m m m m m
Complete with Verified Answers for G
m m m m m
uaranteed Pass m
Insurersmusuallymsendmdenial mlettersmSel
ect mone:
A. Bymemail mtomensuremprompt mreceipt mbymtheminsured.
B. Bymcertifiedmmailmwith mamreturn mreceipt mrequested.
C. Bymovernight mcourier.
D. Bymregisteredmmail.mCORRECTmANSWER:mB.mBymcertifiedmmailmwithmamreturn mrec
eipt mrequested.
Somemwill malso msendmamcopymviamregular mmailmin mcasemthemcertifiedmlettermismnot maccepted
.
Asmmethodsmofmcommunication mevolve,mit'smimportant mformclaimsmprofessionalsmtomreme
mbermthat manymwritten mclaimsmcommunication mmaymbe
Select mone:
A. Replacedmwith mverbal mcommunication.
B. Misinterpreted.
C. Editedmlater.
D. Subpoenaed.mCORRECTmANSWER:mD.mSubpoenaed.
Anymwritten mclaimsmcommunication mmaymbemsubpoenaed.
Tomdeterminemwhethermanminsurermtypicallymunderreservesmor moverreservesmclaims,mactu
ariesmcomparemtheminsurer'smpaidmlossesmto
a. Theminsurer'smprofits.
b. NAICmmodel mregulations.
c. National maverages.
d. Theminsurer'smcasemreserves.mCORRECTmANSWER:md.mTheminsurer'smcasemrese
rvemThemfirst mkeymtomcommunicatingmempatheticallymasmamclaimsmprofessional mis
a. Amcomprehensive munderstandingmofmrelevant minsurancempolicies.
b. Listening.
c. Speakingmcalmlymandmclearly.
d. Beingmpreparedmwith mallmdocumentationmrelatingmtomthemclaim.mCORRECTmANSWE
R:
b.mListening
Carolinamismamclaimmrepresentative mhandlingmamliabilitymclaim.mShemismspeakingmtomthemcl
aimant movermthemphonemandmhasminformedmhimmthat mhismstatementsmmust mbemtruemunde
r
,penaltymofmperjury.mWhenmcompleted,mshemsentmamtranscriptionmofmthemconversation mtomt
hemclaimant mformhim mtomsign mbeforemamnotary.mCarolinamhasmtaken ma(n)
a. Deposition.
b. Examination munder moath.
c. Recordedmstatement.
d. Affidavit.mCORRECTmANSWER:mc.mRecordedmstatement
Rikomisman mexperiencedmsettlement mnegotiator.mWhenmnegotiatingmwithmclaimant mrepres
entatives,mshemusesmtechniquesmsuch masmtimingmsettlementsmeffectively,menticingmamreaso
nablemdemand,mmakingmconcessionsmcautiously,mandmleaningmonmthemevaluation.mShemun
derstandsmthat mhermcurrent mclaimantmismeager mtomreceivemmoney,msomshemismdelayingmthem
negotiationsmasmlongmasmpossible.mWhich mnegotiation mtechniquemismRiko musing?
a. Enticingmamreasonablemdemand
b. Timingmsettlementsmeffectively
c. Learningmon mthemevaluation
d. MakingmconcessionsmcautiouslymCORRECTmANSWER:mb.mTimingmsettlemen
tsmeffectively
Mitsukimwasmseverelyminjuredmwhen mthemsafetymlatch mon manmamusement mparkmridemfaile
dmandmshemwasmthrown mfrommthemride.mIn mhermlawsuit mwith mthemamusementmpark,mMitsu
kimwasmawardedmpayment mformpain mandmsuffering,memotional mdistress,mdisfigurement,ma
ndmlossmofmearnings.mWhich monemofmMitsuki'smawardsmismconsideredmspecial mdamages?
a. Lossmofmearnings
b. Disfigurement
c. Emotional mdistress
d. Pain mandmsufferingmCORRECTmANSWER:ma.mLossmofmearnings
Which monemofmthemfollowingmexplainsmwhymamcomputer mrecursivelymappliesmammodel?
a. Tomdeterminemthemprobabilitymofmamtarget mvariable
b. Tomanalyzemdifferent msplitsmin mthemvaluesmofmattributes
c. Tomidentifymattributesmthat mcan mbemused
d. TomanalyzemclaimsmdatamfrommpreviousmyearsmCORRECTmANSWER:mb.mTomanal
yzemdifferent msplitsmin mthemvaluesmofmattributes
Which monemofmthemfollowingmexplainsmwhymamcomputer mrecursivelymappliesmammodel?
a. TPAsmaremtypicallymusedmbymbusinessesmthat mhavemchosen mnot mtomself-insure.
b. TPAsmhandlemclaims,mkeepmclaimsmrecords,m,andmperform mstatistical manalyses.
c. TPAsmarememployedmonlymbymindependent madjustingmfirms.
d. TPAsmaremgenerallymfoundminman minsurer'smclaimsmdepartment.mCORRECTmANSWE
R:
b.mTPAsmhandlemclaims,mkeepmclaimsmrecords,mandmperform mstatistical manalyses
,In mher mrolemwith manminsurer,mKatarinamhasmopportunitymtomcollaboratemwithmnot monlymem
ployeesmfrom mher mcompany,mbutmalsomexternal mexpertsmwith mparticular mexpertise.mFor mex
ample,masmpart mofmher minvestigation,mshemhiredmanmengineer mtomconductmamreviewmofmamm
achinemthat mwasminvolvedmin mampersonal minjury.mKatarinamisma(n)
a. Claim mrepresentative.
b. Medical mprovider.
c. Expert mWitness.
d. Premiummauditor.mCORRECTmANSWER:ma.mClaimmrepresentati
vemThemclaimsmlitigation mprocessmbeginsmwith mthemreceipt mof
a. Amnoticemofmclaim.
b. Amsummonsmandmcomplaint.
c. Amcivil mviolation mnotice.
d. Amsettlement moffer.mCORRECTmANSWER:mb.mAmsummonsmandmcomplaint
In mwhich monemofmthemfollowingmscenariosmismampublicmadjuster mmost mlikelymtombecomeminv
olved?
Select mone:
A. An minsurer mfindsmitmfinanciallymunfeasiblemtomhiremitsmownmclaimsmstaffminmamgivenmstat
e.
B. An minsuredmismunablemtomaffordmlegal mrepresentation mtomcontest mamclaim.
C. Amcatastrophicmdisaster mstrikes,minvolvingmdamagemtommanymproperties.
D. An minsured'smnegotiationsmwith mtheminsurer mon mamcomplexmclaim maremnotmgoingm
well.mCORRECTmANSWER:mD.mAn minsured'smnegotiationsmwithmtheminsurermon mam
complexmclaim maremnot mgoingmwell.
Ifmamclaim mismcomplex,mormifmsettlementmnegotiationsmaremnot mprogressingmwithmtheminsur
er,mtheminsuredmmaymhiremampublicmadjuster mtomprotect mhismor mher minterests.
Which monemofmthemfollowingmstatementsmregardingmthird-
partymadministratorsm(TPAs)mismmost maccurate?
Select mone:
A. TPAsmaremtypicallymusedmbymbusinessesmthat mhavemchosen mnot mtomself-insure.
B. TPAsmhandlemclaims,mkeepmclaimsmrecords,mandmperform mstatistical manalyses.
C. TPAsmaremgenerallymfoundmin man minsurer'smclaimsmdepartment.
D. TPAsmarememployedmonlymbymindependentmadjustingmfirms.mCORRECTmANSWER:
mB.mTPAsmhandle mclaims,mkeepmclaimsmrecords,mandmperform mstatistical manalyses.
Hugomismconductingman mauditmofmambranchmofficemclaimsmoperation.mHemismevaluating
mtimeliness mofmreports,mnumbermofmfilesmopened,mproper mreleases mtaken,mandmaccurac
ymofmdatamentry.mWhich monemofmHugo'smmetricsmismamqualitative maudit mfactor?
Select mone:
A. Proper mreleasesmtaken
B. Timelinessmofmreports
C. Number mofmfilesmopened
D. AccuracymofmdatamentrymCORRECTmANSWER:mA.mProper mreleasesmtaken
, Proper mreleasesmtaken mismamqualitative maudit mfactor;mthemothersmaremquantitative.
Aaron mworksmformammulti-
lineminsurer.mHemworksmwithminsurancemproducersmandmapplicantsmtomevaluatemnewmbusi
nessmsubmissionsmandmconduct mrenewal munderwriting.mAaron mismamSelect mone:
A. Staffmunderwriter.
B. Publicmunderwriter.
C. Personal mlinesmunderwriter.
D. Linemunderwriter.mCORRECTmANSWER:mD.mLinemunderwriter.
Linemunderwriter.mThismdescribesmthemdutiesmofmamlinemunderwriter,mrather mthan mamstaffm
underwriter.mTheremismnotmenough minformation mtomdeterminemwhich mlinemofmbusinessmism
beingmwritten.mAmpublicmunderwriter mdoesmnot mexist.mLinemunderwritersmevaluatemnewms
ubmissionsmandmperformmrenewal munderwriting,musuallymbymworkingmdirectlymwithminsur
ancemproducersmandmapplicants.mStaffmunderwriters,mmeanwhile,mmanagemrisk mselectionm
bymworkingmwithmlinemunderwritersmandmcoordinatingmdecisionsmaboutmproducts,mpricing
mandmguidelines.
Themfirst mkeymtomcommunicatingmempatheticallymasmamclaimsmprofessionalmis
mSelect mone:
A. Amcomprehensive munderstandingmofmrelevant minsurancempolicies.
B. Speakingmcalmlymandmclearly.
C. Beingmpreparedmwith mallmdocumentation mrelatingmtomthemclaim.
D. Listening.mCORRECTmANSWER:mD.mListening.
Claimsmprofessionalsmshouldmfirst mlistenmcarefullymtomunderstandmwhat mthemclaimantmisms
aying.
Miamtracksmlossmadjustment mexpensem(LAE)masmpart mofmher mmanagementmofmthemclaimsmd
epartment mforman minsurer.mMiamconsidersmLAEmtombemthe
Select mone:
A. Total mamount mofmlossmreservesmofmallmclaims.
B. Paidmportion mofmclaims.
C. Cost mtominvestigate,mdefend,mandmsettlemclaims.
D. Total mincurredmamount mofmclaims.mCORRECTmANSWER:mC.mCost mtominvestig
ate,mdefend,mandmsettlemclaims.
Cost mtominvestigate,mdefend,mandmsettlemclaims.mLAEmismthemexpensemthat manminsurer minc
ursmtominvestigate,mdefend,mandmsettlemclaimsmaccordingmtomthemtermsmspecifiedmin mthemin
surancempolicy.
In mher mrolemwith manminsurer,mKatarinamhasmopportunitymtomcollaboratemwithmnot monlymem
ployeesmfrom mher mcompany,mbutmalsomexternal mexpertsmwith mparticular mexpertise.mFor mex
ample,masmpart mofmher minvestigation,mshemhiredmanmengineer mtomconductmamreviewmofmamm
achinemthat mwasminvolvedmin mampersonal minjury.mKatarinamisma(n)
Select mone: