Documentation & Reporting Standards Flashcards
7 cards from real CALA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Documentation & Reporting Standards flashcards as text
When documenting actual cash value (ACV) for a personal property item, the adjuster must record:
Answer: The replacement cost minus applicable depreciation, with the depreciation basis documented
ACV documentation must show both the replacement cost and the depreciation calculation methodology to support the final valuation.
Which report format is typically used for large commercial losses exceeding $100,000?
Answer: A detailed narrative report with full investigation findings, coverage analysis, and valuation
Large commercial losses require comprehensive narrative reports that document every aspect of the investigation to support the significant financial exposure.
In liability claims, why is it critical to document all potential witnesses immediately?
Answer: Because witness memories fade and witnesses may become unavailable as time passes
Prompt witness documentation captures accurate accounts before memories fade or witnesses relocate, preserving valuable evidence for the investigation.
A 'status report' submitted to the insurer on a complex claim typically covers:
Answer: Current investigation status, coverage issues, reserve adequacy, and anticipated next steps
Status reports keep the insurer informed of claim progress, flag any coverage concerns, and address whether current reserves reflect the evolving exposure.
When an insured submits a sworn proof of loss that contains material misrepresentations, the adjuster should:
Answer: Document the discrepancies, notify the SIU, and consult with counsel before taking further action
Suspected fraud must be referred to the Special Investigations Unit (SIU) and documented thoroughly, as material misrepresentations can void coverage under most policies.
The '3-point contact' documentation standard in claims handling requires:
Answer: Initial contact with the insured, claimant, and witnesses within specified timeframes, all documented
The 3-point contact standard requires timely documented contact with the insured, claimant, and at least one other party (such as a witness) within required timeframes.
Why should an adjuster document every telephone conversation in the claim file?
Answer: To create a complete record of representations, agreements, and information exchanged that may affect coverage or settlement
Documented phone logs protect all parties by recording what was said, promised, or agreed to — omissions can create disputes or expose the insurer to bad faith claims.