CAIA Claims Investigation Techniques 2

Question 1

When an adjuster suspects a claimant is exaggerating injuries, which investigative tool is most appropriate to document daily activities?

Accepted Answer

Surveillance video

Answer

Surveillance video provides objective, real-time documentation of a claimant's physical activities that can contradict exaggerated injury claims.

Question 2

A vehicle is submitted with alleged hail damage but the roof shows indentations only on horizontal panels. What does this pattern suggest?

Accepted Answer

Possible staged damage using a tool

Answer

Genuine hail strikes random surfaces, including vertical panels and trim, so damage limited to horizontal areas suggests mechanical staging.

Question 3

Which database is primarily used by adjusters to check whether a vehicle has prior reported accident history?

Accepted Answer

CarFax/AutoCheck

Answer

CarFax and AutoCheck compile vehicle history reports from title records, odometer readings, and reported accidents, giving a comprehensive ownership history.

Question 4

An insured reports a theft claim but the vehicle's GPS data shows it traveled 80 miles on the night of the alleged theft. What is the adjuster's best next step?

Accepted Answer

Obtain a recorded statement addressing the GPS data

Answer

Confronting the discrepancy during a recorded statement under oath allows the adjuster to document the insured's explanation and preserve evidence for potential fraud referral.

Question 5

What is the purpose of an Examination Under Oath (EUO) in an auto insurance claim investigation?

Accepted Answer

To compel the insured to testify under oath about claim circumstances

Answer

An EUO is a contractual right allowing the insurer to question the insured under oath, with the transcript admissible as evidence if the claim goes to court.

(CAIA) Certified Automotive Insurance Adjuster Practice Test

(CAIA) Certified Automotive Insurance Adjuster Practice Test

CAIA Claims Investigation Techniques 2