AIC-M
Based on the age-to-age development factors in the table below, which one of the following represents the factor that would be used to develop losses that are 12 months from maturity? Assume that the analyst would use the average factors. AccidentMonths of DevelopmentYear12-2424-3636-Final11.1001.0910.95821.1671.048 31.143 4- Average1.1371.0700.958
0.958
According to a study by the Center for American Progress, replacing an employee can cost an organization what percentage of that employee's annual salary?
20%
Gulford Insurance Company (Gulford) has a written plan outlining its strategy for accomplishing the following objectives: Attracting a new generation of business leaders with relevant skill sets; Providing the necessary training for these new employees; and Creating job opportunities which provide the challenges and rewards needed to retain such new employees. Gulford should make sure that its written plan begins with
A detailed projection of Gulford's future leadership needs.
Which one of the following explains why a divisional structure of an organization is better suited for a more diverse organization?
A divisional structure is better suited for a more diverse organization because it can contribute to an organization's ability to react to external forces more easily.
Joe's Java is a chain of corporate-owned stores that serve only coffee and pastries. Joe's has adopted a no-frills approach to business. In order to keep overhead low, the company often switches suppliers to obtain the lowest prices and it offers few benefits to employees. Joe's slogan is: "Good coffee shouldn't be a luxury." Joe's business-level marking strategy is best defined as
A focused cost leadership strategy.
Linda tells her manager that she does not wish to be promoted, but would like more variety in her duties in her current position. Linda desires
A horizontal career path.
Argot Insurance Company ("Argot") has a business continuity plan that includes sections addressing the following topics: An increase in employee retirement rates; Predicted talent shortages; and Key-executive succession planning. Which one of the following is a justification for addressing the above topics in Argot's business continuity plan?
A lack of strong leadership at crucial times can result in major business interruptions.
Insurer ABC has established a $500,000 reserve and settlement authority limit for its field offices. The local field office typically provides its claim representatives with at least one year of experience authority to $10,000 and a senior representative up to $25,000. Claim supervisors typically have $100,000 in reserve and settlement authority. Which one of the following scenarios would be true based on these facts?
A large fire occurred totaling $120,000 and will need the claim manager's approval to be settled.
Which one of the following best describes a directive management style of leadership and communication?
A manager who makes most decisions and tells others exactly what to do to achieve goals
Which one of the following describes how a product team should function?
A product team should function as a self-sufficient group in which decisions are made collectively.
In a product team structure, members of functional departments report to which one of the following?
A single team manager.
ABC Company uses a balanced score card with four key performance indicators (KPIs) to measure success. Supervisors are required to align performance goals with the KPIs. Which one of the following explains how a supervisor should assign performance goals to an employee, targeting each KPI?
A supervisor would need to review the actual tasks performed by the employee. These tasks can then be sorted into four KPI categories: Financial, Customer, Internal Business Process, and Learning and Growth. From there, specific metrics are developed. Goals should be challenging, yet attainable.
Which one of the following expresses how the mission statement usually differs from a vision statement?
A vision statement focuses on the future, while the mission statement focuses on the present.
Great Fire Insurance Company is considering an option of using predictive analytics in an effort to improve it declining subrogation and reinsurance recovery referral rate. This being one of a number of options, GFCI is weighing the cost and effect of such a venture. Which one of the following is likely true regarding the pursuit of this option?
Acquiring and developing this program would have considerable cost and minimal impact is likely as individual representative claims work is needed to develop recovery.
Process-oriented organizations use process teams to meet process-oriented production goals. An example of a process team is one that
Acts self-sufficiently and makes decisions collectively.
Which one of the following insurer functions includes calculating insurance rates, developing rating plans, estimating loss reserves, and providing predictive modeling services?
Actuarial
Claims department staff typically fall into several different categories of job responsibilities. Which one of the following best describes a claims specialist?
Adjusts most complex, potentially litigated, high-severity, third-party claims, including first-party claims involving high-value physical damage
Claims department staff typically fall into several different categories of job responsibilities. Which one of the following best describes a senior claims representative?
Adjusts potentially litigated high-severity third-party claims, including first-party claims involving physical damage
The process map in the application of process mining to claims handling
Allows the insurer to understand the average length of time for each process instance in the current claims process.
An approach to decision-making that involves a contest of persuasion and defense of positions can best be described as
An advocacy approach.
Jeff Hartwell, CEO of a large manufacturing firm, has called together the firm's top executives to discuss the firm's competitive strategy. Jeff believes that managers from all functions should be included in the process; he welcomes critical thinking and constructive criticism from the group and values minority views so that all managers will have a sense of ownership in the firm's strategy. Which one of the following best describes Jeff's approach to strategic decision-making?
An inquiry approach.
The first step in the strategic management process is strategy formation. Strategy formation usually begins with
Analysis of the organization's internal and external environments.
A 360-degree feedback system employs self-evaluation and peer appraisals delivered through
Anonymous employee surveys.
Gulford Insurance Company (Gulford) insures numerous private homes and commercial buildings in five coastal states. Recently, each of these states was affected by a major hurricane which swept up the coast. Many homes and buildings sustained damage from strong winds, storm surge, and falling trees. Because of the number of claims which it received after the hurricane, Gulford decided to outsource a substantial amount of claim-handling activities. It contracted with a third-party claims handler for the investigation and processing of at least 60 percent of the hurricane claims received from Gulford policyholders. Which one of the following describes an action that the third-party claims handler should be required to take under its contract with Gulford to meet a pre-loss goal of ensuring legality of operations?
Arranging for the licensing of the claims representatives handling the hurricane claims on behalf of Gulford
The management team at Hallbinger Corporation, a commercial printer, decided that it needed to incorporate Internet and other online technology to remain competitive. Realizing that its many long-term employees might be resistant to the change, it formed an empowered project team to align the changes with Hallbinger's vision, mission, and goals. It communicated the vision of the change to the stakeholders and held celebrations as each milestone was accomplished. After it was certain that the changes were fully implemented and incorporated into Hallbinger's culture, management should
Assess the results.
An insurer typically categorizes each new claim it receives into a group according to the claim's expected complexity and severity. The purpose of this grouping is to
Assign claims to the appropriate claim representatives.
Some insurers use predictive modeling software to estimate characteristics of claims as they are received. This helps the organization to
Assign the claim to the appropriate representative.
To ensure that a claims function is operating in a way that supports an organization's overall direction, the claim philosophy must
Be aligned with the corporate mission and strategy.
Much of the work that claim representatives do involves judgment and discretion, so claim representatives must
Be innovative and creative.
Change initiatives should be divided into defined stages to allow the organization to implement and adapt the change incrementally. To motivate the employees, successful implementation of each stage should
Be rewarded with some type of celebration.
The bases of organizational culture are beliefs, values and
Behaviour.
The most loyal employees are those who
Believe in the organization's mission.
Organizations establish techniques that, when implemented effectively, help to achieve their goals more efficiently than by other means. These are commonly known as
Best practices.
Which one of the following statements is correct with respect to bulk (or aggregate) reserves?
Bulk reserves include reserves for claims that have been settled and then reopened.
Which one of the following best describes how an organization that pursues a single business corporate-level marketing strategy can work toward establishing a competitive advantage?
By developing expertise and adaptability to meet consumer needs
Which one of the following statements is true regarding the establishment of loss reserves?
Case reserves are established by the claim department while IBNR reserves are established by actuaries.
Which one of the following elements of the claims function is concerned with ensuring the goals of the claims department are shared by all of the insurer's functional departments?
Claim culture.
The home office of ABC Insurance Company has identified stairstepping of reserves to be a significant issue in its field offices. It has had a negative impact on ABC's loss ratio. This stairstepping of reserves was most likely determined by
Claim settlements being significantly higher than reserves.
Which one of the following elements of the claims function involves the balance between the responsibilities of individual claims representatives and the need for managerial controls?
Claims Structure.
Which one of the following is intended to align decisions on high-value claims more with the organization's mission and strategy and make the organization's claims processes and culture more consistent?
Claims management involvement.
The regional claim managers have prepared a chart of options to compare the cost and effects of each to improve the referral rate and dollars recovered for subrogation and reinsurance for the General Fire Insurance Company. Based on your acquired knowledge, which one of the options will have the lowest cost and provide the highest return?
Claims manager quarterly file reviews
To have a global claims function, a company must first have an effective
Claims processing system.
Which one of the following explains how classification tree analysis can be used to improve the claims handling process?
Classification tree analysis can be used to assign new claims according to target variables.
Insurers define a claims philosophy as part of managing the claims function. Which one of the following components of the claims philosophy ensures the philosophy is not vague and that it is understood by the organization?
Clear message
Claims departments use metrics to assess the performance of the department and individual claims representatives. Which one of the following identifies typical claims representative metrics?
Closing ratio, number of open claims pending, and number of new claims assigned
Which one of the following explains why a data scientist might select cluster analysis to improve the claims handling process?
Cluster analysis is an exploratory technique without predefined variables that can be used when attributes are not known.
Which one of the following is an example of the "we find you" approach to soliciting candidates for employment?
Collaborating with an executive search firm
To gain a better understanding of what is involved in the investigation and resolution of different types of claims, the insurer will need to
Combine process mining with data analysis techniques.
Claims representatives must be customer-focused, which includes being sensitive to customer expectations. This is especially important when
Communicating coverage restrictions to the customer.
Which one of the following explains why communication to employees is critical to any organization?
Communication is critical to alignment in any organization. Communication that is a continuous effort encouraging employee investment is similar to a targeted marketing campaign creating awareness and affecting employee behavior.
Which one of the following is the most significant element of a healthy organizational culture?
Communication.
Claims representatives can often find evidence that someone may be lying by
Comparing his or her social media posts with his or her statements in a claim.
Which one of the following is an example of an external stakeholder that does not have a business relationship with an organization?
Competitors
The ABC Insurance Company's claim's people typically provide a great deal of claim data for ABC's computer system as they manage company claims. Many areas of ABC make use of this data and for it to be meaningful for their use, the data must be
Complete and relevant.
In order to train inexperienced new employees having diverse educational backgrounds, a company should
Conduct initial training sessions followed by training needs analyses.
A claim representative refuses to provide the claimant's medical records to the claimant's employer. The claim representative's behavior illustrates
Confidentiality.
In addition to aligning with an organization's strategic direction, sound strategic decisions must
Consider concerns of internal and external stakeholders.
Which one of the following statements is true regarding claim department contacts?
Consumer complaints are investigated by the state insurance departments.
Taunton Insurance Company ("Taunton") has decided to recruit recent college graduates for open positions in its underwriting units. Taunton plans to base its recruiting strategy on the preferences and career aspirations of college graduates currently entering the job market. In order to help accomplish its recruiting goals, which one of the following should Taunton emphasize as a benefit of working in its underwriting units?
Continued mentoring opportunities
In the claim function, supporting the insurer's profit goal is accomplished through
Controling expenses.
For smaller organizations, the benefits of deploying virtual teams may be outweighed by the
Cost of reliable technology.
Some organizations establish best practices to monitor vendor activities, such as billing practices by outside counsel. Which one of the following identifies an outside counsel practice that insurers should avoid?
Creating unnecessary work.
Marilyn is a new employee at Major Indemnity Insurance Company. Shortly after beginning her job, she was rebuked by an underwriter for asking questions that the underwriter felt were not related to her job as a claims representative. Marilyn explained to her supervisor, Ed, that at her previous employer, the claims representatives were encouraged to challenge coworkers in other departments and to foster teamwork by making group decisions. Marilyn asked Ed if she could form a committee to help foster communications between the departments, and Ed agreed. Marilyn is attempting to improve her company's claims
Culture.
Marilyn was recently hired away from her employer of 20 years by Major Indemnity Insurance Company. Her supervisor, Ed, told her that her perspective as an experienced claim representative could help Major Indemnity to improve its operations and he encouraged her to speak up if she detected inefficiencies. Marilyn approached an underwriter to discuss a loss trend that she detected at an insured operation, but the underwriter told her that her question was inappropriate to pose to an underwriter and that she should stick to handling claims. This situation describes an opportunity to improve the company's claims
Culture.
Maintaining a brand involves managing both tangible and intangible characteristics of the brand. Which one of the following is an intangible brand characteristic?
Customer loyalty
Which one of the following explains why customers might be willing to pay more for the products of an organization that pursues a differentiation strategy?
Customers may perceive the products of organizations that pursue a differentiation strategy as offering more value than those offered by competitors.
Internal stakeholder relationships are strengthened when an organization's departments view other departments as
Customers.
Sound decision making entails a series of steps. Which one of the following is the first step in the decision-making process?
Define the problem
Which one of the following best describes the first step in developing a brand?
Defining the target market and identifying the differentiating characteristics of the brand subject
Traditional fraud indicators
Depend on fraud that has happened in the past.
Staff turnover can be very costly for a claims department. Following a staff departure, the initial step should be to
Determine the cause of the turnover.
Claim representatives are given individual authority to set reserves, settle claims, and make payments up to certain limits. Each representative's knowledge, experience, and quality of judgment
Determine the level of claim authority the representative earns.
In the mid-'90s, Daniel Goleman popularized the concept of emotional intelligence. He used the term "self-regulation" to describe one's ability to
Display honesty, trustworthiness, accountability, integrity, adaptability, and innovation and to manage one's own stress levels.
Which one of the following terms describes an organizational structure in which groups are organized by the products they produce, the geographic regions in which they operate or the markets they serve?
Divisional.
Job interview questions should be designed to encourage a candidate to
Do most of the talking.
Carla is the new risk manager for Pravalt Booksellers, Inc. (Pravalt). One of her accomplishments is the completion of an improved disaster recovery plan for Pravalt. This disaster recovery plan includes a very wide variety of response activities applicable to disaster situations.
Each phase of a disaster requires a different response.
Carla is the new risk manager for Pravalt Booksellers, Inc. (Pravalt). One of her accomplishments is the completion of an improved disaster recovery plan for Pravalt. This disaster recovery plan includes a very wide variety of response activities applicable to disaster situations. Which one of the following is a justification for having many response activities in Pravalt's disaster recovery plan?
Each phase of a disaster requires a different response.
Risk control measures focus primarily on reducing loss severity, rather than loss frequency, for which one of the following causes of loss?
Earthquakes.
In assessing and reviewing employee performance, a manager is generally best served by
Emphasizing the employee's strengths.
Encouraging data sharing among teams and measuring an employee's teamwork are ways for a manager to foster
Employee unity.
Which one of the following describes the best way for an organization to handle the communication to employees of the vision of changes within the organization?
Employees will better understand the need for change if it is communicated in terms of its support of the organization's vision, mission, and goals.
Unless certain criteria are met, the courts and the Internal Revenue Service will tend to presume that a contracted relationship is that of
Employer-employee.
Which one of the following statements is correct with respect to state insurance regulators' involvement in the claim handling process?
Enforcement of controls by state insurance regulators is usually handled under the Unfair Claims Settlement Practices Act or similar legislation.
During the most recent senior executive meeting of Richley Manufacturing Company (Richley), a lively discussion took place regarding the differences between traditional crisis management and enterprise crisis management. Most of the Richley executives agreed that the company needed to choose between these two types of crisis management approaches, and that this choice needed to be made very soon. Which one of the following factors should Richley consider in choosing its approach to crisis management?
Enterprise crisis management begins long before any potential disruption.
Fredine Auto Parts, Inc. (Fredine) has a written set of procedures for handling crises. This set of procedures has several main characteristics, including the following: The crisis management process continues before, during and after a disruption. Fredine managers are encouraged to question existing crisis management practices. There is a shift towards a new language of crisis management. Crisis management training involves learning to deal with numerous unexpected crisis scenarios. Fredine's crisis handling procedures constitute an example of
Enterprise crisis management.
Which one of the following best describes an objective of branding?
Establish an emotional connection with the target audience
Typically, the first step in a performance management system is for the manager and employee to
Establish the year's goals.
Which one of the following is an example of the "you find us" approach to soliciting candidates for employment?
Establishing a regular presence at industry job fairs
Claim representatives must honor the promises made in the insurance contract, pay fair amounts for claims, and inform first-party claimants of potential coverage of which they may be unaware. These traits describe the quality of being
Ethical.
An after-action review can provide information that will improve the team's processes and should also help the manager to
Evaluate team members' performance.
Actuaries use several common methods to estimate ultimate losses. Which one of the following methods is an actuary likely to use when current loss experience is limited or of little predictive value?
Expected loss ration method.
The extent of an organization's "social license to operate" is largely determined by the organization's
External stakeholders.
In the area of strategic management, business level strategy is
Externall focused.
In a high-functioning virtual team, the role of the manager is best described as that of a
Facilitator.
Which one of the following terms describes the approach of deploying a workflow in which tasks in a virtual team pass from one time zone to the next?
Follows the sun.
Which one of the following statements is correct with respect to claimants' representation by lawyers?
For some types of claims and in certain areas of the U.S., claimants are more likely to hire lawyers.
Organizational change requires the engagement of all affected employees to be successful. The most effective way to bring about change is to
Form a team of stakeholders to develop a vision and lead the change.
The ABC Insurance Company claims department plans to use predictive analytics to assist in identifying potentially fraudulent claims. Even with the use of predictive analytics, it will be difficult for ABC to accurately identify which claims are fraudulent. Which one of the following is likely to cause errors for ABC in this endeavor?
Fraud indicators causing failure to pay a legitimate claim.
The primary purpose of the claims function is to
Fulfill the insurer's promise.
According to the study, "Motivating People: Getting Beyond Money," employees rated all of the following among the top three financial motivators, EXCEPT:
Gift cards.
Which one of the following explains how a formal performance review supports an organization's vision?
Goals can be assessed during the performance review and those that are not aligned with the organizational vision may be discarded or modified.
Which one of the following may be required to protect an insurer against exchange rate volatility?
Hedging strategies.
Which one of the following is the responsibility of the underwriting department of an insurer?
Helping the insurer avoid the problem of adverse selection
The board of directors of the Mellfor Corporation needed to appoint a new CEO after the current one retired. The board hired an executive recruiting firm to assist with the search. The board told the firm that they needed a self-actualized individual who was driven toward achievement and yet was likeable and had been successful in leading and motivating others. The new CEO needed to communicate effectively, readily adapt to change, and handle stress well. From this description, the Mellfor board of directors was looking for someone with
High emotional intelligence.
Which one of the following should be the primary focus in hiring new employees?
Hiring employees who are equipped to help fulfill the organization's objectives
As a result of a noticeable nationwide increase in workers compensation claim severity, the VP of claims for BRE Insurance Company has met with BRE's field claims managers and developed a number of options to try to address this issue. Based on the cost and effect of an option to assign nurse case managers to all lost time claims, which one of the following is likely to be true?
Hiring more nurses will increase costs but likely have an overall positive financial effect.
Which one of the following types of data is used to test a predictive model?
Holdout data
Two large airlines merged. The merger resulted in an organization able to serve a larger customer base (by combining hubs and destinations), and generated significant savings for the combined organization compared to expenses the two companies would have incurred without a merger. This strategic marketing strategy is best described as an example of
Horizontal integration.
In addition to determining how an organization operates, core values include
How an organization interacts with business associates.
The first step in the risk management process for reputation risk is to
Identify and evaluate reputation risks.
Which one of the following activities is the first step in the business continuity process?
Identify the organization's critical functions.
Strategies developed at all levels of an organization should align with the organization's vision, mission, and goals and consider the needs of internal and external stakeholders. Corporate level strategic marketing seeks to
Identify the organization's crucial customers and potential customers that can be served in alignment with corporate vision.
Which one of the following best describes one of the steps in the business continuity process?
Identify the risks to the organization's critical functions
The claims manager receives various reports to review based on the data that his employees input into the claims system. He recently received a report in regard to the office use of subrogation. The data indicated that over the past twelve months the referrals to the subrogation unit had gone down in each of the months although the overall new claim volume had remained the same. This report is assisting in
Identifying trends.
Which one of the following should be the primary determinant in assessing how well a candidate for employment would align with the organization's mission?
Impressions from the candidate's interview.
An insurer must plan to communicate its claim philosophy effectively before the plan will have the intended results. An effectively communicated plan is one that receives buy-in from the claims professionals, changes intended behaviors, and
Improves performance.
Claims management for ABC Insurance Company is concerned that its claims payments may be as much as 15 percent too high because of claims leakage. ABC has begun a claims leakage analysis through the review of closed claims files. Which one of the following is one of the examples of claims handling that may result in claims leakage?
Inadequate supervisor review
Which one of the following identifies a benefit to the insurer of having customer-focused claims representatives who provide better customer service than competitors?
Increased customer retention
One option for addressing the increase in workers compensation loss severity observed by BRE Insurance Company claims management is to increase claim supervisor involvement in all lost time claims. The most likely cost and effect of implementing this option is
Increasing cost by hiring more supervisors with a positive effect on financial results.
The ABC Insurance Company sets reserves for new claims that occur often based on the loss data that ABC has gathered. For claims such as auto physical damage, the computer can easily establish a reserve amount based on past claim data. For more complex bodily injury claims reserves may be best established by
Individual claim representatives.
Which one of the following statements is correct with regard to the various users of claim information?
Individual underwriters are interested in claim information for the specific accounts they have underwritten.
In the mid-'90s, Daniel Goleman popularized the concept of emotional intelligence. He used the term "social skills" to describe one's ability to
Influence and persuade others, develop open listening skills, effectively negotiate and resolve conflicts, and inspire and lead others.
Business continuity management was initially developed with a focus on
Information technology concerns.
Late one night, a car ran into Becky's parked car, and when she came out of her house, the car backed up and left the scene. Candice, the claim representative, asks Becky if she remembers anything specific about the car. Becky replies that it was blue. Candice notes the description and thanks Becky for her help. A desirable quality that Candice could improve on the most is
Inquisitiveness.
Which one of the following has enabled minor corporate disruptions to develop quickly into serious crises?
Interdependencies between global organizations
Which one of the following functions within an organization audits claims for compliance with the insurer's financial procedures?
Internal control.
The term "silo effect" refers to the extent to which an organization's departments or workers function in
Isolation.
Which one of the following is correct with respect to a business continuity plan?
It is designed to be used during a crisis, so it should be clear and able to be quickly read and understood.
The ABC Insurance Company organizes claim data in its computer system according to various codes and fields. Which one of the following is a likely use for this organized data?
It will be used to determine the most likely cause of auto accidents.
Which one of the following is an algorithm used to group data into clusters of claims?
K-means
According to the Power/Interest Matrix for Prioritizing Stakeholders, what is the best course of action for dealing with stakeholders who have low interest in the organization and high power over the organization?
Keep them satisfied
The acronym "KSAs" stands for
Knowledge, skills and attitudes.
In establishing a global claims program, which one of the following would be a likely disadvantage to hiring an executive in the country of operations?
Lack of familiarity with the insurer and its practices
China is an example of a country where it may be difficult for actuaries to determine appropriate financial reserves due to which one of the following?
Lack of historical data.
Which one of the following is a limitation of the loss development method of estimating loss reserves?
Large one-time events such as catastrophes would disrupt the historical pattern of development.
Typically, every step and procedure in claims investigation and management is governed by
Law or regulation.
An organization must clearly communicate its message when responding to stakeholders in times of crisis. Mishandling information provided to stakeholders concerning a crisis can
Lead to new regulatory constraints.
A branch of a classification tree that leads to a classification of a target variable ends at a
Leaf node.
Which one of the following correctly describes lift in evaluating a predictive model's effectiveness?
Lift is the percentage of a model's positive predictions divided by the percentage expected by chance.
Fredine Carpets, Inc. ("Fredine") sells various styles of carpeting to homeowners throughout the country. Fredine stores its inventory in several large warehouses, all of which are equipped with sprinkler systems, burglar alarms, and waterproofing. Last week, the managers of one of Fredine's warehouses arrived at the building at 6:00 AM and discovered about one inch of water covering the floor of a 900-square foot storage area. Some of the carpets stored in this area suffered water damage, but the carpets kept in the other fifteen storage areas were unaffected. It was determined that an overflowing sink was the cause of the flood. In order to deal with the inventory damage resulting from this incident, Fredine should follow its
Loss mitigation procedures.
A great deal of loss data is available from an insured's computerized claim system. This data is used in many different financial ratios. One of the most common ratios used to show insurer profitability is the
Loss ratio.
The claims manager for ABC Insurance Company is charged with managing his office and using trend analysis of the data that is available to him. A priority for data trend analysis for the claims manager is
Loss reserves.
Margo, a new claim manager, is meeting with her subrogation unit to discuss changes in state regulations that will modify the unit's goals. Which one of the following explains how Margo should prepare for this meeting, which involves strategic communication with a small group?
Margo should clarify the purpose of the meeting, prepare a timed agenda and demonstrate how the changes affect the unit's alignment to the corporate mission.
Producer Tina has recently received many requests for cell phone coverage from auto insurance customers. She feels that this type of coverage could be inexpensive for the insurer to develop but could possibly attract youthful policyholders. Tina should discuss her product innovation ideas with the insurer's
Marketing and distribution department.
Three core functions exist within the structure of a typical insurer. These core functions are
Marketing and distribution, underwriting, and claims.
Which one of the following terms describes an organizational structure in which members of functional departments are also assigned to product teams?
Matrix.
In determining employee results and behaviors through job analysis, each set of KSAs (Knowledge, Skills and Attitudes) should be described in terms that suggest a way to
Measure or quantify them.
Providing flexible work schedules is an effective way for a manager to
Meet employees' work-life balance needs.
Which one of the following is a way that moral decisions differ from ethical decisions?
Moral decisions involve deciding between a right and a wrong decision.
Claims processes dictate how the organization's resources should be utilized in support of its claims philosophies. Organizations must prioritize claims processes because
Most organizations do not have the resources to support every process.
Daniel Goleman popularized the concept of emotional intelligence in the mid-'90s. Which one of the following best describes one of the skills and abilities he identified?
Motivation includes the showing of initiative and persistence, drive for excellence, and commitment to meeting goals.
Delmond Insurance Company ("Delmond") is in the process of recruiting recent college graduates for actuarial trainee positions in several of its major office locations. Delmond's executives understand that this recruiting process will present some challenges, and that these challenges must be met in order to attract the best people for the available jobs. Which one of the following is an example of a challenge to be faced by Delmond as it proceeds with its recruiting efforts?
Negative perceptions of the insurance industry among students
Which one of the following is the study of the nodes and edges in a network?
Network analysis
Chloe is the personal auto claim supervisor for Parker Insurance. She notices an increase in bodily injury claims in one of her territories, and suspects that some of the claims may be fraudulent. Parker's internal fraud detection system identifies a number of claimants who were all being treated by the same medical group. Chloe suspects that a fraud ring may be involved. Which one of the following methods should Chloe use to help her identify the fraud ring?
Network analysis.
The ideal result of a manager offering consistent feedback throughout an employee's evaluation period would be that
No new information is revealed during the formal review.
Mark is a claim representative who adjusts personal auto claims. If there is a claim for a broken windshield, Mark always recommends his favorite glass repair business because it is consistently fast and affordable. Is this an example of a conflict of interest?
No, because the recommendation is based on the merits of the vendor.
Regarding career paths, which one of the following statements is true?
Not everyone is a potential manager or wants to be a manager.
BRE Insurance Company claims management is considering the option of using predictive analytics in an effort to identify the potentially more severe workers compensation claims at the time of the initial claims report. The goal is to improve BRE financial results by better managing these claims. The cost, effect on employees, and results of using predictive analytics will likely
Only have the cost of developing the system, a positive employee effect by better assignments, and a positive financial effect.
Which one of the following explains how operational goals align with strategic goals?
Operational goals, established at the line management level, articulate specific tasks relating to producing the organization's products or services. Operational goals support tactical goals, which in turn support strategic goals.
The goal of business process management (BPM) is to
Optimize a business process, such as claims handling.
A manager's directives should include an explanation of the directives' relevance to the employee's role and to the
Organization's mission and vision.
Which one of the following describes how the culture and management style of an organization affects its communications?
Organizational culture determines the style of communications. Organizations with a delegatory style of management will provide communications that are broad and strategic, allowing employees to create their own way of achieving goals. Directive managers will tell others what to do. Supportive management will explain the rationale for goals and encourage employees to pursue related endeavors.
Which one of the following explains how organizational structures change over time?
Organizational structures respond to internal growth, profit goals, and the external environment.
Smith is a claim manager for ABC Insurance Company and is charged with using available data to assist in the management of his claim office. Smith recently downloaded claims for an accident year into a spreadsheet and then sorted the data by claim representative. Using loss data in this manner is an example of
Organizing claim data.
The VP of claims for BRE Insurance Company has observed a significant increase in claims loss severity over the past year. In addressing this issue with local claims field managers, it was found to be a nationwide problem and a number of possible corrective actions were discussed. Which one of the following would be true in regard to the cost and effect of the option of providing additional training to the claims representatives?
Overall cost for training is low but the results are difficult to quantify.
ABC Insurance Company's computer system generates a number of reports regarding loss data. What might ABC's claims managers review from reports on data involving loss reserves?
Paid to incurred ratios
The most productive organization-stakeholder relationships are those in which the two parties view each other as
Partners.
Which one of the following explains how pathos may be demonstrated in oral communications?
Pathos may be demonstrated by listening and analyzing the statements made by others in the conversation.
Hallbinger Biochemicals, Inc. (Hallbinger) is preparing a new set of crisis management training sessions for its executives. The main goal of this training is to help Hallbinger's executives become better prepared for any type of crisis scenario.
Pay more attention to the beginning and end of crisis situations.
Hallbinger Biochemicals, Inc. (Hallbinger) is preparing a new set of crisis management training sessions for its executives. The main goal of this training is to help Hallbinger's executives become better prepared for any type of crisis scenario. Hallbinger plans to include a list of crisis management action steps in its new training sessions. These action steps are designed to create a crisis management mentality within the organization. Which one of the following should Hallbinger include in its list of crisis management action steps?
Pay more attention to the beginning and end of crisis situations.
John, a claim representative, is facing some conflicting demands and needs between his insurance company's insureds and the company's stockholders. When approaching this ethical decision, John has decided to resolve the issue based on the manner in which he would want to be treated in a similiar situation. This type approach would be considered a
People based approach.
Which one of the following explains how performance management and project management align an organization to its mission statement?
Performance management relates the organizational mission to its goals, and connects goals to the tasks and skills needed. Project management aligns resources with the tasks needed to fulfill the organization's mission.
Effective leadership is predicated primarily upon the ability to
Persuade.
Marilyn recently began to work as a claims representative for Major Indemnity Insurance Company after handling claims at a competing company for many years. Her supervisor, Ed, gave her several small claims to handle during her first weeks on the job. Marilyn offered the insureds the minimum amounts she thought she could offer to settle the claims, which the insureds all accepted. After reviewing her work, Ed explained that their company always strives to offer fair settlements, not necessarily the lowest settlements. This example illustrates Marilyn's misunderstanding of the company's claims
Philosophy.
In determining results and behaviors, desired results in a job analysis are
Phrased as objectives.
Which one of the following types of workers compensation claims are the most difficult for insurers to identify at the time of first report?
Potentially complex claims
A common theme among management theories is that an individual will not be motivated to meet objectives until that individual's needs have been met. These needs include the emotional, such as the need for rest, work-life balance, equity, financial rewards, and
Praise and reinforcement.
According to the study, "Motivating People: Getting Beyond Money," employees rated which one of the following as the top overall motivator?
Praise from immediate manager
Insurance Company (IC) management is facing soft market pricing and is very concerned about upcoming financial results. IC is very interested in leveraging loss data to improve these results. One evolving way IC can do this is through
Predictive analysis.
Claim representatives should continually look for ways to improve department operations and should be able to anticipate a customer's questions and concerns. These traits describe the attribute of being
Proactive.
Millstone Insurance (MI) wants to identify potential ways to improve its claims handling process. Process mining begins with data analysis of claims activity logs to identify the claims handling activities and the timing of them. Which one of the following would help MI set the initial benchmarks for each activity in the current claims handling process?
Process map
Millstone Insurance (MI) wants to identify potential ways to improve its claims handling process. Process mining begins with data analysis of claims activity logs to identify the claims handling activities and the timing of them. Which one of the following would help MI set the initial benchmarks for each activity in the current claims handling process?
Process map.
Which one of the following statements regarding process mining is true?
Process mining differs from typical data mining in that process mining applies results to an entire process.
After Marilyn began to work for Major Indemnity Insurance Company, her supervisor, Ed, showed her how to use the claims program. This software uses predictive modeling to predict claim characteristics and to group claims according to likely severity and complexity. This software is an example of the company's claims
Process.
Insurers have hardware and software tools to help claims representatives in the process of handling claims. These tools can help less experienced claims representatives to
Produce results similar to more experienced representatives.
Which one of the following statements is true concerning claim information users?
Producers must have policyholder loss information to prepare renewal policies properly.
Project management in a process-oriented organization is responsible for
Producing real results through the adaptation of an abstract vision developed by upper management.
Formal management training, on-the-job training and mentoring are all elements of a
Professional development plan.
A claims manager for ABC Insurance Company has been closely monitoring claims data available to him and has noticed that there is an imbalance of new claim assignments to the more experience claims representatives causing them to do more than their share of work. In an effort to balance the workload and smooth out the caseload data the claims manager should most likely
Provide additional training and p
Delmond Insurance Company (Delmond) realizes that it needs to consider future leadership needs as part of its business continuity plan. The executive management team at Delmond is therefore looking for ways to interest more students in the benefits of an insurance career. In order to help convince students of the benefits of working in the insurance field, which one of the following actions should Delmond's managers take?
Provide internship assistance by matching students with available positions at Delmond's headquarters
Delmond Insurance Company (Delmond) has a long history of preparing its executives and managers for disruptions and crises which could affect its operations. As Delmond has grown its business over the past ten years, it has developed a wider range of internal and external stakeholders. Accordingly, Delmond is even more concerned about the information it shares with stakeholders regarding its crisis response procedures. Which one of the following steps should Delmond take to help address stakeholder concerns during an organizational crisis?
Provide supporting documentation to stakeholders when communicating its decisions regarding the crisis.
Daniel has developed a business continuity plan to address the threat of the loss of utility services at his company's large manufacturing plant. The management team has reviewed his plan and agrees that the plan can be quickly read and understood and should be effective in the event of a crisis. Daniel has provided copies of the plan to all relevant parties. Which one of the following should be Daniel's next step?
Provide training and periodic rehearsals of the procedures
A claims department's optimal reporting structure should give claims representatives the authority to make decisions while
Providing the appropriate level of supervision to allow them to succeed.
Customer Marna reported a slip-and-fall accident to a store owner who denied responsibility stating she should have been aware of the condition of the premises. Nine months later, Marna sued the store owner for $30,000 related to her injuries. The insurer was not aware of the incident until legal action was pursued. Prior to the legal action, the insurer would likely have used which one of the following types of loss reserves to account for this claim?
Pure incurred but not reported loss reserves
An insurer wants to determine the complexity of a claim at the time of first report. Which one of the following is an important step after identifying the attributes of complex claims?
Ranking the attributes according to their relative information gain
The purpose of loss reserve analysis is to determine whether the carried loss and loss adjustment expense reserves can be expected to adequately cover the losses that have bee incurred but not yet paid. Which one of the following would participate in loss reserve analysis on behalf of potential investors or creditors?
Rating agencies.
An insurer should be prepared to
Reevaluate the attributes in a predictive model.
because of its labor practices. The Department of Labor (DOL) investigated complaints from five female employees that MPC discriminated against them. The DOL found the claim was true. The Immigration and Naturalization Service (INS) found that the company employed illegal immigrants and paid them less than the minimum wage. When this news became public, MPC's reputation was severely harmed. This scenario illustrates which source of reputation risk?
Regulatory and legal compliance
Meat Products Company (MPC) runs packing plants in three Midwest states. The company was in the news recently because of its labor practices. The Department of Labor (DOL) investigated complaints from five female employees that MPC discriminated against them. The DOL found the claim was true. The Immigration and Naturalization Service (INS) found that the company employed illegal immigrants and paid them less than the minimum wage. When this news became public, MPC's reputation was severely harmed. This scenario illustrates which source of reputation risk?
Regulatory and legal compliance.
Which one of the following is a supporting function of an insurance company?
Reinsurance.
Difficulty in direct supervision, communication issues and the time and cost of in-person meetings are all challenges presented by
Remote reporting relationships.
Risk control can assist premium auditing by
Reporting the existence of new operations.
An intangible asset resulting from a collection of perceptions and opinions, past and present, about an organization that resides in the consciousness of its stakeholders is known as an organization's
Reputation.
Bio-Pharma was a highly-regarded pharmaceutical company. That changed last year when it was revealed that Bio-Pharma researchers had fabricated test results of the company's new hypertension drug, and a company official bribed a key regulator to get the drug approved. These revelations led to a sharp decline in sales of all of Bio-Pharma's drugs, a sharp decline in net income, and a decline in Bio-Pharma's stock price. This scenario clearly indicates the value of a corporation's
Reputation.
Through the use of predictive analysis the ABC Insurance Company is able to identify the more severe claims early in their receipt. Due to this identification, ABC will likely be able to
Reserve these claims more accurately.
The main components of an insurer's bulk (or aggregate) loss reserves are reserves for unreported claims plus
Reserves for losses that have inadequate case reserves and reserves for claims that have settled and then reopened.
Stairstepping of reserves appears to be a claims issue in all the ABC Insurance Company offices and occurs at all levels of experience and impacts ABC's loss ratio. ABC's experienced claims representatives have the knowledge but do not seem to apply it and the lesser experienced seem to lack knowledge. Which one of the following would likely be true regarding providing reserving training for all ABC's claims representatives?
Reserving training would likely be effective for the less experienced representatives but not effective for the experienced representatives and not really affect the loss ratio.
The aptitudes needed for success in a given role fall into which two categories of objectives?
Results and behaviours.
The recovery manager of the Great Fire Insurance Company has recently noticed a drop off in referrals from the claims offices for both subrogation and reinsurance recovery. After meeting with Great Fire field claims managers, one option that is to be considered to address this issue is to have claims managers review referral coding and investigation on files they review. Which one of the following explains the likely probable effects of this option?
Results are not likely to improve significantly since claim managers are already reviewing claims files.
Durham Insurance wants to analyze and improve its auto claims handling process through process mining. Which one of the following would be an example of process instance that would be used in the analysis?
Reviewed policy.
Which one of the following statements is true concerning risk control?
Risk control can assist marketing by providing advice on improving safety.
Which one of the following statements is correct regarding the interaction between risk control and other insurer functions?
Risk control personnel can assist underwriters in modifying a new applicant's loss exposures to meet eligibility requirements.
Three Hills Insurance had a problem with predicting which workers compensation claims would develop into long term disability claims. The data science team decided to use a classification tree technique to develop a predictive model based on the attributes of long term disability claims. The availability of light duty work was determined to be the most informative attribute. Which one of the following parts of the classification tree should be assigned to this attribute?
Root node
William decides to reject a claim made by an insured because he followed a standard claim procedure and the loss was excluded on the policy, although, William would like to pay the claimant for their loss. William is taking a
Rule-based approach at ethics.
The Wireless Wizards Corporation (WWC) specializes in providing information technologies (IT) capabilities for businesses on a contract basis. To assist in determining the appropriate strategies to grow its customer base, WWC's senior managers will perform an analysis to evaluate both the business itself and the external environment in which the organization operates. Which one of following best describes the method WWC should follow to complete its analysis?
SWOT analysis.
The first goal of the claim function is to
Satisfy the insurer's obligations to the policyholder.
BRE Insurance Company has observed a significant increase in severity in lost time workers compensation claims throughout its claims offices. To address this issue the field claims managers for BRE have gotten together and come up with a number of options that they believe would address this issue. Which one of the following is true regarding its affect on costs, employees, and overall financial results?
Segmentation used with predictive analytics would have low costs and positively affect both employees and overall financial results.
In establishing a global claims function, the staff will likely be hired in the country of operations with the possible exception of
Senior Managers.
Which one of the following explains how senior management's definition of an organization's mission supports its vision?
Senior management should clearly define the organization's mission providing direction on everything from the product to management techniques.
In establishing a global claims function, the staff will likely be hired in the country of operations with the possible exception of
Senior managers.
Loss data for ABC's claim office has shown a growing number of long-tail severe liability claims. In conjunction with ABC's Home Office, the local claim manager has been charged with coming up with a plan, based on this claim data, to reduce the number of open claims in this data set. As a likely part of this plan the claim manager will have proposed a
Settlement initiative.
For an organization to manage its reputation risk, it must earn and retain the trust and confidence of its key stakeholders. A key external stakeholder for a corporation is the corporation's
Shareholders.
Social media sites are effective venues for establishing brand identity because
Social media offer the advantage of direct, real-time dialogue between the branding organization and large numbers of customers.
Which one of the following is the application of network analysis to social media and is the study of the connections and relationships among people in a network?
Social network analysis
Marilyn was recently hired away from her employer of 20 years to work at Major Indemnity Insurance Company. The claims department at Major Indemnity was very busy with each representative handling approximately 250 files. Marilyn was an addition to staff, which had the effect of reducing the number of files at each representative's desk. Marilyn was likely hired to improve the company's claims
Staffing.
Which one of the following is usually the regulatory authority that may direct the activities of a claims function?
State insurance department
Which one of the following statements is true concerning claim department contacts?
State regulators monitor insurers' activities in the claim settlement process.
The third stage of the strategic management process is
Strategy evaluation or control.
Assignment of specific responsibilities, tasks, authority, and accountability throughout an organization typically takes place during
Strategy implementation.
Marilyn is an experienced claim representative who just started working for Major Indemnity Insurance Co. Her supervisor, Ed, assigned a few simple claims so that he could evaluate her work methods. Marilyn quickly settled each claim and closed them out. Afterwards, Ed told her that all settlements at Major Indemnity are supposed to be approved by a supervisor before being presented to the insured. This situation best illustrates Ed's failure to properly communicate the company's decision-making authority, which is part of the claims
Structure.
ABC insurance Company recently noted that the amount of money that ABC was recovering based on paid loss amounts has been consistently declining over the past year. Which one of the following loss data reports that ABC monitors should ABC analyze first to attempt to determine any problems that may be developing?
Subrogation referrals.
The organizational process of identifying and cultivating employees to fill key positions as they are vacated is known as
Succession planning.
The claim office of insurer ABC holds quarterly meetings with its staff of claim representatives. In communicating the proper claim philosophy to the staff, claim management should ensure that the philosophy of the company is part of every decision and communication. Management's communication should
Support the promise to promptly pay amounts that are due.
One of the primary goals of the claim function is
Supporting the insurer's financial goals.
One approach to managing reputation risk for an organization involves carefully managing the organization's interactions with the general public, its stakeholders, and its employees. This method is a
Systematic approach.
The most obvious advantage associated with virtual teams is that they expand an organization's potential
Talent pool.
Team members in successful process-oriented organizations trust each other, share sacrifices, and coach and learn from each other. This is because
Team members are equally accountable for the team's output.
Management must be prepared to overcome employee resistance when trying to implement organizational change. Which one of the following statements about managing resistance to change is true?
The best strategy to overcome resistance to change is to engage employees.
Which one of the following statements is correct regarding the marketing value of the claim function?
The claim adjusting process can be a source of new coverage ideas and product niche innovations.
Which one of the following statements is correct regarding the claim function of an insurer?
The claim function helps insurers achieve underwriting profit through control of expenses.
Which one of the following best defines strategic management?
The coordination of interrelated activities of functional areas of a business to achieve an established purpose.
Loss severity in workers compensation claims has become a severe issue for the BRE Insurance Company. Rather than random assignment of new lost time workers compensation claims, BRE is considering an option of segmenting new claims based on severity criteria along with the use of predictive analytics. Which one of the following would be a correct analysis of the cost, effect on employees, and probable financial results of implementing this option?
The cost is associated with hiring more supervisors to segment the claims reports, the cost of a new system providing positive use of employees and a positive financial result.
Which one of the following is often a sign that an employee possesses leadership potential?
The employee asks questions directed at solving problems.
Lily is an actuary with Insurance Company D. She is evaluating the company's loss reserves to prepare an updated estimate of ultimate losses. She begins with an analysis of the company's current experience to date. She then reviews the historical loss experience and prepares an estimate using that data. In analyzing her results, she finds that the trends in the current experience to date indicate an increase of about 25 percent in the loss reserves. In her final analysis and recommendation, she decides to ignore the current experience because she believes that it is an anomaly. Which one of the following methods is Lily using?
The expected loss ratio method
A PESTLE analysis is best described as a method of assessing
The external environment in which an organization operates.
Claims managers perform staffing analyses to determine the ideal number of claims representatives for a department. One of the factors that may be considered in this analysis is level of experience because
The higher the level of a representative's experience, the higher that person's level of efficiency in adjusting claims is likely to be.
The type of structure that would be best for an organization that must quickly adapt to environmental changes is
The hybrid structure.
Leveraging loss data to consistently improve its customer service has always been a strength of the ABC Insurance Company. One piece of loss data that ABC's commercial customers regularly review and praise ABC for is
The length of time to contact after a claim is reported.
Which one of the following explains why some mission statements are flavored with marketing strategy?
The mission statement is part of the public face of a company, and is used in all company publications.
Part of using people effectively in the claims process typically involves initially assigning the more complex and severe claims to
The more experienced claims representatives.
Process-oriented organizations differ from traditional ones in that they use process and performance management tools to align their processes with their missions. Which one of the following statements about process-oriented organizations is true?
The most important characteristic of an effective team is loyalty among team members and to the process owner.
Assuming that an organization is structured along functional lines, which one of the following describes how it can overcome its major communication disadvantage?
The organization must try to avoid "silo" effects by increasing the level of communications and actively aligning departmental objectives.
Employees are most successful when they perceive a connection between their contributions and
The organization's mission.
Which one of the following explains how overarching goals of an organization should support the organization's vision?
The overarching goals should be realistic and achievable, with the vision statement as motivation for all employees to improve the organization.
The loss ratio of ABC Insurance Company has been negatively affected by what has been identified as reserve stairstepping in the field claims offices of ABC. One option to correct the stairstepping issue is to have the local ABC claims managers review reserve ratios and reports every 30 days. Which one of the following would be true of this approach to addressing the stairstepping of reserves and improve the accuracy of the loss ratio?
The ratios and reports will identify representatives with reserving issues to supervisors to address individually resulting in a more accurate loss ratio.
Which one of the following statements is correct regarding the relationship between risk control and claims?
The risk control department needs claim experience information to direct loss-control resources and efforts to crucial areas.
John has been charged with developing a new budget for the claims office for the upcoming year. Data on trends of new, open, closed, and reopened claims are all important in the budgeting process. Which one of the following is likely determined with this data?
The staff necessary to manage changes in volume.
Larry is a claim representative with the responsibility of entering information into the insurance companies data base that provides information to various areas of the insurance company. Which one of the following is the likely result of improperly coding the "cause and result" of a specific claim?
The type of claim experience will be misrepresented.
Jancy Supermarkets (Jancy) has had a business continuity plan for many years. One section of its business continuity plan sets forth procedures for recovering from the effects of disasters. Jancy reviews its business continuity plan once every quarter, and continually tries to improve the provisions of the plan. While reviewing the plan this quarter, Jancy began to include an additional list of disaster recovery options in the post-loss section of the plan. Which one of the following will affect the availability of the disaster recovery options being added to Jancy's business continuity plan?
The warning time variations for disasters
Organizations use many metrics to measure the effectiveness of individual claims representatives and the claims department. While these are comprehensive and timely measures of a representative's performance,
They are only tools and may not indicate all relevant information.
The claims vice president of ABC Insurance Company has looked at various options to address stairstepping of reserves that seems to be prevalent throughout the ABC field offices. One possible corrective action being considered by the VP is to have claims supervisors review all reserves at 30-day intervals. Which one of the following would be true regarding this type corrective action?
This action should result in a more accurate ABC loss ratio.
In an effort to improve the number of subrogation and reinsurance recovery referrals, the Great Fire Insurance Company has had its field claims managers develop some optional programs. One such option being considered is to have claims supervisors review all files for these possibilities. Which one of the following is true of this option?
This could have a significant positive effect on referrals but could remove the ownership of the process from the claims representatives.
Which one of the following explains why a performance review should be framed in the context of organizational alignment?
This focus depersonalizes the conversation allowing the manager and employee to look at how tasks and performance aligns with the organization mission rather than an individual's abilities.
ABC Insurance Company needs to improve the overall accuracy of the company loss ratio by improving claims reserving by minimizing the stairstepping of reserves. As a result, ABC is considering the purchase of computer software to assist in setting reserves. Which one of the following is likely true of this option in regard to improving the loss ratio accuracy and reducing the stairstepping of reserves?
This option is likely to increase the loss ratio and reserving for severity indicators.
A possible option to improve subrogation and reinsurance referrals to recovery for Great Fire Insurance Company is to have its regional claims managers become involved in random quarterly file reviews. The managers would be sure the files they reviewed had referral indicator coding if the investigation warranted one. Which one of the following would be the likely cost and effect of implementing this option?
This option will likely increase referrals at a very low cost but not correct the underlying problem with the claims representatives.
When determining whether an employee is a potential leader, a manager should first assess the employee's knowledge, skills, and attitudes (KSAs) relative to
Those associated with leaders.
An organization's external stakeholders can be divided into which one of the following groupings?
Those who have a business relationship and those who do not
Claim representatives can collaborate with other departments within the organization by participating in a SWOT analysis. This is an analysis of internal strengths and weaknesses and external opportunities and
Threats.
Which one of the following explains why a computer recursively applies a model?
To analyze different splits in the values of attributes
Claim manager Johnson has established a list of vendors that his office claim representatives must use whenever a vendor is necessary in the management of a claim. Which one of the following might explain why Johnson might establish such a list of vendors?
To be sure the most effective vendors are used.
If a customer or potential customer posts a negative comment or product review on an organization's social media venue, the best way for the organization to protect the brand is to
To courteously reply to the poster to seek more information, address concerns, or offer solutions.
Claim manager Jones has recently hired a group of new claim trainees. Which one of the following is the most important thing that must be communicated to these new trainees by the claim management?
To pay promptly what is due to its insureds.
Why should claim representatives remain alert to vendors' goals to sell products or services?
To prevent a conflict of interest.
Which one of the following best identifies one of the purposes of a claims reporting structure?
To timely notify the right people of certain events
Which one of the following is essential to maintaining the quality of a claims department and contributes to a claims representative's feelings of job satisfaction and empowerment?
Training.
Which one of the following is the most significant determinant of a virtual team's success?
Trust among the team members and their manager.
Claims managers conduct staffing analyses to determine the correct number of claims representatives for the department. This analysis typically includes which one of the following sets of factors?
Type of claim, line of business, class of business, and complexity
In the mid-'90s, Daniel Goleman popularized the concept of emotional intelligence. He used the term "empathy" to describe one's ability to
Understand and develop others by acknowledging their feelings, concerns, perspectives, and developmental needs.
Once the marketing department has developed a relationship with potential customers, which one of the following departments determines if and under what conditions the insurer is willing to provide insurance products and services to these potential customers?
Underwriting.
Joshua has worked in personal auto claims for many years. He is frustrated with the ever-evolving fraud schemes. Joshua feels that they work hard at developing predictive models to help them identify fraudulent claims, but the models quickly become outdated when new fraud tactics emerge. Which one of the following methods could help Joshua and his team stay ahead fraudulent claims, rather than rely on the dated indicators used in the predictive models?
Unsupervised learning by cluster analysis
A training initiative is being considered as an option by General Fire Insurance Company, in an effort to improve their referrals of potential subrogation and reinsurance recovery claims to their recovery department. By increasing the number of potential recovery claims files, the dollar amount recovered will likewise increase. Which one of the following is likely a correct cost and effect analysis of such a training initiative?
Use of outside resources to train can be expensive but the result is likely to be improved recovery referrals and dollars.
Groupthink occurs
When participants' desire for harmony overcomes their willingness to raise concerns or express disagreement.
Increased operational efficiency through the use of loss data has been an ongoing goal of the ABC Insurance Company. To this end, ABC has been using and expanding the use of segmentation in its field claims offices. Which one of the following is the best example of segmentation in the ABC claims office?
Workers compensation claims are divided between medical only and severity levels of lost time claims.
Worthley Insurance Company's board of directors wants information about Worthley's current financial position. Which one or the following individuals can best assist the board with evaluating Worthley's financial position?
Yusuf, manager of accounting and finance
In the mid-'90s, Daniel Goleman popularized the concept of emotional intelligence. He used the term "social skills" to describe one's ability to
nfluence and persuade others, develop open listening skills, effectively negotiate and resolve conflicts, and inspire and lead others.