Download CPCU 520 Exam Questions and Answers (Solved Papers) and more Exams Nursing in PDF only on Docsity!
(Solved Papers)
With an increasingly price-conscious public forcing less room to slash prices, how can insurers develop ways to maintain competitive advantage? Explain the meaning of this term - Correct Answers ✅dive deeper into value chain interconnected activities in a business through which a product or service is produced and sold, often used to understand and improve upon the internal dynamics of a business's operations. three types of risk control services
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Who might analyze public loss data to assess risk, generate models for potential catastrophic events, enabling use of chatbots, using text mining? A business-level strategy through which a company seeks cost efficiencies in all operational areas. - Correct Answers ✅physical surveys, performing risk analysis/improvement, developing safety management programs IT cost leadership
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which entity coordinates insurance regulation activities among state insurance departments and developed uniform financial statements required in all its states? In what way is federal regulation involved with insurance? - Correct Answers ✅balance insurers' ability to earn profits with consumers' rights to access reasonably priced coverage. Regulation also ensures that after insurers issue coverage, they maintain the financial stability to pay for losses they promised to cover in their insurance policies. state insurance departments
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NAIC
protect consumers in policy documentation, maintain solvency, prevent destructive competition regulations that may be implemented by state insurance dept if model law is passed insolvency is when what occurs?
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Select one: A. Medical services B. Investment services C. Risk management products and services D. Legal counsel As a claims representative for Taunton Insurance, Maria often consults with the underwriter. Which one of the following is a key point that a claims representative would ask the underwriter to clarify? Select one: A. Was adequate premium collected for the claim? B. What are the insured's safety and training policies? C. What was the actual agreement for coverage? D. What are the codes and standards for this industry? - Correct Answers ✅C. Risk management products and services
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C. What was the actual agreement for coverage? Which one of the following would be considered a duty of the state insurance commissioner, rather than an activity performed by the state insurance department? Select one: A. Holding hearings on insurance issues B. Rehabilitating or liquidating insolvent insurers C. Issuing cease-and-desist orders D. Investigating policyholder complaints
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organization providing administrative services associated with risk financing and insurance outside organization to represent insured in claim for a fee handle field work when specialized skillset needed or staff is overloaded - Correct Answers ✅Social inflation and nuclear verdicts (awarded more $$ than anticipated) third party administrators (TPAs)
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public adjusters Independent adjusters T/F: Because producers often have a relationship with insureds, some insureds call their producer first when a loss occurs. Insurers sometimes even allow producers to pay smaller claims up to a certain amount, which reduces their waiting time When an insurer's loss ratio increases, the Claims Department, along with other insurer functions, is pressured to reduce expenses. How could claims representatives could quickly reduce LAE in the short and long term? - Correct Answers ✅true
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devices gather data transmit automatically/wirelessly to central hub. Claims folks learn from these and communicate results - Correct Answers ✅Best practices: internal usage to produce superior performance Claim audits- quantitative and qualitative factors needed Customer satisfaction- acknowledge compliments, respond to complains in timely manner Internet of Things (IoT) -- Data itself and what it can tell us help as well as external sources scraping web -- IoT sensors can also provide data about human behaviors and much more. Businesses can use this data for risk assessment, risk control, and claims investigation. What can telematics do? - Correct Answers ✅When attached to a vehicle, telematics devices can track location, braking, acceleration, speed, cornering, lane shifting, turns, time of day the vehicle is driven, and much more. The devices then transmit that
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information to the insurer to be analyzed. More efficient collection of info done faster and paid properly Describe the claims process IF coverage may not be available for loss, this letter specifies coverage issues and informs insured that insurer is handling a claim with the understanding that insurer may later deny coverage should facts warrant it. Must make a TIMELY denial there is also another form that could be sent indicating signed agreement indicating during course of investigation, either insurer or insured waives rights under the policy. it's called.... - Correct Answers ✅acknowledge claim/assign to representative, identify policy to ensure it applies to claim coverage, contact insured or rep to gather info, investigate and document claim, determine cause of loss and loss amount, negotiate and conclude claim
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Diary/suspense- system to remind claims personnel to perform particular task on claim Activity logs- record of all activities and analyses that occur while handling claim File reports trained third party can identify issues parties couldn't see on their own. An alternative dispute resolution (ADR) method by which disputing parties use a neutral outside party to examine the issues and develop a mutually agreeable settlement. An alternative dispute resolution (ADR) method by which disputing parties use a neutral outside party to examine the issues and develop a settlement, which can be final and binding.
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A method of resolving disputes between insurers and insureds over the amount owed on a covered loss. - Correct Answers ✅mediation Arbitration Appraisals An alternative dispute resolution method by which a case undergoes an abbreviated version of a trial before a panel or an adviser who poses questions and offers opinions on the outcome of a trial, based on the evidence presented.
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B. Misinterpreted C. Subpoenaed. D. Edited later. 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. Timeliness of reports B. Proper releases taken C. Number of files opened D. Accuracy of data entry Which one of the following statements regarding third-party administrators (TPAs) is most accurate? A. TPAs are typically used by businesses that have chosen not to self-insure. B. TPAs are employed only by independent adjusting firms.
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C. TPAs are generally found in an insurer's claims department. D. TPAs handle claims, keep claims recor - Correct Answers ✅C. Subpoenaed. B. Proper releases taken
