Documentation & Reporting Flashcards

An adjuster discovers that an earlier file note contained an error. What is the proper way to correct it?

Answer: Add a new dated note correcting the error without deleting the original

Corrections should be made by a new dated entry so the file's integrity and audit trail are preserved.

When an insurer pays a claimant's attorney for a settlement, which federal tax form is typically issued to the attorney?

Answer: Form 1099-MISC or 1099-NEC as applicable for gross proceeds

Payments of gross proceeds to attorneys are generally reportable on a Form 1099 under IRS rules.

A closing report for a claim file should document:

Answer: The final disposition, payments made, and status of subrogation or salvage

A closing report summarizes the outcome and confirms all payments, recoveries, and open items are resolved.

Which statement about documenting a telephone conversation with a claimant is most accurate?

Answer: The adjuster should promptly note the date, participants, and substance of the call

Prompt, specific notes on every material contact demonstrate diligent and timely handling.

Documenting the insurer's potential subrogation rights early in a claim is important because:

Answer: It helps preserve evidence and notify the responsible party before rights are compromised

Early identification and documentation protects evidence and recovery rights against the at-fault party.

A diagram of an auto accident scene in the claim file is most valuable when it shows:

Answer: Vehicle positions, directions of travel, points of impact, and road features

Scene diagrams clarify the physical facts used to evaluate liability.

Which reporting obligation applies when an insurer suspects a claim is fraudulent in most U.S. states?

Answer: Reporting the suspected fraud to the state fraud bureau or designated authority

Most states require insurers to report suspected insurance fraud to the state fraud bureau, often with immunity for good-faith reports.