CCA Claims Handling and Investigation 4

Question 1

A claimant's vehicle is declared a total loss. The insurer offers ACV of $12,000, but the claimant insists the car is worth $15,000. What is the BEST next step?

Accepted Answer

Obtain an independent appraisal or use an agreed-value process

Answer

When valuation disputes arise on total losses, obtaining an independent appraisal or invoking the policy's appraisal clause is the proper resolution method.

Question 2

What is 'comparative negligence' and how does it affect a liability claim settlement?

Accepted Answer

It reduces the claimant's recovery in proportion to their own degree of fault

Answer

Under comparative negligence, a claimant's recovery is reduced by their percentage of fault; e.g., 30% at fault means 30% less in damages.

Question 3

Which of the following scenarios BEST represents 'moral hazard' in an insurance context?

Accepted Answer

An insured drives less carefully because they know they are covered

Answer

Moral hazard refers to the tendency of insured individuals to take greater risks because they are protected from the financial consequences of loss.

Question 4

An adjuster receives a demand letter with a 30-day deadline to respond or face litigation. What is the MOST appropriate action?

Accepted Answer

Acknowledge receipt and evaluate the demand promptly within the stated timeframe

Answer

Prompt acknowledgment and timely evaluation of settlement demands is required by good-faith claims handling standards and most state regulations.

Question 5

What is the purpose of a 'non-waiver agreement' in a claims investigation?

Accepted Answer

To allow the insurer to investigate a claim without waiving any policy defenses

Answer

A non-waiver agreement, signed by both parties, allows investigation to proceed while preserving the insurer's right to later deny coverage based on policy defenses.

(CCA) Certified Claims Adjuster Practice Test

(CCA) Certified Claims Adjuster Practice Test

CCA Claims Handling and Investigation 4