Preview Questions Claims Adjuster | Role Specific Skill

Question 1: What is the purpose of the "appraisal clause" in an insurance policy?

Which action should you take?

Choose only one option

Specifies the conditions under which premiums can be increased

Determines the policyholder's eligibility for coverage

Resolves disputes over the value of a claim

Outlines the renewal terms for the policy

Question 2: When assessing the risk of a claim related to cyber incidents, what is the most important factor to evaluate?

Which action should you take?

Choose only one option

The claimant's historical relationship with technology vendors

The claimant's insurance policy limits without regard to the specifics of the cyber incident

The nature and scope of the data breach or cyber attack and its potential legal consequences

The size of the business involved, regardless of the actual incident

Question 3: What is the role of third-party experts (e.g., contractors, forensic investigators) in assessing risk for claims?

Which action should you take?

Choose only one option

They are unnecessary and should be avoided

Their assessments should be disregarded unless the insured requests it

They provide valuable expertise to assess risk, validate claims, and support investigations

They should be used sparingly and only for high-value claims

Question 4: How do you handle "Multiple Parties" involved in a claim in your report writing, especially when different parties provide conflicting information?

Which action should you take?

Choose only one option

Multiple parties should be cited equally, without addressing conflicting information

Conflicting statements should be removed to simplify the report

Only the claimant's statement should be considered, and conflicting statements should be ignored

The report should include all parties' statements, clarify the discrepancies, and explain how each piece of information impacts the outcome

Question 5: How do you assess "Claimant Liability" in cases where there is ambiguity about the claimant's fault, and what legal principles guide this decision?

Which action should you take?

Choose only one option

I consult the claimant's attorney to determine liability

I review the claimant's actions, relevant law (e.g., negligence), and policy terms to assess liability

I disregard legal principles and rely on intuition to make decisions

I automatically assume the claimant is liable, based on available documents

Question 6: What is the significance of "Subrogation" in claim investigation, and how do you identify subrogation opportunities in complex cases?

Which action should you take?

Choose only one option

Subrogation is the process of recovering damages from a third party responsible for the loss, and opportunities are identified by investigating liability and causality

Subrogation applies only to bodily injury claims, not property damage claims

Subrogation is irrelevant and should not be pursued for any claims

Subrogation only applies when a claim exceeds a certain threshold