CAIA Claims Investigation Techniques 3

Question 1

An adjuster receives a claim where the at-fault driver fled the scene and cannot be identified. Under which coverage would the claimant typically seek compensation for vehicle damage?

Accepted Answer

Uninsured motorist property damage

Answer

Uninsured motorist property damage (UMPD) is designed to cover vehicle damage caused by a hit-and-run or uninsured driver when the at-fault party cannot be identified.

Question 2

When documenting vehicle damage during a physical inspection, what is the primary advantage of using a standardized damage diagram?

Accepted Answer

It provides a consistent, universally understood record of damage location

Answer

Standardized diagrams use zone codes and directional references that any adjuster, appraiser, or court can interpret consistently without ambiguity.

Question 3

A claimant states the accident occurred at 2:00 PM, but the responding police officer's report notes arrival at 1:45 PM. Which document controls for establishing the timeline?

Accepted Answer

The police report, which is a contemporaneous official record

Answer

Police reports are contemporaneous official records prepared by a neutral third party and carry greater evidentiary weight than self-reported claimant statements.

Question 4

An adjuster discovers that the VIN plate on a claimed vehicle does not match the confidential secondary VIN found on the engine block. This discrepancy most likely indicates:

Accepted Answer

A stolen or salvage vehicle with a swapped VIN

Answer

Mismatched primary and secondary VINs are a classic indicator of a 'VIN swap,' where a stolen vehicle is given the identity of a legitimately titled vehicle.

Question 5

Which of the following is a red flag that may indicate an auto insurance fraud ring rather than a single isolated claim?

Accepted Answer

Multiple unrelated claimants using the same attorney and treatment facility

Answer

Fraud rings coordinate participants to use the same legal and medical providers, creating a detectable pattern when multiple claims are cross-referenced.

(CAIA) Certified Automotive Insurance Adjuster Practice Test

(CAIA) Certified Automotive Insurance Adjuster Practice Test

CAIA Claims Investigation Techniques 3