CALA Claims Investigation Process 5

Question 1

What is the primary legal standard an adjuster must meet when handling claims under the duty of good faith?

Accepted Answer

Promptly, fairly, and thoroughly investigate and settle claims without unreasonable delay or denial

Answer

Good faith requires insurers to conduct prompt, thorough, and fair investigations and settlements without unreasonably favoring the insurer's interests.

Question 2

An insured's collision claim is submitted 18 months after the accident occurred. The adjuster should first:

Accepted Answer

Review the policy's notice and cooperation provisions and assess prejudice caused by the delay

Answer

Late notice may be a coverage defense, but most states require the insurer to demonstrate actual prejudice from the delay before denying on that basis alone.

Question 3

When an adjuster closes a claim file with a payment, which document formally acknowledges the settlement and releases the insurer from further obligation?

Accepted Answer

A signed release or settlement agreement

Answer

A signed release is the legal document by which the claimant accepts payment and waives future claims arising from the same loss.

Question 4

Which of the following is a common indicator of a staged accident during the investigation?

Accepted Answer

Vehicles towed to a pre-arranged body shop with immediate attorney representation and multiple soft-tissue injury claimants

Answer

Staged accidents often involve a pattern of pre-arranged service providers and multiple soft-tissue injury claimants designed to maximize fraudulent payouts.

Question 5

When an adjuster determines a vehicle is a total loss, what happens to the salvage vehicle?

Accepted Answer

The insurer typically takes title and sells the salvage to offset the total loss payment

Answer

After paying ACV, the insurer acquires title to the salvage and sells it, reducing the net cost of the total loss claim.

(CALA) Certified Automotive Loss Adjuster Practice Test

(CALA) Certified Automotive Loss Adjuster Practice Test

CALA Claims Investigation Process 5