CALA Customer Service and Communication in Auto Claims 1 — Questions and Answers
Question 1: When an insured calls to report a new auto claim, what should the adjuster prioritize during the initial contact?
- Immediately request all repair estimates
- Acknowledge the loss, express empathy, and explain the claims process (Correct answer)
- Advise the insured to contact an attorney
- Instruct the insured to obtain three competing repair bids
Correct answer: Acknowledge the loss, express empathy, and explain the claims process
The initial contact should focus on acknowledging the loss, offering empathy, and setting clear expectations about the claims process to build trust.
Question 2: An insured is upset about the timeline of their claim. Which communication approach is most appropriate for a CALA-certified adjuster?
- Transfer the call to a supervisor immediately
- Listen actively, validate their concern, and provide a specific update on next steps (Correct answer)
- Remind the insured that claim timelines are dictated by policy terms
- Ask the insured to submit their concerns in writing
Correct answer: Listen actively, validate their concern, and provide a specific update on next steps
Active listening combined with a concrete update demonstrates professionalism and helps de-escalate frustration.
Question 3: Which of the following best describes the purpose of setting a 'reservation of rights' letter in auto claims communication?
- To formally deny a claim
- To inform the insured that the insurer is investigating while reserving the right to deny coverage (Correct answer)
- To extend the statute of limitations on the claim
- To notify the claimant of the settlement amount
Correct answer: To inform the insured that the insurer is investigating while reserving the right to deny coverage
A reservation of rights letter notifies the insured that coverage is being evaluated and the insurer reserves the right to deny coverage if the investigation warrants it.
Question 4: When communicating a total loss determination to a claimant, what information should the adjuster provide?
- Only the ACV of the vehicle
- The ACV calculation, deductible, payoff amount if applicable, and next steps for title transfer (Correct answer)
- The replacement cost of a new vehicle
- A list of preferred dealerships for replacement
Correct answer: The ACV calculation, deductible, payoff amount if applicable, and next steps for title transfer
A complete total loss communication includes the ACV, deductible, any lien payoff coordination, and the process for transferring the title.
Question 5: An adjuster receives a complaint from a third-party claimant who feels their vehicle was undervalued. What is the most professional first response?
- Refer the claimant to their own insurance company
- Acknowledge the concern and review the estimate with the claimant, explaining the methodology used (Correct answer)
- Deny additional payment without review
- Immediately escalate to litigation support
Correct answer: Acknowledge the concern and review the estimate with the claimant, explaining the methodology used
Acknowledging the concern and transparently explaining the valuation methodology demonstrates professionalism and may resolve the dispute without escalation.
Question 6: Which federal law governs the privacy of personal information shared by insureds during the claims process?
- Fair Credit Reporting Act (FCRA)
- Gramm-Leach-Bliley Act (GLBA) (Correct answer)
- Health Insurance Portability and Accountability Act (HIPAA)
- Freedom of Information Act (FOIA)
Correct answer: Gramm-Leach-Bliley Act (GLBA)
The Gramm-Leach-Bliley Act requires financial institutions, including insurers, to protect the privacy of nonpublic personal information shared by customers.
Question 7: An insured asks why their rental car coverage ends before their vehicle repairs are complete. How should the adjuster respond?
- Advise the insured to pay out of pocket and seek reimbursement
- Explain the policy's rental reimbursement limit and explore whether an extension or alternative is available (Correct answer)
- Tell the insured the policy is non-negotiable
- Refer the insured to the repair shop for an explanation
Correct answer: Explain the policy's rental reimbursement limit and explore whether an extension or alternative is available
The adjuster should explain the policy's rental limits clearly and proactively explore any available options to assist the insured within policy guidelines.
CALA Customer Service and Communication in Auto Claims 1
When an insured calls to report a new auto claim, what should the adjuster prioritize during the initial contact?