CCA Claims Handling and Investigation 2

Question 1

When a claimant reports a loss, what is the adjuster's FIRST priority?

Accepted Answer

Acknowledge receipt and set expectations for the process

Answer

Prompt acknowledgment and communication of next steps is a best practice and often a regulatory requirement to initiate good-faith handling.

Question 2

Which document grants an adjuster the legal authority to act on behalf of an insurer in settling claims?

Accepted Answer

Letter of Authorization

Answer

A Letter of Authorization (or similar delegation letter) formally grants the adjuster authority to act on the insurer's behalf in a specific claim.

Question 3

A claimant submits a sworn Proof of Loss 65 days after a fire loss, but the policy requires submission within 60 days. What should the adjuster consider?

Accepted Answer

Waive the requirement if the insurer's conduct did not prejudice the claimant

Answer

Courts often find that an insurer waives a late Proof of Loss deadline if its own conduct (e.g., ongoing negotiations) prevented timely submission or caused no prejudice.

Question 4

What is the primary purpose of an Examination Under Oath (EUO) in a claims investigation?

Accepted Answer

To allow the insurer to gather sworn testimony about the loss

Answer

An EUO is a contractual right that allows the insurer to question the insured under oath to fully investigate the facts and circumstances of a claim.

Question 5

An insured's home is burglarized and personal property is stolen. The insured cannot produce original receipts. What is the BEST approach for the adjuster?

Accepted Answer

Use alternative documentation such as credit card statements, photos, or owner's manuals

Answer

Adjusters should work with claimants to gather alternative evidence of ownership and value when original receipts are unavailable.

(CCA) Certified Claims Adjuster Practice Test

(CCA) Certified Claims Adjuster Practice Test

CCA Claims Handling and Investigation 2