Solutions
A claims representative should have the ability to persuade or
influence Correct Answers Claimants, insured's, supervisors
and others.
Adam manages a claims department for an insurer. He measures
the department's performance by best practices, claims audits,
customer satisfaction data, and loss ratio. Which one of Adam's
measures refers to a system of identified internal practices that
claims representatives perform to produce superior
performance? Correct Answers Best practices
Alva works for an international, multi-line insurer. She helps her
company to manage risk selection by working with other
underwriters and coordinating decisions about products, pricing,
and guidelines. Alva is a Correct Answers Staff Underwriter
Among the methods used to pay claims are the issuance of
checks and bank drafts. The main difference between the two is
that Correct Answers With a bank draft, the bank must verify
that the insurer has authorized payment.
An insurer that finds it economically impractical to establish a
claims office in a given state is likely to use which one of the
following to perform the claims handling function? Correct
Answers Independent Adjusters
Antonia has a general liability policy with a self-insured
retention of $50,000. The policy has an occurrence limit of
, $250,000 and an aggregate limit of $500,000. She had submitted
one prior claim this policy term for which $100,000 was paid by
the insurer. How much will Antonia's insurer pay on a
subsequent claim under the same policy period that is valued at
$400,000? Correct Answers $250,000
As a claims representative, Joshua frequently requests proofs of
loss and affidavits, and conducts examinations under oath and
recorded statements. Which one of Joshua's sworn statements is
administered by the insurer's attorney at the office of the insurer,
attorney, or court reporter? Correct Answers Examination
under oath.
As a part of the first contact with an insured on a property
damage claim, a claims representative may provide a blank
Correct Answers Proof of loss form.
Attorney Grace is representing an insurer in a case and is
preparing a pretrial motion. Her argument is that the court has
no jurisdiction for the cause of action brought by the claimant.
Grace is preparing a Correct Answers Motion to Dismiss.
Because a full or partial denial of a claim may result in a bad-
faith lawsuit, a claims representative should Correct Answers
Carefully document their reasoning for denial.
Bettina's apartment is burglarized and several items are stolen.
In filing her claim, she tells her insurer that her stolen television
was both newer and larger than it actually was. This constitutes
which one of the following types of fraud? Correct Answers
Soft Fraud.