CLAIMS QUESTIONED BY ADJUSTERS 

 

 

Chapter 3

Aspects of Claims Frequently Questioned By Adjusters

Introduction

 

 

[A] General Questions Adjusters Ask

First Party Claims

1) Fire Loss

2) Burglary Loss

3) Liability Coverage

 

 

 

4) Uninsured, Motorist Claim

[B] Red Flag Areas on Basic Claims

1. First Party Casualty Losses
2. First Party Property Losses
3. Third Party Liability Claims
4. Workers Compensation

[C] The Ramification of Insurer Involvement in Claims

1. Duty to Defend
2. Reservation of Rights
3. Conflict of interest
4. Index Bureau
5. Fraud
6. Permissive Use
7. Other Insurance

[D] Contract Affecting Liability or Responsibility

[E] Specific Categories Adjusters watch out for

1. Problem Raised by Product Liability Cases
2. Fraud
3. Permissive Use
4. Other Insurance

Conclusion

*****Lecture seminar for  this course is 1.5 hours for Continuing Education (CE) This course includes current cases and the change of how the court view aspects of the  Duty to defend,  reservation of rights  as well as fraud and other  matter pertaining to  Insurance claims handling  

Course study for Professional Designation  requires 4 hours study time. Student will understand  the  obstacle adjusters undergo  in dealing  with claims  presented  of  indemnity. The course also provides case law of how the courts have ruled on  issues on  the duty to defend.