Project Management & Workflow Flashcards
7 cards from real CA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Project Management & Workflow flashcards as text
A claimant provides an oral notice of loss but does not submit a written proof of loss. What is the adjuster's correct workflow step?
Answer: Send a written request for a proof of loss and document the timeline
Requesting a proof of loss in writing creates a documented record and gives the claimant an opportunity to comply.
Which of the following best describes a 'RACI matrix' in claims project management?
Answer: A framework clarifying who is Responsible, Accountable, Consulted, and Informed for each task
A RACI matrix eliminates ambiguity about roles and responsibilities on complex, multi-party claims.
What is the significance of California's 40-day rule in claims workflow?
Answer: Insurers must accept or deny a claim within 40 days of receiving proof of claim
California's Fair Claims Settlement Practices Regulations require a coverage decision within 40 days of receiving a complete proof of claim.
An adjuster notices that 30% of their claims have missed diary dates over the past month. What is the BEST corrective action?
Answer: Conduct a workflow audit to identify bottlenecks and reset priority diaries
A workflow audit identifies systemic issues causing missed diaries and allows for targeted corrective action.
Which of the following is an example of a 'hard close' in claims workflow?
Answer: Permanently closing a file after a final settlement agreement and release are executed
A hard close signals that all obligations are satisfied and the file is finalized with a signed release.
What risk does an adjuster face when paying a claim without obtaining a signed release on a first-party property claim?
Answer: The insured may sue for additional damages beyond the payment made
Without a release, the insured retains the right to pursue additional amounts, exposing the insurer to further liability.
In managing catastrophe claims, what does 'status tracking' enable that routine claim handling does not require?
Answer: Real-time visibility into large volumes of claims for executive reporting and resource reallocation
Status tracking dashboards allow supervisors to identify bottlenecks and redeploy adjusters in real time during mass loss events.