Preview Questions Claims Adjuster | Role Specific Skill

Question 1: Which factor is most likely to affect the severity of a claim investigation outcome?

Which action should you take?

Choose only one option

The quality of evidence and documentation provided

The emotional state of the claimant during the interview

The insurer's historical relationship with the claimant

The number of claims filed by the insured

Question 2: How should a Claims Adjuster assess the authenticity of evidence submitted by a claimant?

Which action should you take?

Choose only one option

Checking only for formatting issues in the submitted evidence

Cross-referencing submitted documents with external databases for verification

Relying on the claimant's statement without needing supporting evidence

Accepting documents without further verification

Question 3: In what way can you balance policy guidelines and claimant demands during negotiation?

Which action should you take?

Choose only one option

Prioritize the claimant's demands over policy guidelines

Ignore the claimant's demands and enforce policy guidelines

Find creative solutions that align with policy guidelines while addressing claimant concerns

Rigidly follow policy guidelines without considering the claimant's needs

Question 4: How do you handle a situation where the claimant is represented by legal counsel and disputes the terms of the settlement offer?

Which action should you take?

Choose only one option

I work with legal counsel to clarify terms, resolve discrepancies, and negotiate an agreeable settlement while respecting legal boundaries

I agree to the claimant's legal demands without challenging them

I avoid negotiations with legal counsel and escalate the case to senior management

I refuse to engage with legal counsel and proceed with the initial offer

Question 5: What is the significance of "Statute of Limitations" in claims, and how do you assess whether a claim is time-barred based on this statute?

Which action should you take?

Choose only one option

I ignore the statute of limitations if the claim is substantial

I ensure claims are filed within the statute of limitations and review the date of the incident and the applicable laws

I dismiss claims only if they are several years past the statute of limitations

I assume the claim is valid if the claimant submits it, regardless of timing

Question 6: When conducting a site inspection for a claim, what is the first thing to look for?

Which action should you take?

Choose only one option

Immediately start repairing the damages

Confirm that the damage matches the claimant's description

Take photographs and document all visible damages or discrepancies

Speak to the claimant to understand their point of view