Customer Service & Communication Flashcards

A claimant calls angry because a payment is late. What should the adjuster do first to de-escalate?

Answer: Listen without interrupting and acknowledge the frustration

Acknowledging emotions through active listening lowers tension before you move on to solving the problem.

Which question is the best example of an open-ended question in a claimant interview?

Answer: Can you describe what happened as you approached the intersection?

Open-ended questions invite a narrative answer and draw out more detail than yes/no questions.

An adjuster restates a claimant's concern: "So you're worried the repair shop won't be paid on time." This technique is called:

Answer: Paraphrasing

Paraphrasing confirms understanding by restating the speaker's message in the listener's own words.

When a claimant has an attorney representing them on the claim, the adjuster should generally:

Answer: Send all claim communications through the attorney

Once a claimant is represented, communications should go through counsel unless the attorney gives permission otherwise.

Which statement best shows empathy without admitting liability?

Answer: I'm sorry you're going through this; let's work through the next steps together.

Empathy recognizes the person's situation without making promises about coverage or fault.

Under the NAIC Unfair Claims Settlement Practices model, an insurer typically must acknowledge a claim notice within about how many days?

Answer: 15 days

The NAIC model regulation generally requires acknowledgment within 15 days, though exact deadlines vary by state.

What is the main purpose of setting expectations early in the claims process?

Answer: To reduce misunderstandings about timelines, steps, and documents needed

Explaining the process up front prevents surprises and builds trust, which lowers complaints.