Los Angeles Claims Adjuster Property and Causality Practice Exam

If a claim is made for an incident occurring outside the policy period, what will the outcome typically be?

1. The claim will be fully covered

2. The claim will be denied

3. The claim will be partially covered

4. The claim will require further investigation

The correct answer is: The claim will be denied

When a claim is made for an incident that occurred outside the policy period, it is generally denied because insurance policies specify coverage only for incidents that take place during the active policy period. Each policy has defined start and end dates, and any claims related to incidents outside of this timeframe do not meet the criteria for coverage. This principle is fundamental in insurance contracts, ensuring that the insurer is only responsible for claims related to risks it assumed during the specified term of the policy. In other scenarios, such as when assessing the potential for partial coverage or further investigation, these are more applicable to claims that occur within the policy period or involve ambiguous circumstances that require clarification. However, when the incident falls outside the coverage period entirely, the basis for denial is clear and removes any possibility for coverage.