West Virginia Adjusters Practice Exam

Which unfair claims settlement practice involves an adjuster making false statements about policy coverage in order to reduce the settlement?

1. Claims Adjustment Delay

2. Fraud

3. Misrepresentation

4. Underwriting

The correct answer is: Claims Adjustment Delay

The correct answer is misrepresentation. This practice refers specifically to an adjuster providing false statements regarding the terms or coverage of an insurance policy, often with the intent of lowering the settlement amount owed to the policyholder. Misrepresentation undermines the trust and fairness that should characterize the claims settlement process, as it can lead to policyholders receiving less compensation than they are entitled to based on their coverage. Claims adjustment delay does not focus on the accuracy of policy coverage but rather on the timing of the claims processing. Fraud involves intentional deception for the purpose of financial gain, but it does not specifically refer to the context of an adjuster misrepresenting policy details. Underwriting pertains to the process of evaluating risk and setting premiums rather than handling claims or settlements. Thus, misrepresentation is the most accurate descriptor of the action outlined in the question.