CIP C112 Practical Issues In Claims Management
Exam Newest 2026 Questions and Correct Detailed
Answers Already Graded A+
what is needed to set a reserve - CORRECT ANSWER-1. Assess coverage under
the contract
2. Assess the insured's legal liability
3. Consider any avenues for recovery
4. Assign forensic experts as needed
5. Assess the damage
Claims audit - CORRECT ANSWER-The ultimate monitoring function to ensure
that claims are handled effectively, and expeditiously.
Performed to preserve the financial stability of the insurer by examining the
claims operation at many levels
Proactive approach (audit) - CORRECT ANSWER-Audit undertaken in order to
take the initiative and control the claims operations before any actual problems
have been identified.
,reactive approach (audit) - CORRECT ANSWER-Respond to problematic areas
that the marketplace or regulators have already identified.
Full review audit - CORRECT ANSWER-Examines every facet of how a claims
department operates (Costly to perform - Provides useful information )
Specific Audit - CORRECT ANSWER-Examines limited aspects of the operation
( Focus narrow (reserving / indemnity / financial reporting requirements)
External audits can be imposed by - CORRECT ANSWER-Reinsurers holding
treaties .
( Focus on handling of claims in general)
2. Government regulators ( Solvency, market conduct, consumer rights)
3. Insurance company's external financial auditing firm
(Focus on the financial transactions and on establishing credibility for the
corporation's financial results)
when a company executes an audit to uncover the root cause of an issue,
unknown, immediately is an example of an - CORRECT ANSWER-emergency
audit
,What does claims management encompass ? - CORRECT ANSWER-1. Handling
individual claims 2. Departmental claims processes and procedures.
(What term/s do the ) courts use to determine bad faith? - CORRECT ANSWER-
harsh, vindictive, reprehensible, high-handed, oppressive, malicious
what benchmark are adjusters held to? - CORRECT ANSWER-Utmost good
faith
broader claims management functions (6) - CORRECT ANSWER-1. establish
procedures, 2. providing administrative support, 3. establish a system of record
keeping, 4. align operations to corporate vision and strategy, 5. ensuring
regulatory compliance, 6. staffing and educating claims department.
5 ways monitor claims operation - CORRECT ANSWER-Supervisor or team lead
reviews all files of new adjusters, Claims audit, Customer survey, Letters to
claimant to confirm payments, Statistical claims reports
(examples of) claims Reports - CORRECT ANSWER-Open / close ratios,
Exceptional claims for special attention, Trends
, (what is the) claims managers role (8 items)? - CORRECT ANSWER-Planning -
day to day claims procedure, Official spokes person, Decision maker at the
departmental level, Review strengths and weakness of department, Admin
functions, Inspire staff, Handle conflicts
3 types of claims operations - CORRECT ANSWER-Centralized, Decentralized,
Hybrid
describe Hierarchical Configuration - CORRECT ANSWER-Like multilayer
wedding cake, More employees (room for advancement, specialization)
describe Flat configuration - CORRECT ANSWER-Single layer cake, Fewer
designated managers, Staff are more multiline.
successful claims strategies must demonstrate (guidelines):- - CORRECT
ANSWER-be specific, be challenging, be capable of being measured.
approaches to learning (6) - CORRECT ANSWER-learning by doing, self paced
learning, interactive e-learning, coaching and mentoring, classroom instruction,
case study approach
Exam Newest 2026 Questions and Correct Detailed
Answers Already Graded A+
what is needed to set a reserve - CORRECT ANSWER-1. Assess coverage under
the contract
2. Assess the insured's legal liability
3. Consider any avenues for recovery
4. Assign forensic experts as needed
5. Assess the damage
Claims audit - CORRECT ANSWER-The ultimate monitoring function to ensure
that claims are handled effectively, and expeditiously.
Performed to preserve the financial stability of the insurer by examining the
claims operation at many levels
Proactive approach (audit) - CORRECT ANSWER-Audit undertaken in order to
take the initiative and control the claims operations before any actual problems
have been identified.
,reactive approach (audit) - CORRECT ANSWER-Respond to problematic areas
that the marketplace or regulators have already identified.
Full review audit - CORRECT ANSWER-Examines every facet of how a claims
department operates (Costly to perform - Provides useful information )
Specific Audit - CORRECT ANSWER-Examines limited aspects of the operation
( Focus narrow (reserving / indemnity / financial reporting requirements)
External audits can be imposed by - CORRECT ANSWER-Reinsurers holding
treaties .
( Focus on handling of claims in general)
2. Government regulators ( Solvency, market conduct, consumer rights)
3. Insurance company's external financial auditing firm
(Focus on the financial transactions and on establishing credibility for the
corporation's financial results)
when a company executes an audit to uncover the root cause of an issue,
unknown, immediately is an example of an - CORRECT ANSWER-emergency
audit
,What does claims management encompass ? - CORRECT ANSWER-1. Handling
individual claims 2. Departmental claims processes and procedures.
(What term/s do the ) courts use to determine bad faith? - CORRECT ANSWER-
harsh, vindictive, reprehensible, high-handed, oppressive, malicious
what benchmark are adjusters held to? - CORRECT ANSWER-Utmost good
faith
broader claims management functions (6) - CORRECT ANSWER-1. establish
procedures, 2. providing administrative support, 3. establish a system of record
keeping, 4. align operations to corporate vision and strategy, 5. ensuring
regulatory compliance, 6. staffing and educating claims department.
5 ways monitor claims operation - CORRECT ANSWER-Supervisor or team lead
reviews all files of new adjusters, Claims audit, Customer survey, Letters to
claimant to confirm payments, Statistical claims reports
(examples of) claims Reports - CORRECT ANSWER-Open / close ratios,
Exceptional claims for special attention, Trends
, (what is the) claims managers role (8 items)? - CORRECT ANSWER-Planning -
day to day claims procedure, Official spokes person, Decision maker at the
departmental level, Review strengths and weakness of department, Admin
functions, Inspire staff, Handle conflicts
3 types of claims operations - CORRECT ANSWER-Centralized, Decentralized,
Hybrid
describe Hierarchical Configuration - CORRECT ANSWER-Like multilayer
wedding cake, More employees (room for advancement, specialization)
describe Flat configuration - CORRECT ANSWER-Single layer cake, Fewer
designated managers, Staff are more multiline.
successful claims strategies must demonstrate (guidelines):- - CORRECT
ANSWER-be specific, be challenging, be capable of being measured.
approaches to learning (6) - CORRECT ANSWER-learning by doing, self paced
learning, interactive e-learning, coaching and mentoring, classroom instruction,
case study approach
