CA Claims Investigation & Evaluation 5

Question 1

When a liability claim involves a claimant who is a minor, what special procedural requirement typically applies to any settlement?

Accepted Answer

Court approval of the settlement is usually required to bind the minor

Answer

Settlements involving minors generally require court approval (minor's compromise) to ensure the settlement is in the minor's best interest and to obtain a valid, binding release.

Question 2

What is the significance of 'comparative fault' jurisdictions for adjusters evaluating liability claims?

Accepted Answer

The claimant's damages are reduced proportionally by their percentage of fault

Answer

In comparative fault states, a claimant's recovery is reduced by their percentage of fault, so adjusters must assess both parties' negligence to calculate the appropriate damages.

Question 3

A homeowner's policy excludes 'earth movement.' A retaining wall collapses due to soil saturation from a covered water event. How should the adjuster analyze coverage?

Accepted Answer

Analyze whether the efficient proximate cause was the covered water event or the excluded earth movement

Answer

The efficient proximate cause rule requires identifying the dominant cause of loss; if a covered peril (water) set the excluded peril (earth movement) in motion, coverage analysis depends on which was the efficient proximate cause.

Question 4

Which element is NOT required to establish a negligence claim against the insured?

Accepted Answer

The insured's intent to cause harm

Answer

Negligence is an unintentional tort; the claimant must prove duty, breach, causation, and damages — intent to harm is not a required element and is actually inconsistent with negligence.

Question 5

What is the function of 'surveillance' as an investigative tool in bodily injury claims?

Accepted Answer

To obtain objective evidence of the claimant's actual physical capabilities

Answer

Surveillance is used to document the claimant's actual daily activities and physical abilities, which may confirm or contradict their reported injury limitations.

(CA) Certified Adjuster Designation Practice Test

(CA) Certified Adjuster Designation Practice Test

CA Claims Investigation & Evaluation 5