MC Questions Flashcards
What is a reservation of rights letter?
An insurers’ notification that coverage for a claim may not apply
Feedback: A reservation of rights letter is an insurer’s notification to an insured that coverage for a claim
may not apply. Such notification allows the insurer to investigate or defend a claim to determine whether
coverage applies without waiving its right to later deny coverage based on the information revealed by the
investigation.
Why is obtaining a statement important for the adjuster?
Facts need to be verified so that the adjuster knows he or she is dealing with an accurate
chain of events.
Feedback: Statement-taking is important because the adjuster needs to ensure that the events as
reported are accurate.
What are the different categories of bodily injury claims?
Soft tissue, catastrophic, and psychological injuries
Feedback: The different types of bodily injury claims an adjuster may deal with include soft tissue,
catastrophic, and psychological injuries.
What is the definition of estoppel?
When someone, by his or her action or lack thereof, indicates that a right will not be
exercised
Feedback: Estoppel is a bar created when someone by his action or lack of it indicates that he will not
exercise a right he has. He estops himself from exercising that right later.
What is the definition of subrogation?
When a company has paid a loss for which someone other than the policyholder is
responsible and may therefore have the right to recover this loss from the guilty party
Feedback: Subrogation is when a company that has paid a loss for which someone other than the
policyholder is responsible may have the right to recover this loss from the guilty party.
What are other possible sources of information an investigator may wish to explore when investigating
a claim?
Questioning the claimant more thoroughly as the case develops
Feedback: An adjuster will always have to obtain permission to review medical files and tests from the
injured parties when investigating a claim. It is through good questioning techniques and thorough
investigations that complete, accurate information is obtained.
What is a forensic expert?
A person connected to a court of law who can be hired by an insurer or an insured to appear
in court as a witness
Feedback: A forensic expert is a person connected to a court of law who can be hired by an insurer or an
insured to appear in court as a witness. The expert applies knowledge of legal cases to the principles of a
profession. The expert can help prove or contradict the clause of a claim.
What is the skin?
A sensory organ
Feedback: The skin is the largest organ of the human body. Since it covers the body, it responds to
many different stimuli. It is a sensory organ.
What is the cause of neurological deficit?
Traumatic nerve damage
Feedback: Nerves can also become damaged in traumatic injury and cause neurological deficit.
Which type of burn is deemed to be superficial?
First degree
Feedback: First-degree burns are superficial. The skin becomes reddened and inflamed on the skin
surface. The inflammation usually subsides in a couple of days and the outermost layer of skin peels.
What is the definition of shock?
A condition brought on by the collapse of the circulatory system, often caused by severe
injury
Feedback: Shock is a condition brought on by the collapse of the circulatory system, often caused by
severe injury. The symptoms include pallor, sweating, weak pulse, and very low blood pressure.
Which one of the following muscle groups is responsible for movement?
Skeletal muscles
Feedback: Skeletal muscles move the bones of the body. They must be stimulated by a nerve to function
and are known as the voluntary muscles. They are sometimes called striated muscles. They have a great
capacity for healing because of the large number of blood vessels that run through them.
What is the definition of a sprain?
A sprain involves the partial or complete tearing of the ligament.
Feedback: If stress or force results in the tearing of a ligament it is called a sprain. A sprained ligament is
often referred to as a torn ligament. A sprain involves the partial or complete tearing of the ligament.
What is the definition of a strain?
A strain is the overstretching and possible tearing of muscle or tendon fibres.
Feedback: A strain is overstretching or tears to muscle or tendon fibres. Strains can be mild, moderate,
or severe. It is the overstretching and possible tearing of muscle or tendon fibres.
What is fibromyalgia?
A condition that is persistent, causing disabling pain in the muscles over a long period of time
Feedback: A diagnosis of fibromyalgia—also called chronic pain syndrome—is used for conditions of
disabling pain that persists three to six months beyond a normal recovery period for a soft tissue injury. It
is a persistent, disabling pain in the muscles over a long period of time.
What is chronic pain syndrome?
Pain that persists over a long period of time
Feedback: Chronic pain syndrome is a diagnosis for conditions of disabling pain that go beyond the
normal recovery period. It is pain that persists over a long period of time. It is another term for
fibromyalgia.
What are some of the most common injuries that adjusters deal with?
Muscle injuries
Feedback: Muscular injuries are some of the most common injuries dealt with by adjusters. It is important
that adjusters understand the injury described in medical reports and documents as well as the
associated treatments.
How many bones are there in the human skeleton?
206
Feedback: There are 206 bones in the human skeleton
How are bones classified?
By shape
Feedback: Bones are classified according to shape.
What is the sternum?
A bone that is flat and narrow and linked to the clavicles (collarbones) and the true ribs
Feedback: The sternum is a flat and narrow bone linked to the clavicles (collarbones) and the true ribs.
What are the most common injuries to the pelvis?
Fractures and dislocations
Feedback: The most likely traumatic injuries to the pelvis are mainly fractures and dislocations.
What is avascular necrosis?
The death of bone from the absence or restricted flow of blood
Feedback: Avascular necrosis is the death of bone from the absence or restricted flow of blood.
What is a condyle?
Condyles are rounded projections found on the humerus, femur, tibia, and scapula.
Feedback: Condyles are rounded projections found on the humerus, femur, tibia, and scapula.
What is the most common type of joint in the human body?
Movable joints
Feedback: Movable joints are the most common types of joints in the human body and are needed to
facilitate basic movement like walking, bending, or gardening.
Where is a ball and socket joint found?
Hip and shoulder
Feedback: Types of movable joints include ball and socket joints, which are found in the hip and
shoulder.
What is synovitis?
An inflammation of the synovial membrane, which lines the capsule of a joint
Feedback: Synovitis appears as swelling and is characterized by generalized discomfort. It is an
inflammation of the synovial membrane, which lines the capsule of a joint.
How would one describe a comminuted fracture?
One that is a complete break into three or more fragments. The smaller fragments are found
between the two main fragments.
Feedback: A comminuted fracture is a complete break into three or more fragments. The smaller
fragments are found between the two main fragments.
Vertebrae are divided into how many groups?
5
Feedback: The spinal column is made up of 33 vertebrae, divided into five groups.
What is spinal fusion?
The fusing or rigid joining together of two or more vertebrae
Feedback: It is a surgical procedure whereby two or more of the vertebrae are fused together. This may
result in a decrease in bending ability.
What is kyphosis?
An exaggerated increase in the thoracic curve
Feedback: The spine may develop abnormal, exaggerated curves from disease, injury, or postural
problems. Kyphosis is the exaggerated increase in the thoracic curve.