CALA Adjuster Professional Ethics 4

Question 1

Under the NAIC Model Unfair Claims Settlement Practices Act, failing to acknowledge claim communications within a reasonable time is considered:

Accepted Answer

An unfair claims settlement practice subject to regulatory penalties

Answer

The NAIC model act requires prompt acknowledgment of claims communications, and failure to do so constitutes an unfair practice.

Question 2

An adjuster finds evidence during a vehicle inspection that suggests the insured intentionally damaged their car. The adjuster should:

Accepted Answer

Document findings, complete a thorough investigation, and refer to the Special Investigations Unit

Answer

Suspected intentional damage must be carefully documented and escalated to the SIU following established protocols before any claim decision.

Question 3

Which behavior demonstrates an adjuster's commitment to professional competence as an ethical obligation?

Accepted Answer

Pursuing continuing education and staying current with industry standards and regulations

Answer

Professional competence requires ongoing continuing education to maintain up-to-date knowledge of evolving standards, technology, and regulations.

Question 4

A claimant who is a non-English speaker is at a disadvantage during the claims process. The adjuster's ethical duty is to:

Accepted Answer

Arrange for interpreter services or translated documents to ensure the claimant understands the process

Answer

Fair and ethical claims handling requires ensuring all claimants can meaningfully participate in the process regardless of language barriers.

Question 5

When an adjuster's personal beliefs about a claimant's lifestyle or background influence their claim evaluation, this is known as:

Accepted Answer

Discriminatory bias, which is both unethical and potentially illegal

Answer

Allowing personal biases based on protected characteristics to influence claim outcomes violates ethical standards and anti-discrimination laws.

(CALA) Certified Automotive Loss Adjuster Practice Test