CIA Claims Investigation & Reporting Standards 2

Question 1

When an insurer receives a first notice of loss (FNOL), what is the primary purpose of the immediate acknowledgment requirement?

Accepted Answer

To comply with state prompt-payment statutes and preserve the claimant's rights

Answer

State prompt-payment laws require timely FNOL acknowledgment to protect claimant rights and trigger investigation timelines.

Question 2

A property adjuster discovers that a claimant's recorded statement contradicts physical evidence at the loss scene. The BEST next step is to:

Accepted Answer

Document the discrepancy and conduct further investigation to reconcile the conflict

Answer

Contradictions between statements and evidence require additional investigation rather than premature denial or acceptance.

Question 3

Which document is typically used to formally transfer a claimant's right of recovery against a third party to the insurer after the insurer pays the claim?

Accepted Answer

Subrogation Receipt or Assignment

Answer

A subrogation receipt or assignment formally conveys the insured's right of action against responsible third parties to the insurer.

Question 4

Under the Unfair Claims Settlement Practices Act (UCSPA) model, which of the following constitutes an unfair claims practice?

Accepted Answer

Failing to acknowledge communications within a reasonable time period

Answer

Failing to acknowledge communications within a reasonable timeframe is a defined unfair practice under most states' UCSPA statutes.

Question 5

A claimant presents a claim for theft of business equipment. The adjuster should request which document to establish the value of the stolen items?

Accepted Answer

Original purchase invoices, receipts, or purchase orders

Answer

Original purchase invoices and receipts are the primary documentation to establish actual cash value or replacement cost of stolen business property.

(CIA) Certified Insurance Appraiser Practice Test

(CIA) Certified Insurance Appraiser Practice Test

CIA Claims Investigation & Reporting Standards 2