Preview Questions Claims Adjuster | Role Specific Skill

Question 1: How do you ensure that all required documentation is received before proceeding with a claim investigation?

Which action should you take?

Choose only one option

Rely on the claimant's verbal confirmation

Wait until the claimant initiates further contact

Automatically close the claim if documentation is not received

Communicate the required documents clearly to the claimant and follow up if necessary

Question 2: In "Third-Party Liability" cases, what legal principles must be applied to determine whether the third party is responsible for the loss?

Which action should you take?

Choose only one option

Third-party liability does not need to be verified; the claimant is responsible

Third-party liability is assessed based on negligence, breach of contract, and policy terms that define liability

Third-party liability is assumed when the third party is uninsured

Third-party liability only applies when the claimant is not at fault

Question 3: When preparing a claims report for a denied claim, what is the most critical element to include?

Which action should you take?

Choose only one option

A general explanation without policy references

The claimant's history of claims, even if unrelated

An apology letter to the claimant with no reference to evidence

Clear evidence and references to policy terms and exclusions

Question 4: How do you ensure the completeness of a claim report?

Which action should you take?

Choose only one option

By documenting all communications with the claimant

By relying on verbal statements rather than written records

By avoiding the use of legal terminology

By including only key findings and omitting irrelevant details

Question 5: In what scenario would you apply the principle of "subrogation" in a claim investigation?

Which action should you take?

Choose only one option

When the damages exceed the coverage limits of the policy

When another party is responsible for the damage but the insurer has already paid the claim

When the insured is partially at fault for the damage

When the claimant provides false information during the investigation

Question 6: When handling a claim, how would you identify exclusions in a standard commercial property policy?

Which action should you take?

Choose only one option

Review the entire policy manually

Refer to state regulations

Check the exclusions section specifically

Consult with legal experts