CA Ethical & Legal Compliance 2

Question 1

A claimant offers an adjuster a gift card after a favorable settlement. What is the ethical obligation of the adjuster?

Accepted Answer

Decline it to avoid any appearance of impropriety

Answer

Adjusters must decline gifts from claimants to avoid conflicts of interest and maintain impartiality.

Question 2

Under the Unfair Claims Settlement Practices Act, which action is explicitly prohibited?

Accepted Answer

Delaying acknowledgment of a claim beyond 10 days

Answer

The UCSPA requires insurers to acknowledge claims promptly, typically within 10 days of receipt.

Question 3

When handling a liability claim, an adjuster learns the insured was intoxicated during the incident. What must the adjuster do with this information?

Accepted Answer

Keep it confidential but include it in the claim file

Answer

Sensitive information must remain confidential within the claim file and shared only on a need-to-know basis per privacy laws.

Question 4

Which principle requires adjusters to treat similarly situated claimants with the same degree of fairness?

Accepted Answer

Consistency in claims handling

Answer

Consistency in claims handling prevents discriminatory treatment and ensures all claimants receive equal consideration.

Question 5

An adjuster discovers that a colleague submitted a falsified estimate. The adjuster's first step should be to:

Accepted Answer

Report the misconduct through appropriate internal channels

Answer

Fraud and misconduct must be reported through proper internal channels such as a supervisor or compliance department.

(CA) Certified Adjuster Designation Practice Test