Walking Through the Claims Department
(Objective 1)
(Objective 1)
_______ ________ is important because it is needed for all departments to work together for efficient claims process.
What is Interdepartmental Cooperation?
What is the final step of the Handling Claim Process?
What is Concluding the Claim?
_______ allows the insurer to take possession of the insured property for which it has paid a total loss.
What is Salvage Rights?
If coverage applies, insurers often prefer to settle Liability Claims outside of court due to these three points...
What is the time, expense, and uncertainty involved in a lawsuit?
A request by a person or business seeking compensation from an insurer for a loss that may be covered by an insurance policy is...
What is Claim?
What are three types of Claims Representatives?
What is...
- telephone representatives?
- Feild representatives?
- specialized representatives?
The Claims Handling Process is sometimes referred to _______ and could vary between different organizations.
What is Loss Adjusting?
Agreed Value Method is used for...
What is to insure property that is difficult to value, such as fine arts, antiques, and collections?
There are two main types of damages awarded in a liability suit... these are?
What is Compensatory and Punitive Damanges?
What is the definition of Actual Cash Value (ACV)?
What is the cost to replace property with new property of like kind and quality less depreciation?
Starting from the top, working down, what is the Claims Department Hierarchy?
What is Claims Manager(s)/Vice President(s), Claims Supervisor(s), and Claims Representatives?
Once a claims representative has received the claim file, the rep searches the organizations database for the corresponding policy... What step is this in the Handling Claim Process?
What is step 2, Identifying the Policy?
What are the three methods that can be used to determine the value of the property that was damaged?
What is...
- Actual Cash Value?
- Replacement Cost Basis?
- Agrees Value Method?
Courts issue this other main type of damage call _______, to punish defendants for reckless, malicious, or deceitful acts. ________ help deter others from following their example.
What is Punitive Damages?
The process by which an insurer can, after it has paid a loss under the policy, recover the amount paid from any party (other than the insured) who caused the loss or is otherwise legally liable for the loss.
What is Subrogation?
Two-part question: Claims Process
Claims personnel help ______ by ensuring that claims are paid fairly and according to the policy.
The Claims Department provides the ________ with information about customer satisfaction, timeliness of settlements, and other variables that help market insurance products.
What is...
1) Underwriting Department?
2) Marketing Department?
What are the 6 Steps in the Claims Handling Process?
What is...
1) Acknowledging a Claim?
2) Identifying the Policy?
3) Contacting the Insured?
4) Investigating and Documenting the Claim?
5) Determining Cause of Loss and Loss Amount?
6) Concluding the Claim?
What are 4 questions when processing a Property Claim Process?
What is...
1) Insured have an insurable interest in the property?
2) The damaged property is covered by the policy?
3) Is the cause of loss covered by the policy?
4) Any additional coverages/endorsements/limitations apply?
Compensatory Damages are awarded to reimburse a victim for harm experienced, what are the two types of Compensatory Damages?
What is General Damages and Special Damages?
Insurable interest is?
What is an interest in the subject of an insurance policy that is not unduly remote and that would cause the interested party to suffer financial loss if an insured event occurred?
Premium Auditing helps other departments with the claims process by... (two answers)
What is...
- Claims information can benefit an auditor by verifying employment classifications?
- Premium auditors can provide inventory levels, contractors, equipment lists and/or other information that are important to the claims function?
Name 5 Supporting Documents that help with investigation and documenting a claim. (There is a total of 9).
What is...
Police Reports, Auto Reports, Medical Records, Credit Reports, Motor Vehicle Reports, Photos, Videos, Voice Recordings, Corresponding Reports/Inspections conducted by the insurer?
How do you calculate the Actual Cash Value? Explain the steps.
Example: Bill's three-year-old stereo was completely destroyed in a covered loss. Its expected useful life was ten years. Its Replacement Cost is $600. Its Actual Cash Value (ACV) is?
What is...?
1) # years old / total lifespan years = % of depreciation
2) total replacement value X % of depreciation = cash value reduction amount
3) total replacement value - cash value reduction amount = Actual Cash Value
Example:
1) 3 / 10 = 30%
2) $600 X 30% = $180
3) $600 - $180 = $420 is the Actual Cash Value?
What are the four key differences between the Property Claim Process and the Liability Claim Process from a Liability view?
What is...
1) If coverage applies to liability claim, is the insured responsible for the loss?
2) Determining legal responsibility for liability claims has complex investigations?
3) Insurers often settle outside of court?
4) Before a settlement attempt, insurers must have an idea of what damages are/could be?
________ ________ is a monetary award to compensate a victim for losses such as pain and suffering that is not measurable expense. While ________ ________ is compensatory damages that award money for specific, identifiable expenses associated with the injured person's loss, such as medical expenses.
What is General Damages and Special Damages?