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Exam (elaborations)

Claims Handling Verified Exam Questions and Answers Latest update 2026/2027

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Claims Handling Verified Exam Questions and Answers Latest update 2026/2027

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Claims Handling Verified Exam Questions and Answers Latest update
2026/2027

Question:
Why is claims handling important?

Answer:
At the time of a loss that the reaction and behaviour of the insurer's claims team will leave a lasting
impression. Good impression = renewed business.

Question:
Points of Interface - underwriting

Answer:
report wordings that are causing issues in interpretation
- advise on clarity of wordings
- provide up to date claims data for renewal
- liase concerning intent if claim appears to be outside scope of coverage
- underwriting should give claims its view about commercial pressures to settle certain claims.

Question:
points of interface - outwards reinsurance

Answer:
claims must know which reinsurance contain any forms of claims control or co-op clauses to avoid
any unintentional breaches
- provide adequate data to reinsurers to enable clear advice to be made
- code losses accurately to ensure aggregation of reinsurance recoverable
- keeps claim data (esp reserves) up to date so reinsurance renewals are effected on accurate loss
data

Question:
points of interface complaints

Answer:
provide Clear info about handling on any claim to enable compliance handlers to deal with issues
complaints should provide advice on reg info to claims

Question:
points of interface - management information

Answer:
MI should lease with claims for input on systems designs or changes MI should review reports with
Claims to ensure that data is being reported properly.

,Question:
points of interface - legal

Answer:
liaise over any outsourcing of claims to ensure agreements appropriate. liaise where appropriate if
claims go to litigation legal should work with underwriters and claims to advise on issues with
wordings used or proposed.

Question:
points of interface - compliance

Answer:
ensure all claims handlers appropriately trained and authorised claims manager ensure all staff aware
of regulatory requirements

Question:
points of interface - marketing

Answer:
highlight issues where clients have not had a clear understanding of product. marketing should use
claims as a publicity tool

Question:
points of interface - senior management

Answer:
report large claims
- report matters that are of wider importance to the company
- a director should be responsible for the critical function of claims

Question:
points of interface - finance

Answer:
ensure early warning given of large individual payments being made
- liaise in cases of high volumes of claims eg after catastrophic loss so no cash flow issues.

Question:
brokers role

Answer:
provide updated info to insurers as provided by client negotiate on behalf of client if req receive any
claims funds for onward transmission to client

, Question:
insurers role

Answer:
In LM 2 main agreements. However distinction between Lloyd's and IUA agreements. But this can be
complicated by involvement of overseas insurers who can be decision makers.

Question:
claims agreements - Lloyd's market

Answer:
Lloyd's Claims Lead Arrangements

Question:
claims agreements - IUA company Market (marine and aviation)

Answer:
IUA claims handling agreements

Question:
Claims agreements - IUA Company Market (non-marine)

Answer:
no binding possible - each insurer agrees own share.

Question:
IUA Company Market (non-marine)

Answer:
Need individual agreement of all insurers. This rule applies to any info submitted by broker whether
advice or request for settlement. Only exception is individual companies can set up the claims
agreement system to auto bypass them with further advices if share below a pre-set financial limit

Question:
IUA Company Market (marine and Aviation)

Answer:
rules vary if submission is
- advice or settlement
- includes any Lloyd's involvement
- is direct loss or xol reinsurance
Advices can be agreed by lead Company Market underwriter only. settlements have a combo of
requirements

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