Claim Function
Actuarial Operations
Reinsurance Principles and Concepts
Business Needs and IT Alignment
Insurer Strategic Managment
100
A review of claim files to examine the technical details of claim settlements, ensure that claim procedures are followed, and verify that appropriate documentation is included.
What is claim audit?
100
The ratemaking method that uses loss per exposure based on past experience.
What is the Pure Premium Ratemaking Method?
100
Colleen’s favorite “key term” from this assignment.
What is retrocessionaire?
100
One organization that has established standards for data quality.
What are ISO, CAS, or IDMA?
100
A broad expression of an entity’s purpose or goals that reflects the entity’s character and spirit.
What is mission statement?
200
An insurer’s letter that specifies coverage issues and informs the insured that the insurer is handling a claim with the understanding that the insurer may later deny coverage should the facts warrant it.
What is a Reservation of Rights letter?
200
Two of the ideal characteristics of rates.
What is Stable, Responsive, Provide for Contingencies, Promote Risk Control, Reflect differences in risk exposure
200
Two of the functions of facultative reinsurance.
What is large line capacity, reduce exposure in a geographic area, insure a loss exposure with atypical hazard characteristics, insure classes excluded under treaty reinsurance.
200
Which insurer personnel help to bridge the communication gap between an insurer’s business strategy and information technology?
What is business analyst?
200
Two methods to analyze the environment in which an insurer operates.
What are Five Forces and SWOT?
300
The two primary goals of the claim function.
What is Satisfy the insurer’s obligations to the insured as set forth in the policy, and provide fair, prompt, and equitable service to the insured.
300
The number of years of loss experience that most states require insurers to use for fire insurance ratemaking purposes.
What is 5 years?
300
Three sources of reinsurance.
What are professional reinsurers, reinsurance departments of primary insurers, and reinsurance pools, syndicates and associations?
300
These store knowledge and make inferences designed to emulate human decision making.
What are expert systems?
300
Three generic corporate-level strategies for companies in a growth mode.
What are single business, vertical integration, and diversification?
400
Claim personnel who are often associated with large independent adjusting firms or with subsidiaries of insurance companies.
Who are Third-Party Administrators?
400
The three components of an insurance rate.
What is amount needed to pay future claims and LAE, amount needed to pay future expenses, amount for profit and contingencies
400
Under this type of reinsurance agreement, the reinsurer responds to a loss only when the loss exceeds the primary insurer’s retention, or attachment point.
What is Excess of Loss?
400
Three data security risks.
What are destruction of data, espionage, invasion of privacy, social networks, employee fraud, human error, cloud computing, or mobile devices.
400
hree key areas an insurer should evaluate in strategic decisions about global markets.
What is Market analysis, Economy, Political Risks
500
A monetary award to compensate a victim for losses that do not involve specific measurable expenses, such ans pain and suffering.
What are general damages?
500
Two sources of delays in reflecting loss experience in rates.
What is elays by insureds in reporting losses, time required to analyze data and prepare a rate filing, delays in rate filing approval, time required to implement new rates, time period during which rates are in effect
500
The type of reinsurance generally chosen by newly incorporated insurers with limited capital.
What is pro rata?
500
Two of the key advantages of IT to an insurer.
What is Gaining competitive advantage, optimizing operations/resources, providing information to support strategy and decision making, facilitating governance, risk and compliance initiatives
500
Two approaches to global expansion.
What is Joint venture, Merger, Wholly Owned subsidiary