CA Claims Investigation & Evaluation 3

Question 1

Which doctrine holds that a plaintiff cannot recover damages if they were also at fault in causing the accident, regardless of degree?

Accepted Answer

Contributory negligence

Answer

Contributory negligence is a complete bar to recovery if the plaintiff had any role in causing the accident, though most states now use comparative negligence instead.

Question 2

What is the primary purpose of an 'examination under oath' (EUO) in a claims investigation?

Accepted Answer

To obtain sworn testimony from the insured about the loss

Answer

An EUO is a formal, sworn examination required by most policies that allows the insurer to question the insured in depth about the circumstances of a loss.

Question 3

A claimant alleges soft-tissue injuries after a low-speed collision with minimal vehicle damage. Which investigative tool is most useful for evaluating injury causation?

Accepted Answer

Biomechanical analysis correlating impact forces to injury potential

Answer

Biomechanical analysis examines whether the forces involved in a low-speed impact are sufficient to cause the alleged soft-tissue injuries.

Question 4

Under the concept of 'proximate cause,' which loss scenario would most likely NOT be covered?

Accepted Answer

Mold growth occurring two years after an undetected slow leak

Answer

Long-term neglect of a slow leak breaks the chain of proximate causation; mold resulting from maintenance failure is typically excluded as it is not a sudden and accidental loss.

Question 5

What does 'reservation of rights' (ROR) notify the insured about?

Accepted Answer

The insurer's intent to investigate while preserving the right to deny coverage

Answer

A reservation of rights letter informs the insured that the insurer will handle the claim but reserves the right to disclaim coverage if investigation reveals a basis for denial.

(CA) Certified Adjuster Designation Practice Test

(CA) Certified Adjuster Designation Practice Test

CA Claims Investigation & Evaluation 3