CAIA Claims Investigation Techniques 4

Question 1

During a total-loss investigation, the adjuster discovers the vehicle's title is branded as 'salvage' but the insured claimed it was a clean title. What is the most appropriate action?

Accepted Answer

Reduce the settlement to reflect the salvage title status and investigate potential fraud

Answer

A misrepresented title brand affects vehicle valuation and may constitute material misrepresentation, requiring adjustment of the settlement and a potential fraud referral.

Question 2

An adjuster is investigating a rear-end collision where the at-fault vehicle's driver denies the accident. Which piece of evidence would most objectively corroborate the collision?

Accepted Answer

Event data recorder (EDR/black box) data from the at-fault vehicle

Answer

EDR data captures vehicle speed, brake application, and throttle position in the seconds before impact, providing objective, vehicle-generated evidence of the collision.

Question 3

What is 'subrogation' in the context of an auto insurance claim investigation?

Accepted Answer

The insurer's right to pursue a third party responsible for the insured loss after paying the claim

Answer

Subrogation allows the insurer, after indemnifying the insured, to step into the insured's shoes and recover the paid amount from the negligent third party.

Question 4

An adjuster finds that the insured's vehicle had extensive pre-existing rust and frame damage visible in repair shop photos taken six months before the loss. How should this affect the current claim?

Accepted Answer

Pre-existing damage must be excluded from the current claim settlement

Answer

Insurers are only obligated to indemnify damage caused by the covered loss; pre-existing damage documented in prior records must be subtracted from the settlement.

Question 5

When conducting a recorded statement, which practice best protects the integrity of the investigation?

Accepted Answer

Advising the claimant of the recording at the outset and asking open-ended questions

Answer

Disclosing the recording and using open-ended questions produces uncoached, admissible testimony and ensures the process complies with state wiretapping laws.

(CAIA) Certified Automotive Insurance Adjuster Practice Test

(CAIA) Certified Automotive Insurance Adjuster Practice Test

CAIA Claims Investigation Techniques 4