Insurance Claims Handling Process

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18 Questions

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

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

The eyes of the insurer

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

Checking whether the insurance company is liable under the insurance policy

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

Including facts, opinions, and recommendations

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

To protect the insurance company's balance sheet

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

Cedant

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

To recover the insurer's outlay from a third party

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

Negotiation skills

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

To identify potential subrogation opportunities

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

Both insured perils and policy exclusions

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

Reinsurance

What service might a loss adjuster offer to policyholders?

Damage reclamation services

What skill is likely to be required in larger claims?

Negotiation skills

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

To determine the validity of the claim

What is the primary role of a Loss Adjuster?

To support the insurer in investigating technical claims

What is subrogation in the context of claims?

The retrieval of moneys from other parties

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

To provide a professional and top-class service

What is the final step in the claim process?

Complete claim file

Test your knowledge of the insurance claims handling process, including fine-tuning reserves, checking for fraud indicators, making decisions on coverage, and negotiating with clients. Learn about the internal and external processes involved in investigating and resolving claims.

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