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MS Claims Adjuster study materials
MS Claims Adjuster study resources

MS Claims Adjuster: Casualty Insurance and Claims

MS Claims Adjuster · Work through your exam, one topic at a time.

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Casualty Insurance and Claims

Casualty Insurance and Claims tests liability coverage and claim investigation: negligence, commercial general liability, auto liability, uninsured/underinsured motorist coverage, workers compensation, damages, and comparative fault. The exam asks you to separate coverage from liability and to investigate and reserve before paying.

Liability basics

  • Negligence requires duty, breach, causation, and damages.
  • Mississippi follows pure comparative fault, so a claimant's recovery is reduced by the claimant's own percentage of fault rather than automatically barred.
  • The CGL occurrence form provides Coverage A for bodily injury and property damage, Coverage B for personal and advertising injury, and Coverage C for medical payments. Key exclusions include expected or intended injury, contractual liability, pollution, and employer's liability.
  • Auto liability, UM/UIM, medical payments, and workers compensation each have different triggers and offsets.

Investigation

  • Obtain statements, scene photographs, medical records, wage-loss documentation, and the police report.
  • Confirm insured status, additional insured status, and course and scope.
  • Evaluate liability and damages, set reserves, and identify subrogation or lien issues.

Worked example

A rear-end collision causes $60,000 in damages. The at-fault driver has a $25,000 liability limit and pays it. The claimant has $50,000 UM coverage. Assuming no comparative fault, UM pays the UM limit minus the tortfeasor payment: $50,000 - $25,000 = $25,000. The claimant does not receive a full extra $50,000, because UM is reduced by amounts paid by the liable driver.

Traps

  • Confusing no-fault medical payments with liability payment.
  • Missing the UM/UIM offset for tortfeasor payments.
  • Taking a release before checking liens and subrogation.

Key points

  • Negligence requires duty, breach, causation, and damages.
  • Mississippi uses pure comparative fault.
  • CGL occurrence coverage responds to bodily injury and property damage.
  • UM/UIM is generally reduced by tortfeasor payments.
  • Investigate coverage, liability, and damages separately.