CCA Laws, Regulations, and Ethics 3

Question 1

Under the NAIC Unfair Claims Settlement Practices Act, 'knowingly misrepresenting pertinent facts' to a claimant is considered:

Accepted Answer

An unfair claims settlement practice

Answer

Knowingly misrepresenting facts or policy provisions is explicitly listed as an unfair claims settlement practice under the NAIC model act.

Question 2

A public adjuster's primary duty is owed to:

Accepted Answer

The policyholder

Answer

Unlike staff or independent adjusters, public adjusters are hired by and represent the interests of the policyholder.

Question 3

Which ethical standard requires an adjuster to disclose all information relevant to a claim, even if it benefits the claimant?

Accepted Answer

Duty of utmost good faith (uberrimae fidei)

Answer

Uberrimae fidei (utmost good faith) obligates both parties in an insurance contract to full and honest disclosure.

Question 4

State insurance regulations that govern claims handling practices are primarily enforced by:

Accepted Answer

The state insurance commissioner or department

Answer

Insurance regulation in the U.S. is primarily state-based, with each state's insurance commissioner holding enforcement authority.

Question 5

An adjuster who closes a claim without properly investigating because the amount is small is violating the duty of:

Accepted Answer

Reasonable investigation

Answer

Adjusters are legally and ethically required to conduct a reasonable investigation regardless of the claim's monetary value.

(CCA) Certified Claims Adjuster Practice Test