Preview Questions Claims Adjuster | Role Specific Skill

Question 1: How do you address "Missing Documentation" in the claims process, and what is your protocol for requesting additional information from the claimant?

Which action should you take?

Choose only one option

I assume the missing documents will be submitted at a later stage

I proceed with the claim using the documents available and disregard missing items

I close the claim immediately without further action

I send a clear request for missing documents, providing a list of required items and setting deadlines for submission

Question 2: How should discrepancies in claimant-provided documentation be handled in the final report?

Which action should you take?

Choose only one option

Note them but do not include supporting evidence

Focus only on financial discrepancies, disregarding others

Highlight and provide evidence for discrepancies, including efforts to resolve them

Ignore minor discrepancies to expedite claim resolution

Question 3: What is the most important element in ensuring the thoroughness and accuracy of a claim investigation?

Which action should you take?

Choose only one option

Collecting a wide range of evidence, including witness accounts, expert opinions, and physical evidence

Using a checklist to speed up the investigation process

Relying solely on the claimant's statement and documents

Focusing only on the highest value items in the claim

Question 4: What is the appropriate action when reviewing a claim and discovering that critical documentation was intentionally omitted?

Which action should you take?

Choose only one option

Proceed with assumptions based on available information

Reject the claim based on the omission without contacting the claimant

Move forward with the claim and ignore the omission

Contact the claimant and request the missing documentation for proper processing

Question 5: Which of the following best describes the use of "Flowcharts" in claims report writing?

Which action should you take?

Choose only one option

To provide a detailed narrative of the claim's background

To summarize the claimant's personal information

To list all the financial transactions related to the claim

To visually map out the claims process and identify key steps and decision points

Question 6: What is the most critical aspect of documenting a claim in a case of suspected fraud?

Which action should you take?

Choose only one option

Only document the claimant's perspective on the matter

Focus on gathering all facts and evidence that suggest fraud, and report inconsistencies

Rely on the claimant's version of events unless proven otherwise

Document all findings quickly without analysis