OK Public Adjuster flashcards

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

Principle of Indemnity

The insured should be restored to roughly the same financial position as before the loss, neither profiting nor being undercompensated; valued policies are a recognized exception.

Insurable Interest

An economic stake in the property such that its damage or destruction causes the insured financial harm; required for property coverage at policy inception.

Subrogation

After paying a claim, the insurer acquires the insured's legal rights against the responsible third party, preventing the insured from collecting twice for the same loss.

Coinsurance Formula

Payment equals carried insurance divided by required insurance, multiplied by the loss, not exceeding the policy limit; applied to partial losses on commercial property.

Proximate Cause

The dominant and efficient cause that sets a loss in motion without which the loss would not have occurred; used to trace coverage through a chain of events.

Declarations Page

The policy section listing named insured, address, policy period, coverage limits, deductibles, and attached forms; it personalizes the standard policy contract.

Duties After Loss

Insured obligations triggered by a loss, including prompt notice, protection of property, proof of loss, and cooperation; breach can prejudice coverage.

Mortgagee Clause

Provision giving a lender rights to loss proceeds and to notice of cancellation or nonrenewal; the lender's rights survive certain insured acts.

Other Insurance Clause

Provision resolving overlapping coverage among policies, typically by pro rata sharing, excess application, or primary-versus-excess ordering.

Occurrence Policy

Responds to injury or damage that takes place during the policy period, regardless of when the claim is later reported to the insurer.

HO-3 Policy

Homeowners form insuring the dwelling on an open-peril basis and personal property for named perils only; the most widely used homeowners form.

Coverage D Loss of Use

Pays necessary increase in living expenses and lost fair rental value when the residence is uninhabitable, for the shortest reasonable time to repair or relocate.

80% Replacement Cost Rule

Dwelling replacement cost settlement requires insurance at least 80% of full replacement cost; otherwise payment is the greater of ACV or the coinsurance fraction.

HO-6 Condominium Form

Covers the unit owner's building items, personal property, loss of use, and liability; coordinates with the association master policy for commonly owned elements.

HO-4 Renters Form

Insures a tenant's personal property, loss of use, and liability; it does not cover the rented structure, which the landlord insures.

Business Income Coverage

Pays net income lost plus continuing normal operating expenses during the period of restoration following covered physical damage to insured property.

Period of Restoration

The time beginning 72 hours after a covered loss and ending when damaged property is repaired or replaced with reasonable speed and similar quality.

Extra Expense Coverage

Reimburses costs to avoid or minimize business interruption, such as temporary relocation or expedited repairs; typically not subject to coinsurance.

Agreed Value Option

Commercial property endorsement suspending the coinsurance clause when the insured submits an accepted statement of values at policy inception.

Blanket Coverage

A single limit applied across multiple insured locations or properties, which can reduce coinsurance penalties when values vary by site.

Named Peril Form

Policy covering only perils specifically listed in the form; the insured bears the burden of showing the loss resulted from a listed peril.

Open Peril Form

Covers risks of direct physical loss unless excluded; the insurer bears the burden of showing an exclusion applies to the loss.

Ordinance or Law Exclusion

Removes increased costs of complying with building codes after a loss, such as demolition or upgraded construction; limited add-back endorsements exist.

Equipment Breakdown Endorsement

Adds coverage for mechanical and electrical breakdown of covered equipment, a cause otherwise excluded as wear, tear, or maintenance failure.

Spoilage Endorsement

Covers perishable stock lost due to equipment failure or power interruption, a cause often excluded under standard property forms.

Replacement Cost Valuation

Settlement based on the cost to repair or replace with new materials of similar kind and quality, without depreciation deduction, subject to policy limits.

Proof of Loss

A sworn statement from the insured detailing the amount claimed and supporting facts; insurers may require it as a condition of payment.

Overhead and Profit

General contractor charges added to a repair estimate when the scope requires coordinating three or more trades; disputed in many claims.

Betterment

An improvement that increases property value beyond its pre-loss condition; insurers generally are not obligated to pay for it.

Oklahoma Valued Policy Law

Requires insurers to pay the full policy limit for a total fire loss to real property, regardless of actual cash value of the destroyed structure.

Unfair Claims Practices Act

Oklahoma statute listing prohibited claim conduct, including misrepresenting policy provisions, unreasonable delay, and failing to investigate promptly.

Oklahoma Insurance Department

State agency headed by the Insurance Commissioner that licenses producers and adjusters, examines insurers, and enforces Title 36.

60-Day Payment Rule

Oklahoma requires an insurer to pay or deny a claim within 60 days after receiving proof of loss, absent a valid reason for delay.

Public Adjuster

A licensed professional who represents the insured, not the insurer, in preparing, presenting, and negotiating a first-party property claim for compensation.

Adjuster Contract Requirements

Oklahoma requires a written contract stating fees, the basis of compensation, and the insured's right to rescind within a specified period.

Conflict of Interest

Arises when an adjuster represents both insurer and insured on one claim, or has a financial stake in the outcome contrary to the client.

Fiduciary Duty

The adjuster's obligation to handle client funds and claim proceeds honestly, remit promptly, and keep accurate records of transactions.