Claims Processing & Documentation Flashcards
7 cards from real CALA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Claims Processing & Documentation flashcards as text
Which of the following is considered a 'red flag' indicator of potential claims fraud during documentation review?
Answer: The insured recently increased coverage limits before a major loss
Significantly increasing coverage shortly before filing a large claim is a common fraud indicator that warrants further investigation.
A properly completed proof of loss statement must be submitted within what timeframe under most standard auto policies?
Answer: 60 days after the insurer's request
Most auto policies require the insured to submit a signed proof of loss within 60 days after the insurer formally requests it.
When an adjuster identifies pre-existing damage during vehicle inspection, the correct documentation approach is to:
Answer: Note and photograph it separately, clearly distinguishing it from loss-related damage
Pre-existing damage must be documented separately with photos to ensure the insurer only pays for loss-related repairs.
The 'Agreed Value' method of settling total loss claims differs from ACV because it:
Answer: Uses the value stated in the policy without depreciation deductions
Agreed Value policies pay a predetermined amount stated in the policy, eliminating depreciation disputes common with ACV settlements.
Under the Fair Claims Settlement Practices Act, insurers must acknowledge receipt of a claim within:
Answer: 10 business days
Most state regulations based on the UCSPA require insurers to acknowledge claims within 10 working days of receipt.
When a claimant hires a public adjuster, what changes in the claims process?
Answer: The public adjuster represents the insured's interests in negotiations with the insurer
A public adjuster is hired by the insured to advocate for a higher settlement and handles negotiations on the insured's behalf.
Which document is required to transfer ownership of a totaled vehicle's title to the insurance company?
Answer: Signed title and odometer disclosure statement
A properly signed title along with an odometer disclosure statement is required to legally transfer salvage ownership to the insurer.