Claims Handling and Investigation Flashcards
6 cards from real CCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Claims Handling and Investigation flashcards as text
What is the first step in the claims handling process?
Answer: Acknowledge and set up the claim
The initial step in the claims process is to acknowledge and record the claim, establishing the claim file and beginning the investigation.
Which of the following is a key purpose of claims investigation?
Answer: To determine if fraud occurred
Investigation helps verify the facts of loss and determine coverage, liability, and potential fraud.
What is the role of the recorded statement in claims investigation?
Answer: To document claimant’s account of the incident
Recorded statements allow the adjuster to capture the claimant’s version of events, which is essential for verifying facts and consistency.
Which tool is most commonly used to document physical damage during a claims inspection?
Answer: Photographs of the damage
Photographs provide visual evidence of damages and support the written findings in the adjuster’s report.
Why is it important to maintain accurate documentation throughout the claims process?
Answer: To support claim decisions and legal compliance
Accurate documentation ensures transparency, protects against legal liability, and provides a record of actions taken.
What action should an adjuster take if fraud is suspected during a claim?
Answer: Refer to Special Investigations Unit (SIU)
If fraud is suspected, the adjuster should follow internal procedures and escalate the claim to the special investigations unit (SIU).