CALA CALA Medical Claims & Bodily Injury

Question 1

What is the primary purpose of obtaining medical authorizations (HIPAA releases) during a bodily injury claim investigation?

Accepted Answer

To access the claimant's medical records relevant to the injury claimed

Answer

To authorize the insurer to perform surgery

Answer

To waive the claimant's right to future treatment

Answer

To transfer the claim to a health insurer

Question 2

What does the term 'causation' mean in the context of a bodily injury claim?

Accepted Answer

Whether the claimed injury was caused by the insured accident

Answer

The total dollar amount of medical bills

Answer

The claimant's pre-existing health conditions

Answer

The type of insurance policy in force

Question 3

Which type of damages compensates a bodily injury claimant for physical pain and emotional distress?

Accepted Answer

General (non-economic) damages

Answer

Special (economic) damages

Answer

Punitive damages

Answer

Nominal damages

Question 4

What are 'specials' in bodily injury claims terminology?

Accepted Answer

Quantifiable economic losses such as medical bills and lost wages

Answer

Secret settlement amounts

Answer

Special policy endorsements

Answer

Specialty medical procedures only

Question 5

An independent medical examination (IME) is typically requested by an insurer for what purpose?

Accepted Answer

To obtain an objective physician's opinion on the nature, extent, and causation of injuries

Answer

To replace the claimant's treating physician

Answer

To authorize additional surgery at the insurer's expense

Answer

To deny all future medical treatment automatically

Question 6

Which factor most significantly affects the settlement value of a soft-tissue bodily injury claim?

Accepted Answer

Duration of treatment and documented medical expenses

Answer

The color of the vehicle involved

Answer

Whether the insured has a prior traffic citation

Answer

The deductible amount on the policy