CALA Risk Management & Fraud Prevention in Claims Handling 2

Question 1

Which red flag most strongly suggests a staged collision between two cooperating drivers?

Accepted Answer

Both vehicles show damage inconsistent with the described impact angle

Answer

Damage inconsistent with the reported impact angle is a primary physical indicator of a staged collision.

Question 2

A claimant submits repair invoices totaling $8,400 but the adjuster's appraisal is $3,200. What is this discrepancy most likely called?

Accepted Answer

Inflated repair fraud

Answer

When repair invoices significantly exceed a fair appraisal without justification, it is classified as inflated repair fraud.

Question 3

What does the term 'sliding' mean in the context of insurance fraud?

Accepted Answer

Adding unauthorized coverages to a policy without the insured's knowledge

Answer

Sliding is an agent-level fraud where coverages are added to a policy without the policyholder's knowledge or consent.

Question 4

Under the ISO ClaimSearch database, what is the primary purpose of cross-referencing a claimant's prior claims history?

Accepted Answer

To identify patterns of suspicious or repeated claims

Answer

ISO ClaimSearch is used to identify claimants with patterns of repeated or suspicious prior claims across multiple insurers.

Question 5

An adjuster notices a vehicle was reported stolen two days after the insured defaulted on auto loan payments. Which fraud category does this most likely represent?

Accepted Answer

Hard fraud (owner give-up)

Answer

A vehicle reported stolen shortly after financial distress is a classic 'owner give-up,' a premeditated hard fraud scheme.

(CALA) Certified Automotive Loss Adjuster Practice Test

(CALA) Certified Automotive Loss Adjuster Practice Test

CALA Risk Management & Fraud Prevention in Claims Handling 2