Insurance Claims Handling Process

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Questions and Answers

What is the primary purpose of negotiating with product or service providers on time for cost of repairs?

  • To make an offer of settlement to the insured (correct)
  • To determine the apportionment of loss among multiple policies
  • To verify the existence of other policies
  • To ensure the policyholder has an insurable interest

What is the role of the risk engineer in the insurance industry?

  • The eyes of the underwriter
  • The arm of the claims expert
  • The arm of the underwriter
  • The eyes of the insurer (correct)

What is a primary function of a loss adjuster in relation to the insurance policy?

  • Determining the premium rates for the insured
  • Providing investment advice to the insured
  • Checking whether the insurance company is liable under the insurance policy (correct)
  • Issuing insurance certificates to the policyholders

What is a key aspect of a loss adjuster's report to the insurers?

<p>Including facts, opinions, and recommendations (C)</p> Signup and view all the answers

What is the primary purpose of reinsurance in the insurance industry?

<p>To protect the insurance company's balance sheet (B)</p> Signup and view all the answers

What is the term for the insurance company that takes out reinsurance coverage?

<p>Cedant (C)</p> Signup and view all the answers

In the context of a loss claim, what is a key objective of a loss adjuster during negotiations?

<p>To recover the insurer's outlay from a third party (A)</p> Signup and view all the answers

What is an essential skill for a loss adjuster during the claim investigation process?

<p>Negotiation skills (D)</p> Signup and view all the answers

What is the purpose of checking for other policies that may be brought into the apportionment of loss?

<p>To identify potential subrogation opportunities (C)</p> Signup and view all the answers

During a loss assessment, what might a loss adjuster investigate to determine liability?

<p>Both insured perils and policy exclusions (B)</p> Signup and view all the answers

What is the term for the process of passing on a portion of the risk to another insurer?

<p>Reinsurance (D)</p> Signup and view all the answers

What service might a loss adjuster offer to policyholders?

<p>Damage reclamation services (A)</p> Signup and view all the answers

What skill is likely to be required in larger claims?

<p>Negotiation skills (B)</p> Signup and view all the answers

What is the purpose of checking for fraud indicators in the claim process?

<p>To determine the validity of the claim (A)</p> Signup and view all the answers

What is the primary role of a Loss Adjuster?

<p>To support the insurer in investigating technical claims (B)</p> Signup and view all the answers

What is subrogation in the context of claims?

<p>The retrieval of moneys from other parties (B)</p> Signup and view all the answers

What is the importance of a multi-disciplinary approach in claims handling?

<p>To provide a professional and top-class service (D)</p> Signup and view all the answers

What is the final step in the claim process?

<p>Complete claim file (C)</p> Signup and view all the answers

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