C112 Claims Management Dec 2005 Exam

Claims – Dec 2005 Exam

Section A – Multiple-Choice Questions

1. (A)(1-3) To gain an understanding of a company’s commitment to it’s clients, the mission statement is a good place to start. It underpins the philosophy the claims department will embrace for handling claims. It often focuses on the company’s core strengths, values, or culture, and could specifically articulate an approach towards handling claims. The promises made in brochures and other advertising material to promote the sale of policies should also correspond.

2. (D)(1-9) Methods used to evaluate claims handlers performance include: • reviewing all files closed by new loss adjusters to assess procedural and process issues as well as technical claims handling • a claims audit, internal or external, could assess various aspects of identified claims handling issues • policyholders could be surveyed to assess customer service issues

3. (B)(1-11) Specialists deal with one type of claim or one line of business. Loss adjusters who specialize in the more complex areas of claims handling tend to have a broad base of experience in which their work is grounded, because at the beginning of their careers they would have handled a wide variety of claims.

4. (A)(1-26) Timing issues may be artificial. Urgency can easily be confused with emotionalism.

5. (D)(2-6) When assigning claims to independent or staff adjusters, most insurers will organize their claims departments to include claims examiners to oversee and control the handling of the claim file.

6. (C)(2-7) A claims department must learn of a new claim as soon as possible. The insured often needs guidance, reassurance, and general support. Most insureds will look to the insurer for leadership during the claims process, looking for direction on what to do next. The claims handling process can be viewed as a collaborative effort between the insured and the loss adjuster.

7. (B)(2-9) The triaging process...
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