Liability Claims Investigation 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 Liability Claims Investigation flashcards as text
An adjuster investigating a construction site injury must determine if the general contractor is liable for a subcontractor's employee's injury. Which doctrine may impose liability on the general contractor?
Answer: Retained control doctrine
Under the retained control doctrine, a general contractor can be liable for a subcontractor's employee's injury if the general contractor retained control over the work that caused the harm.
What is the difference between 'compensatory damages' and 'punitive damages' in a liability claim?
Answer: Compensatory damages restore the claimant's losses, while punitive damages punish egregious conduct and are often not covered by insurance
Compensatory damages make the claimant whole for actual losses, while punitive damages punish malicious or reckless behavior, and most liability policies exclude punitive damages.
When an adjuster suspects claim fraud during a liability investigation, what is the appropriate next step?
Answer: Refer the claim to the Special Investigations Unit (SIU) and continue to gather evidence
Suspected fraud must be referred to the SIU per most state regulations and company protocols, while the investigation continues to preserve the claim file.
A claimant was injured in a state different from where the policy was issued. Which state's law governs the liability claim?
Answer: Typically the state where the accident occurred under the lex loci delicti doctrine
The lex loci delicti (law of the place of the wrong) doctrine traditionally applies the law of the state where the accident occurred to determine liability.
What role does 'comparative fault' play in states that have adopted a pure comparative negligence system?
Answer: A claimant can recover damages reduced by their percentage of fault regardless of how high that percentage is
In pure comparative negligence states, a claimant can recover even if 99% at fault; their recovery is simply reduced by their own percentage of fault.
Which document should an adjuster obtain to evaluate whether a business defendant had adequate liability coverage for a dram shop claim?
Answer: The liquor liability policy declarations page and any endorsements
Dram shop claims arise from alcohol-related incidents, and the liquor liability policy declarations and endorsements define the specific coverage available for such claims.
A liability adjuster receives a spoliation of evidence letter from the claimant's attorney regarding a defective product. What must the adjuster do?
Answer: Immediately preserve and secure the product and notify all relevant parties, including the insured and defense counsel
A spoliation letter creates a legal duty to preserve evidence; failure to do so can result in sanctions, adverse inferences, or default judgment against the insured.