Ethical & Legal Compliance 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 Ethical & Legal Compliance flashcards as text
Which document establishes the terms under which a public adjuster may represent a claimant?
Answer: Public adjuster contract governed by state law
Public adjusters must use a written contract with the claimant that complies with state licensing and consumer protection requirements.
An adjuster who continues to negotiate directly with a claimant after learning the claimant is represented by an attorney is:
Answer: Violating ethical and potentially legal standards by bypassing counsel
Once represented by counsel, all communications with the claimant must go through their attorney under professional conduct rules.
The statute of limitations on an insurance claim is most relevant to an adjuster because:
Answer: Missing it may bar the claimant from recovering even a valid claim
Adjusters must be aware of statutes of limitations to ensure claims are not improperly delayed past the legal filing deadline.
Which ethical obligation requires an adjuster to inform an insurer of a claim feature that could increase the insurer's exposure, even if it benefits the insured?
Answer: Duty of full disclosure and transparency
Adjusters owe their employers full disclosure of all claim facts, including those that may increase reserve amounts or exposure.
A claimant demands a settlement amount that exceeds the policy limits. The adjuster's correct response is to:
Answer: Offer the policy limits and document the excess demand in the claim file
When a demand exceeds policy limits, the adjuster should tender the policy limit and document the excess demand to protect the insurer from bad faith exposure.
Under the Americans with Disabilities Act (ADA), an insurance adjuster must:
Answer: Provide equal access and accommodation to disabled claimants during the claims process
The ADA requires that adjusters provide equal access and reasonable accommodations to disabled claimants throughout the claims handling process.
Which best describes the adjuster's ethical responsibility when a claim involves a minor as the claimant?
Answer: Ensure a guardian or legal representative is involved and that court approval is obtained if required
Minors lack legal capacity to enter binding settlements, so a guardian must be involved and many states require court approval of minor settlements.