CCP Claims Investigation & Evaluation 2

Question 1

When a claimant refuses to submit to an Examination Under Oath (EUO), what is the most likely consequence under a standard property policy?

Accepted Answer

Coverage may be voided due to breach of policy conditions

Answer

Most property policies require the insured to submit to an EUO as a condition of coverage, and refusal can constitute a material breach that voids the claim.

Question 2

A claims adjuster discovers that the date of loss reported by the insured does not align with weather records. What is the best next step?

Accepted Answer

Obtain certified weather data and request clarification from the insured

Answer

The adjuster should document objective weather records and give the insured an opportunity to explain the discrepancy before drawing conclusions.

Question 3

Which document is most useful when investigating whether a business income claim loss amount is accurate?

Accepted Answer

The insured's prior-year tax returns and financial statements

Answer

Tax returns and financial statements provide objective historical revenue data needed to project the business income loss during the interruption period.

Question 4

In a liability claim, what does 'proximate cause' mean?

Accepted Answer

The direct and efficient cause most closely linked to the loss

Answer

Proximate cause is the primary cause that sets in motion the chain of events leading to the loss, determining legal liability.

Question 5

A recorded statement is best obtained from a claimant:

Accepted Answer

As early as possible in the investigation while details are fresh

Answer

Early recorded statements capture details before memories fade and before parties may be influenced by counsel or other parties.

(CCP) Certified Claims Professional Practice Test

(CCP) Certified Claims Professional Practice Test

CCP Claims Investigation & Evaluation 2