a single line of business, such as property alone. Add a second coverage part and it becomes a package. Hook: one line is monoline; two or more is a package.

The common declarations identify who and what is insured: named insured, mailing address, policy period, a list of the coverage parts in the package, and the premium for each. Hook: the common dec is the who, when, and what of the whole package.

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.

Required coverage is 80% of 500,000, or 400,000. Divide carried by required (300,000 / 400,000 = 0.75) and apply that to the loss: 0.75 times 50,000 equals 37,500. Hook: coinsurance pays did over should, times the loss, here 300/400 of 50,000 = 37,500.

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.

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.

The general aggregate caps total payments for the policy period across most coverages, separate from the per-occurrence limit and from the products-completed operations aggregate. Hook: the general aggregate is the year's total ceiling, separate from each-occurrence.

The commercial crime coverage part handles dishonesty and theft exposures, including employee theft, forgery, robbery, and theft of money and securities. Hook: theft, forgery, and employee dishonesty live in the crime coverage part.

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.

Equipment breakdown, the modern boiler and machinery coverage, pays for sudden and accidental breakdown of boilers, pressure vessels, and mechanical or electrical equipment, plus resulting damage. Hook: equipment breakdown covers the machine blowing up, not wear and tear.

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.

Auto dealers, banks and financial institutions, and bars or similar amusement places are typically excluded from the BOP because of their distinct hazards. Offices, apartments, and small retail are eligible. Hook: car lots, banks, and bars are classic BOP no-gos.

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.

BOPs typically settle covered property losses on a replacement cost basis, paying to repair or replace without deducting depreciation, which is a selling point over ACV forms. Hook: BOP property is usually replacement cost, no depreciation taken.

BOP business income is commonly written for a time period (frequently up to 12 months) rather than a fixed dollar limit, and without a coinsurance requirement, which keeps it simple for small businesses. Hook: BOP business income is time-limited (often 12 months), not coinsured.

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.

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.

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.

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.

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.

Workers compensation pays benefits to employees who are injured or become ill because of their job. It is employee coverage, not customer or personal coverage. Hook: workers comp is for employees hurt on the job.

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.

The two-part test is that the injury must arise out of the employment (be connected to job duties) and occur in the course of employment (during work). Both prongs generally must be met. Hook: covered injuries arise out of and happen in the course of the job.

Workers compensation covers not just sudden accidents but also occupational diseases, illnesses that develop from job conditions over time, such as repetitive stress or exposure to harmful substances. Hook: comp covers both the sudden accident and the slow occupational disease.

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.

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.

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.

Many states let sole proprietors, partners, and corporate officers opt out of their own workers compensation coverage or elect to be included, since they are owners rather than ordinary employees. Hook: owners can often opt in or out of their own comp coverage.

In a monopolistic state, workers compensation must be purchased from the state fund, and private insurers do not write the coverage there. Hook: monopolistic means one seller, the state fund.

An umbrella sits on top of the home and auto policies, adding a high layer of liability limits and broadening coverage for some claims the underlying policies exclude. It is excess liability, not property coverage. Hook: the umbrella is extra liability stacked above your home and auto.

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.

A commercial umbrella adds limits above primary liability lines like CGL, business auto liability, and employers liability. It is excess liability, not excess property coverage. Hook: the commercial umbrella tops up the liability lines, not property.

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.

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.

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.

Large or powerful vessels exceed the homeowners watercraft limits and exclusions, so their liability and physical damage belong on a dedicated boatowners or yacht policy. Hook: the bigger the boat, the more it needs its own watercraft policy.

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 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.