Preview Questions Claims Adjuster | Role Specific Skill

Question 1: When faced with a customer who challenges the terms of a claim settlement, what is the most effective negotiation tactic?

Which action should you take?

Choose only one option

Agree to the customer's terms to resolve the issue quickly

Escalate the case to avoid further conflict without trying to resolve it

Clarify the terms and conditions outlined in the policy and review the claim details together

Offer an immediate compromise without consulting the terms

Question 2: In liability insurance, what does "comparative negligence" refer to?

Which action should you take?

Choose only one option

The insurer's share of the loss

The total amount of damages awarded in a claim

The proportion of fault attributed to the claimant and the defendant in a loss

The policyholder's premium rate

Question 3: What is the role of "Digital Signatures" in claims documentation within the BFSI industry?

Which action should you take?

Choose only one option

To add decorative elements to electronic reports

To track the time when the document was created

To encrypt the contents of the documents

To verify the authenticity and integrity of electronic documents

Question 4: When writing a "Complex Claims Report," how do you ensure that the report remains organized, especially when there are numerous factors to consider?

Which action should you take?

Choose only one option

The report should be kept as short as possible, regardless of complexity

The report should focus only on one aspect of the claim, ignoring others

The report should be divided into clear sections, each addressing a different aspect of the claim (e.g., damages, liability, policy coverage), and each section should have a clear heading

The report should be written in one large block of text to cover all aspects of the claim

Question 5: How do you interpret "Underwriting Guidelines" in relation to claims processing, and what legal implications do these guidelines have in evaluating claims?

Which action should you take?

Choose only one option

I disregard underwriting guidelines if the claimant's situation seems urgent

I rely on general insurance industry standards and ignore company-specific guidelines

I follow underwriting guidelines only for certain claim types, such as health insurance

Underwriting guidelines dictate the scope of coverage, and I review them carefully to ensure the claim aligns with policy terms and legal standards

Question 6: What is the most effective way for a Claims Adjuster to handle a policyholder who consistently offers lowball settlements?

Which action should you take?

Choose only one option

Reject all offers and escalate the claim

Ignore the offers and wait for the policyholder to concede

Accept the first offer to expedite the process

Use counter-offers supported by evidence and remain firm yet flexible