Preview Questions Claims Adjuster | Role Specific Skill

Question 1: In BFSI, what is a key consideration for structuring documentation for regulatory audits of claims?

Which action should you take?

Choose only one option

Claims below a monetary threshold do not need to be documented for regulatory purposes

Only high-value claims should be documented comprehensively

Documentation must be consistent, detailed, and adhere to industry-specific standards

Documentation should prioritize speed over completeness

Question 2: What is the significance of "Subrogation" in insurance claims, and how does it affect the claims process?

Which action should you take?

Choose only one option

Subrogation is automatically performed by the claimant

Subrogation applies only to health insurance claims

Subrogation involves the insurer recovering the amount paid from a responsible third party, and it requires thorough investigation to identify liability

Subrogation is irrelevant and should be avoided in all claims

Question 3: In an insurance contract, what does the insurable interest clause require for a claim to be valid?

Which action should you take?

Choose only one option

The claimant must be the primary beneficiary of the policy

The claimant must have owned the insured property

The claimant must be a close family member of the insured

The claimant must suffer financial loss from the insured event

Question 4: What is the most critical factor to evaluate when determining high-risk clients in a health insurance claim?

Which action should you take?

Choose only one option

The duration of the insurance policy

Client's pre-existing conditions, lifestyle habits, and claims history

The client's financial situation and income level

The number of dependents and dependents' health

Question 5: A claimant alleges miscommunication about policy terms. What's your next action?

Which action should you take?

Choose only one option

Review recorded communications

Offer partial settlement

Apologize and close the discussion

Escalate to management

Question 6: Which type of insurance policy is most likely to include a "waiting period" before benefits are payable?

Which action should you take?

Choose only one option

Life insurance

Fire insurance

Auto insurance

Disability insurance