Free Texas 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.

Keep these three straight and you'll bank easy points all day: a peril is the cause of loss (fire, wind, theft), a hazard is something that increases the chance or severity of that loss, and risk is the uncertainty of loss itself. The peril is the thing that actually does the damage.

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.

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.

A stock insurer is owned by its stockholders (shareholders), who receive taxable dividends when the company profits. Policyholders are just customers. Contrast that with a mutual insurer, which is owned by its policyholders. Stock equals stockholders; mutual equals members/policyholders.

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.

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.

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.

Market value reflects what the property would sell for, including the land and location-driven demand, while replacement cost is purely the cost to rebuild the structure. The two can differ widely. Hook: market value includes the land and the neighborhood; replacement cost is just bricks and labor.

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.

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.

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.

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.

Property insurance is first-party (it pays the insured for their own loss), while liability insurance is third-party: it pays others the insured has harmed and is legally responsible to. The three parties are the insured, the insurer, and the injured third party. Hook: liability pays the third party you injured, not yourself.

Negligence is the failure to act with the care a reasonable, prudent person would under the same circumstances. It's the foundation of most liability claims and is unintentional, unlike an intentional tort. Hook: negligence is falling short of the reasonable-person standard of care.

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.

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.

HO-8 fits older homes whose replacement cost far exceeds market value. It settles dwelling losses on a modified, functional, or actual cash value basis instead of full replacement cost, which keeps the coverage affordable and realistic. Hook: HO-8 is for older homes and pays on a modified or ACV basis, not full replacement.

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 B insures detached structures such as a garage, shed, or fence, usually for 10% of the Coverage A limit. The owner can raise it by endorsement if needed. Hook: Coverage B is detached structures, normally 10% of the dwelling limit.

Coverage D pays additional living expenses and fair rental value when a covered loss makes the home unfit to live in, covering the extra cost of hotels, meals, and similar expenses while repairs are made. Hook: Coverage D keeps a roof over your head, the extra living costs while your home is fixed.

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.

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.

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.

Flood is excluded from homeowners policies and must be insured separately, usually through the National Flood Insurance Program (NFIP) or a private flood policy. Earth movement such as earthquake is likewise excluded. Hook: homeowners never covers flood, that is a separate NFIP 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.

Part D, Coverage for Damage to Your Auto, is the physical damage section that pays for damage to the insured's own car under collision and other-than-collision coverage. Part A handles liability to others, not your own vehicle. Hook: Part D is the D in damage to your own auto.

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.

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.

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.

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.

Hitting an animal is treated as an other-than-collision (comprehensive) loss, not a collision, even though there is an impact. This usually means the comprehensive deductible applies. Hook: hitting an animal is comprehensive, not collision.

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.

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.

Insurance covers fortuitous, accidental losses, so intentional damage caused by the insured is excluded. Allowing it would invite fraud and is against public policy. Hook: on-purpose damage is never covered, insurance is for accidents.

An owner-occupant of a typical home is the target customer for a homeowners policy, which bundles broad property and liability coverage. The dwelling policy is the fallback for homes that do not fit homeowners. Hook: live there yourself and qualify, you want homeowners, not a DP.

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 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 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.

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-2 Broad Form expands the named-perils list well beyond the DP-1, adding perils like weight of ice and snow, accidental water discharge, and falling objects. It remains named perils, just a longer list. Hook: DP-2 is still named perils, just a much longer list than DP-1.

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.

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-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.

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 Inspections and Surveys condition reserves the insurer's right (but not a duty) to inspect the premises and operations and to make safety recommendations. Hook: the right to walk the premises lives in Inspections and Surveys.

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.

Business personal property is the contents the business owns and uses: furniture, fixtures, machinery, equipment, and stock (inventory) located at the described premises. The building itself is insured separately. Hook: business personal property is the contents, furniture, fixtures, machinery, and stock.

Coinsurance rewards insuring to value: carry at least the required percentage (often 80, 90, or 100 percent) of value and losses are paid in full up to the limit; carry less and a penalty applies. Hook: coinsurance pushes you to insure to value or take a penalty.

Business income coverage replaces the net income (and continuing expenses like payroll) the business would have earned had a covered loss not suspended operations. It is time-element coverage. Hook: business income replaces the profit you lose while you are shut down.

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.

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.

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.

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.

Built-in business income means a covered shutdown is protected by default, which guards against the common small-business mistake of forgetting to purchase interruption coverage. Hook: built-in business income protects owners who would otherwise forget to buy it.

A customer hurt on the premises is a third-party bodily injury claim, handled under the BOP liability section (with small medical bills possibly paid under medical payments). Hook: a hurt customer is a liability claim, not a property claim.

Flood and earth movement (including earthquake) are excluded under a BOP just as under other property forms, and must be insured separately. Fire, theft, and vandalism are typically covered. Hook: BOP still excludes flood and earthquake, buy those separately.

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.

When a business outgrows BOP eligibility, it moves to a CPP, which can be assembled from the coverage parts the larger or more complex operation requires. Hook: outgrow the BOP and you graduate to a CPP.

Bundling the core coverages into one BOP reduces the chance of gaps, simplifies administration, and usually costs less than separate policies, which is the whole appeal for a small business. Hook: one bundled BOP means fewer gaps, less hassle, and lower cost.

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.

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.

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.

The states where the employer operates and wants full statutory coverage are the listed states under Part One. States of possible future operation go in Part Three. Hook: where you operate now is listed under Part One.

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.

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 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.

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.

Umbrellas require the insured to carry stated minimum underlying limits (for example on auto and homeowners liability). The umbrella then picks up above those limits. Hook: keep your required underlying limits, or the umbrella will not sit on top.

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.

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.

Inland marine grew out of ocean marine to cover property that moves over land or is hard to insure at a fixed site, plus transportation instrumentalities like bridges and tunnels. Hook: inland marine is property on the move over land, not on the sea.

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.

Unlike insurance, a surety expects the principal to ultimately bear the loss, so after paying the obligee the surety can seek reimbursement from the principal. Hook: the surety pays, then comes back to the principal to be repaid.

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.

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.