CA Client Consultation & Communication 4

Question 1

A claimant refuses to cooperate with the investigation. What should the adjuster document?

Accepted Answer

All attempts to contact and obtain cooperation, including dates, methods, and responses received

Answer

Documenting all contact attempts establishes the record needed to support a denial based on non-cooperation.

Question 2

When an insured's attorney requests claim file materials, the adjuster should:

Accepted Answer

Consult with the insurer's legal team before releasing any materials

Answer

Legal counsel should review disclosure requests to protect privileged materials and comply with applicable discovery rules.

Question 3

What communication technique helps an adjuster confirm that the claimant understood what was explained?

Accepted Answer

Asking the claimant to summarize what was discussed in their own words

Answer

Teach-back or summarization confirms comprehension and catches misunderstandings before they become disputes.

Question 4

An adjuster is negotiating a settlement and the claimant makes an unreasonably high demand. The adjuster's best response is to:

Accepted Answer

Calmly explain the basis for the insurer's valuation with supporting documentation

Answer

Presenting documented support for the insurer's position is professional, defensible, and often leads to resolution.

Question 5

Which of the following is a prohibited practice under most state unfair claims settlement laws?

Accepted Answer

Failing to respond to a claimant's communications within a reasonable time

Answer

Failure to respond within required timeframes is specifically prohibited under most state unfair claims settlement practice acts.

(CA) Certified Adjuster Designation Practice Test