CCA CCA Negotiation and Communication in Claims 2

Question 1

An adjuster receives a policy limits demand with a short deadline. What is the primary risk to the insurer if they fail to respond in time?

Accepted Answer

The insurer could face a bad faith claim if a subsequent verdict exceeds policy limits

Answer

The claim automatically closes in favor of the insured

Answer

The policy is automatically canceled for non-response

Answer

The claimant forfeits their right to sue

Question 2

When a represented claimant's attorney is involved, the adjuster should typically:

Accepted Answer

Direct all communications through the attorney and avoid direct claimant contact

Answer

Contact the claimant directly to negotiate a faster settlement

Answer

Refuse to communicate with the attorney and request a different representative

Answer

Only communicate in person at scheduled mediation sessions

Question 3

What is the purpose of a 'recorded statement' in a claims investigation?

Accepted Answer

To obtain a documented, verbatim account of the events surrounding the loss from the insured or witnesses

Answer

To replace the need for a written proof of loss

Answer

To record the adjuster's conclusions for internal use only

Answer

To formally accept the claim and authorize payment

Question 4

Which communication technique is most useful when a claimant is emotional or upset during a claim interview?

Accepted Answer

Empathetic listening and acknowledging their feelings before proceeding

Answer

Talking over them to redirect the conversation

Answer

Ending the interview and rescheduling when they are calm

Answer

Immediately offering a settlement to diffuse the situation

Question 5

A claimant's attorney sends a lien from a health insurer for medical payments. What obligation does this create for the adjuster?

Accepted Answer

The adjuster must account for the lien in the settlement and ensure it is resolved before or as part of payment

Answer

The adjuster must deny the claim to avoid the lien

Answer

Liens from health insurers are unenforceable and can be ignored

Answer

The adjuster must pay the lien separately from any claimant settlement

Question 6

What does 'BATNA' stand for, and why is it important in claims negotiation?

Accepted Answer

Best Alternative To a Negotiated Agreement — it defines the strongest position if negotiations fail

Answer

Basic Adjustment Terms for Neutral Arbitration — it sets the default arbitration process

Answer

Balanced Approach To Negotiating Agreements — it describes fair settlement principles

Answer

Bureau of Adjuster Training for National Accreditation — it is a licensing body