Match each scenario describing an adjuster's conduct with the corresponding statutory Unfair Claims Settlement Practice violation.
- Telling a policyholder their specific type of water damage is excluded, despite the policy clearly stating it is covered.Misrepresenting pertinent policy provisions relating to coverage at issue
- Failing to return a claimant's phone calls or emails for over a month after a claim is filed.Failing to acknowledge and act reasonably promptly upon communications
- Denying a theft claim the same day it is reported without checking police reports or interviewing the insured.Refusing to pay claims without conducting a reasonable investigation
- Offering a claimant 1,500.Attempting to settle a claim for less than a reasonable person would expect
Answer
1 matches with Misrepresenting provisions; 2 matches with Failing to acknowledge communications; 3 matches with Refusing to pay without investigation; 4 matches with Attempting to settle for less than expected.
Each scenario describes a specific, prohibited action under the NAIC Unfair Claims Settlement Practices Act. Matching the real-world conduct to the statutory language requires identifying the core failure: lying (misrepresentation), ignoring (communication failure), skipping fact-gathering (investigation failure), and lowballing (unreasonable settlement).
Step-by-Step Solution
Key Concept
Unfair Claims Settlement Practices