AIC Claims Processing & Documentation 2

Question 1

An adjuster has a coverage concern but needs to keep investigating a claim. Which document lets the insurer investigate without giving up its right to deny coverage later, and only takes effect once the insured signs it?

Accepted Answer

Nonwaiver agreement

Answer

A nonwaiver agreement is a bilateral contract signed by both insurer and insured, preserving the insurer's coverage defenses during investigation.

Question 2

What is the main advantage of a reservation of rights letter over a nonwaiver agreement?

Accepted Answer

It does not need the insured's signature to take effect

Answer

A reservation of rights letter is unilateral, so the insurer can send it without the insured agreeing.

Question 3

An insured gives a sworn, formal statement before the insurer's attorney, with a court reporter present, as the policy conditions require. What is this called?

Accepted Answer

Examination under oath

Answer

An examination under oath (EUO) is a policy condition that requires the insured to answer questions under oath, usually with counsel and a court reporter.

Question 4

When taking a recorded statement, what should an adjuster do first after starting the recording?

Accepted Answer

State the date, time, and location, and confirm the person consents to being recorded

Answer

Opening with the identifying details and the speaker's consent makes the statement admissible and properly documented.

Question 5

Which entry in a claim file log best reflects good documentation practice?

Accepted Answer

10/14 2:15pm: Spoke with insured J. Smith; confirmed water loss date 10/12; requested plumber invoice by 10/21

Answer

Good file notes are dated, specific, objective, and include next steps and deadlines.

AIC - Associate in Claims Practice Test

AIC - Associate in Claims Practice Test

AIC Claims Processing & Documentation 2