CCA Claims Handling and Investigation

Question 1

What is the first step in the claims handling process?

Accepted Answer

Acknowledge and set up the claim

Answer

Evaluate the damages

Answer

Make payment to the claimant

Answer

Negotiate settlement

Question 2

Which of the following is a key purpose of claims investigation?

Accepted Answer

To determine if fraud occurred

Answer

To delay payment

Answer

To contact law enforcement

Answer

To adjust premium rates

Question 3

What is the role of the recorded statement in claims investigation?

Accepted Answer

To document claimant’s account of the incident

Answer

To increase settlement value

Answer

To offer legal advice

Answer

To close the claim immediately

Question 4

Which tool is most commonly used to document physical damage during a claims inspection?

Accepted Answer

Photographs of the damage

Answer

Policy declaration

Answer

Witness affidavit

Answer

Inspection checklist

Question 5

Why is it important to maintain accurate documentation throughout the claims process?

Accepted Answer

To support claim decisions and legal compliance

Answer

To calculate premium refunds

Answer

To verify claimant income

Answer

To reduce company overhead

Question 6

What action should an adjuster take if fraud is suspected during a claim?

Accepted Answer

Refer to Special Investigations Unit (SIU)

Answer

Close the claim immediately

Answer

Pay the claim partially

Answer

Ignore and proceed as usual