B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not
accepted. -
... [Show More] ANSWER-Insurers usually send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
D. Subpoenaed.
Any written claims communication may be subpoenaed. - ANSWER-As methods
of communication evolve, it's important for claims professionals to remember that
any written claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
D. An insured's negotiations with the insurer on a complex claim are not going
well.
If a claim is complex, or if settlement negotiations are not progressing with the
insurer, the insured may hire a public adjuster to protect his or her interests. -
ANSWER-In which one of the following scenarios is a public adjuster most likely
to become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own claims staff in a given
state.
B. An insured is unable to afford legal representation to contest a claim.
C. A catastrophic disaster strikes, involving damage to many properties.
D. An insured's negotiations with the insurer on a complex claim are not going
well.
B. TPAs handle claims, keep claims records, and perform statistical analyses. -
ANSWER-Which one of the following statements regarding third-party
administrators (TPAs) is most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen not to self-insure.
B. TPAs handle claims, keep claims records, and perform statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms.
A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are quantitative. -
ANSWER-Hugo is conducting an audit of a branch office claims operation. He is
evaluating timeliness of reports, number of files opened, proper releases taken,
and accuracy of data entry. Which one of Hugo's metrics is a qualitative audit
factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter [Show Less]