Insurance Adjusters Code of Conduct Quiz

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Instructions:

Read each question and select the best option.
When all questions have been answered, a rationale for the correct answer will appear.
The quiz is based on the Code of Conduct. The Code can be referenced during the Quiz.
If you score less than 100%, you must retake the quiz from the beginning.
Remember, you can take this test as many times as you wish.
Once you have passed the quiz, print a copy of the Certificate of Completion and file it for future verification.
If you wish to apply continuing education credits for licensing, enter the credit information under Continuing Education Information, found in the far left column under "Licence Holders".

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Which of the following activities is acceptable of an adjuster under the Adjusters' Code of Conduct?*

Signing the claimant's name to the proof of loss.

Asking the Fire Marshall's office to contact the adjusting firm to ensure that it is first to the loss site and begin the adjustment process before any other adjuster is assigned.

Using the services of a remedial company recommended by the insurer.

Relying on the claimant's degree of insurance knowledge to determine what will and will not be paid.

During the investigation, negotiation and settlement of a claim, the adjuster should NOT...*

verify that the insurance policy provides coverage for the property and cause of loss during the policy period as that is the direct role of the insurance company.

advise the insured of any statutory or policy conditions that could affect the claim as these would be commonly understood i.e. protect your property from additional damage and do not admit liability.

provide legal advice on how the insured should address losses that have been declined by the insurance company.

discuss the limitations and restrictions of the policy that is the basis for the coverage.

Which of the following will meet the Quality of Service standard required of the Code of Conduct?*

Delay telling third party claimants when the claim has been denied by the insurer; there might be other information in the future that could change the outcome.

Remind claimants that prescription periods are nearing the deadline.

Have claimants file complaints with Council against competing adjusters when their claims are denied.

Adopt a policy of 80/20: returning eighty percent of telephone calls and ignoring twenty percent.

Not everyone is suitable to be an adjuster. After a number of attempts to hire, train and keep new adjusters, S. Lyme has determined that rather than license new adjusters, he will hire trainees for a year and then determine whether or not they meet his requirements for licensing. During this period the new hires will handle in-house investigation files including writing letters and reports. This activity is permitted...*

only if the new hires obtain licenses.

subject to the new hires becoming enrolled in the Insurance Institute CIP courses.

if the letters and reports are reviewed and co-signed by a senior adjuster.

as the new hires are working in-house and not outside the office without supervision.

In discharging their duty to insurers, adjusters are permitted to...*

The two year proscription period is at the end of tomorrow’s business day. The Smiths leave a message that additional damages that had not previously been recognized have come to their attention.

advise the claimant that the insurer is being unfair when it denies a claim and provides e-mails between the insurance company and adjuster to be used by the claimant.

follow the specific instructions of the insurance company in negotiating the claim even if the adjuster disagrees.

assist the insured in preparing a property claim in exchange for cash from the client.

Ms. Jones has recently received her level 1 adjuster licence and been in the business for two months. Her superiors are away handling catastrophe losses resulting from a recent flood, and are not readily available. The insurance company called to assign a third party bodily injury claim from an industrial accident to the firm. Ms. Jones...*

should take the assignment and wait for one of the other adjusters to be available to handle to file even though it could be two weeks or more depending on the circumstances.

will go to the hospital and take a statement from the injured individual.

should ask her superior if the firm will be able to take the assignment, and if not, advise the insurer immediately.

can advise the injured person that coverage is provided by Worker Compensation and the person should contact that organization.

According to the Code of Conduct, Section 9 Conduct Towards O thers, adjusters...*

must receive confirmation from their principal(s) prior to releasing documents when requested by Council during the investigation of a complaint.

should delay making a settlement offer until the last day of any proscription period to ensure that the offer is accepted.

are required to promptly respond to the insured’s communications.

must contact the claimant within two hours of receiving an assignment from an insurer.

It’s Monday morning and after a week-end of sewer back-up and hail storm claims, Buzz E. Me is at the office at 6:00 am to start his week. The phone rings and he sees that it is lma Coutts leaving the sixth voice message since Saturday morning. Mr. Me promised Ms. Coutts that he would contact her last week with an update on her claim but the insurer had not responded and he had been overwhelmed. Mr. Me should...*

ignore the calls as he doesn't have the answer from the insurer and wants to be able to give her information when it is available.

answer the phone and tell Ms. Coutts that he has a number of more important claims than hers to deal with presently.

have kept his promise to Ms. Coutts last week to meet the expectations that he had set with her and maintain good communication.

have returned the message earlier and told Ms. Coutts to stop bothering him - he would call her when he had an answer.

Compliance with Section 4 Advising Clients is demonstrated when the adjuster...*

tells the claimant that the policy is subject to a co-insurance clause and explains how the loss will be calculated and limited by the policy.

assumes that the claimant will know that he has to protect undamaged property from possible loss.

uses his memory of the policy wording when initially discussing the coverage with the claimant, rather than wasting time ensuring that he has the most up-to- date policy applicable to the risk.

discusses an actual cash value settlement only, rather than full replacement cost, because the claimant is an elderly person waiting to move into an assisted living residence.

U.N. Able has been an adjuster for over twenty years with experience in homeowner policies. Recently she was assigned a claim which would require her to understand complex computer technology policies written in other countries, a subject with which she is unfamiliar. Ms. Able should...*

work with an outside technology expert who will sell products and services to the claimant during the course of the claim; Ms. Able will share in the profits from this activity.

pretend that she is knowledgeable and continue with the adjustment rather than admit her lack of knowledge.

speak with the insurer and if possible reassign the claim to someone in the office with knowledge and experience on this subject.

advise the claimant that any issue arising during the claim should be discussed with the agent who will speak directly with the insurance company on the claimant's behalf.