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CPCU 520 Chapter 6 Questions And Answers With Verified Solutions Already Passed!!!
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CPCU 520 Chapter 6 Questions And Answers With Verified Solutions Already Passed!!!
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By: rlawk02 • 2 months ago
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CPCU 520 Chapter 6 Questions AndAnswers With Verified Solutions Already
Passed!!!
What is the primary goal of the claims function - ANSWER✔✔ complying with the
contractual promise to pay losses that are covered by the policy and supporting
the insurer's financial goals
What is the difference between a 1st party claim and a 3rd party claim? -
ANSWER✔✔ 1st party claims are made by the insured directly against the insurer.
3rd party claims are made indirectly by someone against the insured to whom the
insured might be liable
Describe how claims managers can help maintain an insurer's underwriting profit
- ANSWER✔✔ by managing all claim function expenses, setting appropriate
spending policies, and using appropriately priced providers and services
Describe the marketing department's need for claim information - ANSWER✔✔
information about customer satisfaction and timeliness of settlements assist in
marketing the insurer's product.
What are actions an underwriter might take when a claim rep reports either a
positive or negative loss characteristic found during a claim investigation -
ANSWER✔✔ the underwriter may adjust the premium or take other actions to
accommodate the difference in the exposure in response to loss exposure
characteristics found during the investigation
Describe the result for actuaries when claim payments are recorded accurately
and realistic reserves are set. - ANSWER✔✔ the raw data that actuaries use to
, develop rates will be accurate and the rates will reflect the insurer's loss
experience.
what are 3 circumstances where claims reps interact with state insurance
regulators - ANSWER✔✔ when regulators license claim reps, investigate
consumer complaints, and perform market conduct investigations.
third party claims administrators - ANSWER✔✔ TPA's handle claims, keep claims
records, and perform statistical analyses. They are often associated with large
independent adjusting firms or with subsidiaries of insurance companies
what are the two types of performance measures used to evaluate a claims
department's performance - ANSWER✔✔ profitability measures and quality
measures
identify 3 purposes of claims guidelines - ANSWER✔✔ training new claims
personnel, a reference for when one employee must perform another employees
duties, and they are useful when an insurer must defend a bad-faith lawsuit.
describe 3 uses of an activity log in a claim file - ANSWER✔✔ helping the claims
rep later recall the activities, enabling a team approach to claim handling so
others will know what occurred on a claim, and informing a claims auditor about
what occurred on a claim
describe 3 methods of access security used as a compliance measure -
ANSWER✔✔ using a password, restricting access to certain data in the claims
information system to managers only, and preventing unauthorized individuals
from changing crucial information the claims system.
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