Laws, Regulations, and Ethics Flashcards
7 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 7 Laws, Regulations, and Ethics flashcards as text
Under most state insurance codes, what is the maximum number of days an insurer has to acknowledge receipt of a claim after it is filed?
Answer: 10 days
Most state unfair claims settlement practice acts require acknowledgment of a claim within 10 days of receipt.
Which federal law prohibits insurance companies from using race, color, religion, sex, or national origin as a basis for discriminatory claims handling?
Answer: Civil Rights Act of 1964
The Civil Rights Act of 1964 prohibits discrimination in insurance services based on protected characteristics.
A claims adjuster who inflates repair estimates to earn higher commissions is committing:
Answer: Insurance fraud
Inflating estimates for personal financial gain constitutes insurance fraud, a criminal offense.
The principle requiring adjusters to handle similarly situated claims in a consistent and uniform manner is known as:
Answer: Consistent claims handling
Consistent claims handling ensures that comparable claims are processed with the same standards to avoid discriminatory treatment.
When an insurer denies a claim, which of the following must typically be provided to the claimant?
Answer: A written denial with the specific policy provisions relied upon
State regulations generally require written denial letters citing the specific policy language or exclusions supporting the decision.
Which doctrine holds that an insurer may be legally responsible for claims paid to a third party that the insured has already paid, if the insurer failed to timely accept a settlement within policy limits?
Answer: Excess judgment doctrine
The excess judgment doctrine exposes insurers to judgments exceeding policy limits when they unreasonably refuse to settle within limits.
A claimant alleges an adjuster promised a settlement amount but later reduced the offer. The adjuster may face liability for:
Answer: Promissory estoppel
Promissory estoppel holds a party to a promise when another party has reasonably relied on it to their detriment.