Preview Questions Claims Adjuster | Role Specific Skill

Question 1: In the BFSI sector, how should an adjuster report an investigation's findings when there are concerns about fraud in the claim?

Which action should you take?

Choose only one option

Document evidence of fraudulent activity, report to the relevant authorities, and suspend further payouts

Continue with processing, and ask for additional documentation

Skip the reporting process if it's too time-consuming

Report to management without attaching evidence, assuming good faith

Question 2: Which section of a claims report should outline the conclusions drawn from the investigation and provide actionable recommendations?

Which action should you take?

Choose only one option

Introduction

Conclusion

Findings

Methodology

Question 3: How should you handle discrepancies between the claimant's report and the supporting documentation?

Which action should you take?

Choose only one option

Ignore the discrepancy and proceed

Automatically reject the claim

Investigate the issue by requesting clarification or additional documentation from the claimant

Provide a settlement based on the claimant's initial report

Question 4: What is the primary goal of active listening during claims negotiation?

Which action should you take?

Choose only one option

To quickly conclude the conversation without considering details

To understand the claimant's perspective and address concerns effectively

To identify weaknesses in the claimant's arguments

To agree with the claimant to avoid conflict

Question 5: Under the General Data Protection Regulation (GDPR), what is a key requirement for handling claimant personal data in the EU?

Which action should you take?

Choose only one option

Collecting only non-identifiable information

Sharing data freely with third parties

Storing data indefinitely

Obtaining explicit consent for data processing

Question 6: During negotiation, what is the key to managing a claimant's perception of fairness?

Which action should you take?

Choose only one option

Offering a higher settlement to improve satisfaction

Allowing the claimant to independently interpret the policy

Transparency in the process and consistency in applying policy guidelines

Avoiding detailed explanations to minimize conflicts