CIP C112 Practical Issues In Claims Management Exam All Possible Questions and Answers with complete solution

What does claims management encompass ? - 1. Handling individual claims 2. Departmental claims processes and procedures. (What term/s do the ) courts use to determine bad faith? - harsh, vindictive, reprehensible, highhanded, oppressive, malicious what benchmark are adjusters held to? - Utmost good faith broader claims management functions (6) - 1. establish procedures, 2. providing administrative support, 3. establish a system of record keeping, 4. align operations to corporate vision and strategy, 5. ensuring regulatory compliance, 6. staffing and educating claims department. 5 ways monitor claims operation - Supervisor or team lead reviews all files of new adjusters, Claims audit, Customer survey, Letters to claimant to confirm payments, Statistical claims reports (examples of) claims Reports - Open / close ratios, Exceptional claims for special attention, Trends (what is the) claims managers role (8 items)? - Planning - day to day claims procedure, Official spokes person, Decision maker at the departmental level, Review strengths and weakness of department, Admin functions, Inspire staff, Handle conflicts 3 types of claims operations - Centralized, Decentralized, Hybrid describe Hierarchical Configuration - Like multilayer wedding cake, More employees (room for advancement, specialization) describe Flat configuration - Single layer cake, Fewer designated managers, Staff are more ssful claims strategies must demonstrate (guidelines):- - be specific, be challenging, be capable of being measured. approaches to learning (6) - learning by doing, self paced learning, interactive e-learning, coaching and mentoring, classroom instruction, case study approach