Preview Questions Claims Adjuster | Role Specific Skill

Question 1: How do you apply "Legal Precedents" in claims decisions, especially in complex cases where past court rulings might influence the outcome?

Which action should you take?

Choose only one option

I follow the claimant's advice on legal matters without considering precedents

I rely only on the policy terms and ignore past court rulings

I assume all claims are subject to current law, disregarding past rulings

I review relevant case law and precedents, ensuring that my decision aligns with previous rulings to avoid legal challenges

Question 2: What is the significance of electronic evidence (e.g., phone records, GPS data) in a claim investigation?

Which action should you take?

Choose only one option

It is only useful in fraud cases and not in genuine claims

It is highly relevant and can provide critical insights into the claim's validity

It is not reliable compared to traditional evidence like witness statements

It can be disregarded if it doesn't align with the claimant's statement

Question 3: 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 4: What is the primary purpose of a Claims Adjuster's documentation during a claim investigation in BFSI?

Which action should you take?

Choose only one option

To meet only the minimum reporting standards required by the company

To minimize the amount of work required for claim resolution

To satisfy customer inquiries without needing external validation

To ensure legal compliance and provide a detailed record of findings

Question 5: What are the key considerations when "Organizing Claim Files" for easy retrieval, especially when dealing with complex claims that involve multiple claimants or incidents?

Which action should you take?

Choose only one option

I rely on paper documentation only, without using digital filing methods

I create a structured filing system with clearly labeled categories, and use digital tools for quick searches and cross-referencing

I use a simple file-naming system without considering future searchability

I organize claim files in chronological order with minimal categorization

Question 6: What is the best method to assess risk for a claim involving bodily injury in a personal injury insurance case?

Which action should you take?

Choose only one option

Dismiss the injury if it doesn't meet a specific threshold of severity

Focus only on the claimant's medical records

Rely on the initial medical diagnosis without further investigation

Evaluate the severity of the injury and potential long-term impacts, including medical costs and loss of income