Adjuster Professional Ethics 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 Adjuster Professional Ethics flashcards as text
Under the NAIC Model Unfair Claims Settlement Practices Act, failing to acknowledge claim communications within a reasonable time is considered:
Answer: An unfair claims settlement practice subject to regulatory penalties
The NAIC model act requires prompt acknowledgment of claims communications, and failure to do so constitutes an unfair practice.
An adjuster finds evidence during a vehicle inspection that suggests the insured intentionally damaged their car. The adjuster should:
Answer: Document findings, complete a thorough investigation, and refer to the Special Investigations Unit
Suspected intentional damage must be carefully documented and escalated to the SIU following established protocols before any claim decision.
Which behavior demonstrates an adjuster's commitment to professional competence as an ethical obligation?
Answer: Pursuing continuing education and staying current with industry standards and regulations
Professional competence requires ongoing continuing education to maintain up-to-date knowledge of evolving standards, technology, and regulations.
A claimant who is a non-English speaker is at a disadvantage during the claims process. The adjuster's ethical duty is to:
Answer: Arrange for interpreter services or translated documents to ensure the claimant understands the process
Fair and ethical claims handling requires ensuring all claimants can meaningfully participate in the process regardless of language barriers.
When an adjuster's personal beliefs about a claimant's lifestyle or background influence their claim evaluation, this is known as:
Answer: Discriminatory bias, which is both unethical and potentially illegal
Allowing personal biases based on protected characteristics to influence claim outcomes violates ethical standards and anti-discrimination laws.
An automotive adjuster settles a claim and later realizes they overlooked additional covered damages. Ethically, the adjuster should:
Answer: Notify a supervisor, reopen the claim if possible, and correct the underpayment
Good faith requires adjusters to correct known underpayments even after settlement, subject to applicable release agreements and state law.
Which of the following activities would most likely require an automotive loss adjuster to obtain a separate license in most US states?
Answer: Conducting public adjusting work on behalf of policyholders for compensation
Public adjusting — representing policyholders for compensation — requires a separate public adjuster license distinct from an independent adjuster license.