NV Claims Adjuster flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Nevada Division of Insurance

The state agency headed by the Commissioner that licenses insurers, producers, and adjusters and enforces Nevada insurance statutes and regulations.

Continuing education requirement

Nevada adjusters complete 24 credit hours per two-year license term, including 3 hours of ethics, and must retain records for audit.

Rebating prohibition

Nevada law bars giving or accepting any part of premium or commission not specified in the policy as an inducement to purchase insurance.

Prompt payment statute

Nevada requires insurers to acknowledge claims within 15 days and pay accepted claims within 30 days of settlement, with interest on late payments.

Indemnity principle

The insured should be restored to approximately the pre-loss financial position, no better and no worse, subject to policy limits and deductibles.

Insurable interest

A financial stake in the subject matter that must exist at policy inception for life insurance and at the time of loss for property insurance.

Moral hazard

A condition of dishonesty or intent to defraud that increases the chance of loss, such as deliberately causing a fire to collect insurance.

Law of large numbers

The statistical principle that a large number of similar exposure units allows insurers to predict aggregate losses with reasonable accuracy.

Declarations page

The policy section listing the named insured, policy period, limits, deductibles, and description of insured property.

Endorsement

A written amendment attached to a policy that alters its terms and controls over conflicting printed policy provisions.

Waiver and estoppel

Waiver is voluntary relinquishment of a known right; estoppel prevents asserting a right after conduct led another to rely on it detrimentally.

Coinsurance formula

Recovery equals insurance carried divided by insurance required, multiplied by the loss, capped at the policy limit.

HO-3 special form

A homeowners policy covering the dwelling on an open-peril basis and personal property on a named-perils basis.

Actual cash value

Replacement cost minus depreciation, representing the value of damaged property at the time of loss.

Loss of use coverage

Pays additional living expenses and fair rental value when a covered loss makes the residence uninhabitable during repairs.

Business income coverage

Pays net income loss and continuing expenses during the period of restoration after a covered property loss.

Occurrence vs claims-made

Occurrence policies respond to injury during the policy period; claims-made policies respond when a claim is made, subject to a retroactive date.

Comparative negligence

A doctrine reducing a claimant's recovery in proportion to their own percentage of fault for the injury.

CGL Coverage B

Personal and advertising injury liability covering offenses such as libel, slander, invasion of privacy, and wrongful eviction.

Aggregate limit

The maximum total the insurer will pay for all covered claims during a single policy period.

Personal auto policy parts

Parts A liability, B medical payments, C uninsured motorist, D damage to your auto, and E duties after an accident.

Uninsured motorist coverage

Applies when an at-fault driver has no liability insurance; Nevada requires insurers to offer it, and the insured may reject it in writing.

Other than collision

Comprehensive coverage for damage from theft, fire, vandalism, glass, and weather, as distinguished from collision impact.

Medical payments coverage

Pays reasonable medical expenses for the insured and passengers regardless of fault, up to the stated limit.

Businessowners policy

A package policy combining commercial property and general liability for small businesses that meet size and occupancy eligibility rules.

Workers compensation Part Two

Employer's liability coverage that responds to employee lawsuits outside the statutory workers compensation benefit system.

Builders risk coverage

Covers structures under construction, including materials and equipment, against covered perils during the construction period.

Covered auto symbols

Codes on a commercial auto policy that designate which vehicles or categories of vehicles are insured under each coverage.

Reservation of rights letter

A written notice preserving the insurer's coverage defenses while investigation of a claim continues, without denying coverage outright.

Examination under oath

A formal recorded questioning of the insured under policy conditions, used to verify facts material to a claim.

Subrogation

The insurer's right, after paying a claim, to recover the loss from the third party responsible and to stand in the insured's shoes.

Unfair claims practice

Misrepresenting policy provisions, failing to acknowledge claims promptly, or denying claims without a reasonable investigation or basis.