OIC Investigation Procedures & Methods 4

Question 1

When an Oregon investigator conducts a database search to verify a claimant's prior loss history, which organization's database is MOST commonly used across multiple insurers?

Accepted Answer

ISO ClaimSearch

Answer

ISO ClaimSearch is the industry-standard database used by insurers nationwide to identify prior claims and detect patterns across companies.

Question 2

An insured in Oregon submits a property theft claim but cannot produce a police report. The investigator should:

Accepted Answer

Request that the insured file a police report and obtain the report number as part of the investigation

Answer

A police report is a standard corroborating document; investigators should request it be filed and obtained before drawing conclusions.

Question 3

Which investigation method involves analyzing financial records to trace the movement of money in a suspected insurance fraud scheme?

Accepted Answer

Forensic financial analysis

Answer

Forensic financial analysis traces money flows to identify fraudulent transactions, kickbacks, or unexplained income.

Question 4

In Oregon, when an insurer suspects workers' compensation fraud, the investigator must coordinate with which agency?

Accepted Answer

Oregon Workers' Compensation Division (WCD)

Answer

The Oregon Workers' Compensation Division oversees workers' comp claims and is the primary agency for coordinating fraud referrals in this line.

Question 5

A claimant presents receipts for property claimed as stolen that were printed on the same printer model purchased after the loss date. This is BEST described as:

Accepted Answer

Evidence of post-loss fabrication of proof of ownership

Answer

Receipts produced after the loss date on equipment the claimant did not own at the time of loss indicate fabricated documentation.

(OIC) Oregon Inspector Certification Practice Test

(OIC) Oregon Inspector Certification Practice Test

OIC Investigation Procedures & Methods 4