Claim Process 2020

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Question 1 of 7

1. Question
What is a loss reserves account?
- An account that holds deductibles collected from losses throughout each month
- An account that holds deductibles collected from losses throughout the year
- An account that holds the estimated amount that will be needed to pay a specific claim once it is settled
- An account that holds premiums that each insured has paid in the past year
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Question 2 of 7

2. Question
What does an insurer need to do if they decide to deny a claim?
- Provide resources to help the insured pay for the loss themselves
- Call the insured to inform them of the denial and explain the reason for the denial
- Provide a premium deduction for future months
- Provide a reason for the denial in writing
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Question 3 of 7

3. Question
Which of the following is false regarding claim settlement payment options?
- Federal law prohibits an insurer from paying any money to a claimant before the claim has been officially settled.
- With a full release option, an immediate payment is made to the claimant when the claimant signs a release to relinquish his or her rights to pursue further litigation.
- With a structured settlement, the settlement is paid out in installments over a period of time—instead of one lump sum.
- If a claimant receives an immediate payment, but may also receive additional payments depending on future medical bills, this is called a scheduled payment release.
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Question 4 of 7

4. Question
What is it called if a dispute must be decided in court because it has not been able to be settled outside of court?
- Mediation
- Arbitration
- Appraisal
- Litigation
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Question 5 of 7

5. Question
What is the difference between arbitration and appraisal?
- Appraisal is used for property claims and arbitration is used to settle liability claims.
- Arbitration is similar to appraisal, but it is only used to settle uninsured motorist coverage disputes.
- Arbitration includes an umpire, arbitration only has appraisers.
- Appraisal includes two appraisers and arbitration only includes one appraiser.
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Question 6 of 7

6. Question
Assistance by a third party to help settle an insurance claim dispute is called
- Arbitration
- Litigation
- Mediation
- Appraisal
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Question 7 of 7

7. Question
If there is a delay in settling a claim, the insurer must provide the claimant with
- a check for 10% of the estimated claim amount.
- a reason for the delay.
- a refund of the current month's premium.
- a check for 20% of the estimated claim amount.
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Claim Process 2020

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