Chapter 2 of 340% of exam

Insurance Terms and Related Concepts

Pearson VUE weights this area at 40%. Each question turns on the exact meaning of a term: peril and hazard, insurable interest, actual cash value and replacement cost, subrogation and salvage, waiver and estoppel, appraisal and arbitration, cancellation and nonrenewal, negligence and proximate cause. The PrepPass Texas All Lines Adjuster Study Guide teaches each term with Texas examples and practice questions.

Valuing a loss

Actual cash value is replacement cost minus depreciation; replacement cost pays without deducting depreciation, up to the limit. Agreed value is fixed in advance and waives coinsurance. Salvage is deducted if the insured keeps damaged property, and abandonment to the insurer is not allowed. Pro rata clauses split a loss by limits; primary pays before excess; subrogation transfers the insured's recovery rights to the insurer that paid.

Indemnity
Restore the insured to the pre-loss financial position, not better.

The contract

Texas courts read policies under contract rules, by plain meaning; ambiguity exists only if two readings are reasonable. Waiver is intentional relinquishment of a known right; estoppel protects reliance; neither creates coverage the policy never gave. A reservation of rights letter preserves defenses and, sent in reasonable time, satisfies Texas's affirm-or-deny rule. Misstatements in an application matter only if material to the risk or contributing to the loss.

Cancellation
A permitted Texas cancellation takes effect no earlier than the 10th day after the notice is mailed (Insurance Code §551.104).
Nonrenewal
Written notice at least 60 days before expiration (Insurance Code §551.105, as amended effective Sept. 1, 2023).

Liability

Negligence requires duty, breach, proximate cause and damages; proximate cause is cause in fact plus foreseeability. Texas bars a claimant who is more than 50% responsible and reduces the rest. Strict liability needs no proof of carelessness; vicarious liability imputes an employee's negligence to the employer. Occurrence policies respond to injury during the policy term; claims-made policies to claims made during it.

Exemplary damages
Awarded only on clear and convincing evidence (Civil Practice and Remedies Code §41.003).

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