CCA Fraud Detection and Prevention Flashcards
6 cards from real CCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CCA Fraud Detection and Prevention flashcards as text
What is 'claim padding' in insurance fraud?
Answer: Adding fictitious or inflated items to a legitimate property claim
Claim padding involves adding non-existent or over-valued items to a valid insurance claim to receive more money than is actually owed.
A 'phantom vehicle' scheme in auto insurance fraud typically involves:
Answer: Claiming an accident with a non-existent vehicle to collect bodily injury or property damage payments
Phantom vehicle schemes fabricate accidents with a fictitious vehicle to generate fraudulent bodily injury or property damage claims.
Which tool do adjusters use to verify the legitimacy and ownership history of a vehicle in an auto claim?
Answer: Vehicle History Report (VHR) / CARFAX
A Vehicle History Report (such as CARFAX or AutoCheck) provides accident history, title records, odometer data, and ownership history to help verify auto claims.
An insured reports their car stolen but surveillance shows them parking it at a remote location days before the 'theft.' This evidence primarily suggests:
Answer: A staged theft / hard fraud
Deliberately 'losing' or concealing a vehicle to file a theft claim is hard fraud — a staged theft designed to collect the insurance payout.
What protection does 'qualified immunity' typically provide to insurance adjusters or companies who report suspected fraud in good faith?
Answer: It prevents any civil lawsuit by the accused claimant for the fraud report
Most states grant qualified (or conditional) immunity from civil liability to insurers and adjusters who report suspected fraud in good faith, encouraging reporting without fear of defamation lawsuits.
Which pattern is MOST consistent with a 'swoop and squat' auto fraud scheme?
Answer: A car cuts in front of another vehicle and brakes suddenly to cause a rear-end collision
A swoop and squat involves a fraud vehicle cutting in front of an innocent driver and braking suddenly so the victim rear-ends them, generating a fraudulent bodily injury claim.