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GUIDE 2026-2027 NEW VERSION UPDATE ACTUAL EXAM QUESTIONS AND CORRECT
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1 DETAILED ANSWERS (VERIFIED ANSWERS) 100% PASS SOLUTION/ALREADY
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1 GRADED A+ 1
As methods of communication evolve, it's important for claims professionals to remember t hat
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any written claims communication may be
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Select one: 1
A. Replaced with verbal communication.
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B. Misinterpreted.
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C. Edited later.
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D. Subpoenaed. - ANSWER>>Any written claims communication may be subpoenaed.
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If a claim is complex, or if settlement negotiations are not progressing with the insurer, th
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e insured may hire a public adjuster to protect his or her interests. -
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ANSWER>>In which one of the following scenarios is a public adjuster most likely to beco
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me involved?
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Select one: 1
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
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B. An insured is unable to afford legal representation to contest a claim.
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C. A catastrophic disaster strikes, involving damage to many properties.
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D. An insured's negotiations with the insurer on a complex claim are not going well.
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Some will also send a copy via regular mail in case the certified letter is not accepted. -
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ANSWER>>Insurers usually send denial letters
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Select one: 1
,A. By email to ensure prompt receipt by the insured.
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B. By certified mail with a return receipt requested.
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,C. By overnight courier.
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D. By registered mail
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Which one of the following statements regarding third- party
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administrators (TPAs) is most accurate?
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Select one: 1
A. TPAs are typically used by businesses that have chosen not to self-insure.
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B. TPAs handle claims, keep claims records, and perform statistical analyses.
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C. TPAs are generally found in an insurer's claims department.
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D. TPAs are employed only by independent adjusting firms.
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Proper releases taken is a qualitative audit factor; the others are quantitative. -
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ANSWER>>Hugo is conducting an audit of a branch office claims operation. He is
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evaluatin g timeliness of reports, number of files opened, proper releases taken, and
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accuracy of dat a entry. Which one of Hugo's metrics is a qualitative audit factor?
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Select one: 1
A. Proper releases taken
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B. Timeliness of reports
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C. Number of files opened
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D. Accuracy of data entry
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Line underwriter. This describes the duties of a line underwriter, rather than a staff under writer.
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1There is not enough information to determine which line of business is being writte
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n. A public underwriter does not exist. Line underwriters evaluate new submissions and per form
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renewal underwriting, usually by working directly with insurance producers and applic ants. Staff
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1underwriters, meanwhile, manage risk selection by working with line 1 1 1 1 1 1 1 1
, underwriters and coordinating decisions about products, pricing and guidelines. -
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ANSWER>>Aaron works for a multi-
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line insurer. He works with insurance producers and applicants to evaluate new business su
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bmissions and conduct renewal underwriting. Aaron is a
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Select one: 1
A. Staff underwriter.
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B. Public underwriter.
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C. Personal lines underwriter.
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D. Line underwriter.
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Claims professionals should first listen carefully to understand what the claimant is saying. -
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ANSWER>>The first key to communicating empathetically as a claims professional is
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Select one: 1
A. A comprehensive understanding of relevant insurance policies.
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B. Speaking calmly and clearly.
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C. Being prepared with all documentation relating to the claim.
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D. Listening.
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Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to
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investigate, defend, and settle claims according to the terms specified in the insurance poli cy. -
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ANSWER>>Mia tracks loss adjustment expense (LAE) as part of her management of the cl aims 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1department for an insurer. Mia considers LAE to be the 1 1 1 1 1 1 1 1 1
Select one: 1
A. Total amount of loss reserves of all claims.
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B. Paid portion of claims.
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C. Cost to investigate, defend, and settle claims.
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D. Total incurred amount of claims.
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