Client Consultation & Communication Flashcards
7 cards from real CA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Client Consultation & Communication flashcards as text
What is the primary purpose of providing a claimant with a written denial letter rather than just a verbal denial?
Answer: To create a documented record that satisfies legal and regulatory requirements
Written denial letters are required by most state laws and provide the claimant with the specific reasons and their rights to appeal.
An adjuster who makes promises outside the scope of the policy during a client consultation may be creating:
Answer: Waiver or estoppel that could bind the insurer to unintended coverage
Unauthorized promises can create waiver or estoppel, potentially obligating the insurer to honor coverage it never intended to provide.
Which of the following is considered best practice when conducting a telephone interview with a claimant?
Answer: Confirm the claimant's identity before discussing claim details
Identity verification protects private claim information and prevents unauthorized disclosure.
A claimant who is hard of hearing requires accommodation during the consultation. The adjuster should:
Answer: Arrange for appropriate communication assistance such as written summaries or an ASL interpreter
The Americans with Disabilities Act and fair claims practices require reasonable accommodations for claimants with disabilities.
What is the danger of making premature coverage statements to a claimant before completing the investigation?
Answer: It may create waiver of coverage defenses the insurer later needs
Premature coverage statements can waive the insurer's right to later raise valid defenses or exclusions.
When documenting a client consultation in the claim file, an adjuster should record:
Answer: The date, method, parties involved, key points discussed, and any commitments made
Thorough documentation of consultations ensures an accurate, complete record that protects all parties if the claim is disputed.
If a public adjuster contacts the adjuster on behalf of a policyholder, what should the adjuster verify first?
Answer: Written authorization from the insured confirming the public adjuster's authority to represent them
Written authorization confirms the public adjuster has legal authority to act and receive information on the policyholder's behalf.