Preview Questions Claims Adjuster | Role Specific Skill

Question 1: When conducting a claims investigation in BFSI, what is the first step in determining fraud?

Which action should you take?

Choose only one option

Automatically approving low-risk claims

Analyzing the claimant's history with other insurers

Contacting the claimant immediately to verify the incident

Reviewing all documentation for inconsistencies and discrepancies

Question 2: How do you perform an "Accident Reconstruction," and how does this help in evaluating liability in insurance claims?

Which action should you take?

Choose only one option

Accident reconstruction can be substituted by accepting the claimant's version of events

Accident reconstruction involves reviewing all available evidence (e.g., vehicle damage, eyewitness testimony, and traffic data) to reconstruct the accident scenario

Accident reconstruction only applies to personal injury claims, not property damage

Accident reconstruction is irrelevant and should be avoided

Question 3: When documenting a claim that involves legal action, what information is critical to include in the report?

Which action should you take?

Choose only one option

The claimant's financial history

Only the claimant's contact information

The legal actions taken, involved parties, and any court rulings or legal advice

A summary of any personal details shared during the claim

Question 4: When dealing with complex claims involving multiple policies, how should the report address coverage?

Which action should you take?

Choose only one option

Focus on the primary policy and omit secondary policies

Provide a summary of all policy terms, regardless of relevance

Include only the policy held by the claimant

Reference all applicable policies and explain their relevance to the claim

Question 5: In claims documentation, what is the primary purpose of including "Photographic Evidence"?

Which action should you take?

Choose only one option

To replace the need for written descriptions

To provide visual proof of the damage or loss

To comply with legal requirements for all claims

To enhance the aesthetic appeal of the report

Question 6: When assessing the risk of a claim involving product liability, what is the most critical factor to consider?

Which action should you take?

Choose only one option

The design, manufacturing, and quality control processes for the product involved

The total value of the claim

The claimant's previous product-related claims

The financial situation of the claimant