Preview Questions Claims Adjuster | Role Specific Skill

Question 1: A client refuses to accept your explanation of policy coverage. What is your next step?

Which action should you take?

Choose only one option

Involve a supervisor

Clarify using examples

Repeat the explanation

Offer a partial settlement

Question 2: How can you effectively use data and analytics in the negotiation process?

Which action should you take?

Choose only one option

By ignoring data and focusing on subjective judgment

By using data to manipulate the claimant into agreeing to a low offer

By using statistical models to justify your offers

By using data only when it supports your final settlement offer

Question 3: How do you handle "Complex Claims" involving multiple parties or jurisdictions, and what is the process for coordinating between them?

Which action should you take?

Choose only one option

Complex claims involve coordinating with various parties, gathering jurisdiction-specific information, and seeking expert opinions to resolve the claim fairly

Complex claims should be simplified by only considering one jurisdiction

Complex claims are handled by a separate department, not the claims adjuster

Complex claims should be rejected to avoid complications

Question 4: 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 5: Which tool is most effective for ensuring accuracy in documentation of claim-related financial data?

Which action should you take?

Choose only one option

The claimant's self-reported financial information

A paper-based ledger maintained during the claim process

Manual spreadsheets maintained by the adjuster

Automated claims management software with audit trail capabilities

Question 6: How do you ensure that your "Conclusion" in a claims report is objective, well-supported by evidence, and legally sound?

Which action should you take?

Choose only one option

The conclusion should reflect your personal opinion on the claim

The conclusion can be based on your assumptions about the claimant's intentions

The conclusion can be written without reference to the supporting evidence

The conclusion should be based solely on the facts presented in the report, avoiding personal opinions, and it should align with policy terms and applicable laws