OIC Investigation Procedures & Methods 3

Question 1

Which Oregon statute primarily governs the reporting of suspected insurance fraud by insurers?

Accepted Answer

ORS Chapter 746

Answer

ORS Chapter 746 covers insurance trade practices and includes mandatory fraud reporting requirements for insurers in Oregon.

Question 2

When an Oregon inspector identifies a pattern of claims from the same medical provider, the MOST appropriate investigative technique is:

Accepted Answer

Conduct a link analysis to map relationships between claimants and the provider

Answer

Link analysis maps relationships between claimants, providers, and incidents to detect organized fraud schemes.

Question 3

An investigator is preparing to interview a witness in an Oregon insurance claim. Which approach is MOST effective for obtaining accurate information?

Accepted Answer

Use open-ended questions to allow the witness to narrate events freely

Answer

Open-ended questions allow witnesses to provide narrative accounts, reducing interviewer bias and capturing details the investigator may not have anticipated.

Question 4

In Oregon, the 'two-year look-back' in insurance investigations typically refers to:

Accepted Answer

Reviewing prior claim history within two years to identify patterns

Answer

Reviewing prior claims within a two-year window helps investigators identify patterns of repeated or staged losses.

Question 5

When gathering digital evidence during an Oregon insurance investigation, chain of custody is critical because it:

Accepted Answer

Ensures the evidence is admissible and has not been tampered with

Answer

An unbroken chain of custody demonstrates that digital evidence has not been altered, making it admissible in legal proceedings.

(OIC) Oregon Inspector Certification Practice Test

(OIC) Oregon Inspector Certification Practice Test

OIC Investigation Procedures & Methods 3