CAIA Fraud Detection and Prevention in Auto Claims 2

Question 1

Which of the following best describes a 'swoop and squat' staged accident scheme?

Accepted Answer

One vehicle cuts off another causing it to brake suddenly while a rear vehicle collides

Answer

In a swoop and squat, a 'squatter' vehicle cuts in front of a target car and brakes suddenly, causing the target to rear-end them while a second vehicle blocks escape.

Question 2

Which physical evidence inconsistency most strongly suggests a fraudulent rear-end collision claim?

Accepted Answer

Damage patterns inconsistent with the described impact speed

Answer

When the physical damage pattern does not match the physics of the described collision, it indicates the damage may have occurred differently than claimed.

Question 3

What is the role of the National Insurance Crime Bureau (NICB) in auto fraud investigations?

Accepted Answer

It provides a federal database and investigative resources to combat insurance fraud

Answer

The NICB is a non-profit organization that partners with insurers and law enforcement to investigate and prevent insurance fraud and vehicle theft.

Question 4

An adjuster reviews social media and finds the claimant posting photos of strenuous physical activity days after claiming a disabling back injury. This evidence is best used to:

Accepted Answer

Support referral to the SIU and potential fraud investigation

Answer

Social media evidence of activity inconsistent with claimed injuries supports an SIU referral and is documented in the claim file as a material inconsistency.

Question 5

Which of the following is considered 'hard fraud' in auto insurance?

Accepted Answer

Reporting a stolen vehicle that was actually sold

Answer

Hard fraud involves deliberately fabricating an entirely false event, such as reporting a vehicle as stolen when it was actually sold or hidden.

(CAIA) Certified Automotive Insurance Adjuster Practice Test

(CAIA) Certified Automotive Insurance Adjuster Practice Test

CAIA Fraud Detection and Prevention in Auto Claims 2