CA Digital Tools & Software 3 — Questions and Answers
Question 1: What does an integrated payment portal within a claims system allow insurers to do that traditional check processing does not?
- Issue electronic funds transfers directly to claimants in real time (Correct answer)
- Automatically deny duplicate claims
- Photograph the damaged property remotely
- Calculate premium adjustments mid-term
Correct answer: Issue electronic funds transfers directly to claimants in real time
Integrated payment portals enable real-time ACH or EFT disbursements, reducing settlement cycle time compared to mailed paper checks.
Question 2: Which cybersecurity practice is most critical when an adjuster accesses a claims system from a public Wi-Fi network?
- Using a Virtual Private Network (VPN) to encrypt the connection (Correct answer)
- Disabling the firewall to improve speed
- Logging in with a shared team password
- Clearing browser cookies after each session only
Correct answer: Using a Virtual Private Network (VPN) to encrypt the connection
A VPN encrypts all data transmitted over unsecured public networks, protecting sensitive claim and policyholder information from interception.
Question 3: In a property claims context, what is the primary use of aerial imagery software such as EagleView or Nearmap?
- To measure roof dimensions and assess storm damage remotely without a physical inspection (Correct answer)
- To process medical bills from treating physicians
- To calculate bodily injury settlement ranges
- To generate depreciation schedules for contents
Correct answer: To measure roof dimensions and assess storm damage remotely without a physical inspection
Aerial imagery platforms provide high-resolution overhead photos and precise measurements, allowing adjusters to assess roof damage and scope repairs remotely.
Question 4: When an adjuster uses optical character recognition (OCR) technology in claims handling, what task does it primarily automate?
- Converting scanned paper documents into searchable, editable digital text (Correct answer)
- Photographing vehicle damage at the scene
- Calculating liability percentages
- Sending automated status updates to claimants
Correct answer: Converting scanned paper documents into searchable, editable digital text
OCR software reads text from scanned images or PDFs and converts it into machine-readable data, eliminating manual data entry for documents like medical records or repair invoices.
Question 5: What is the function of a 'reserve diary' feature in a claims management platform?
- To schedule periodic reviews of reserve adequacy and flag files for supervisory attention (Correct answer)
- To photograph property damage on a set schedule
- To automatically deny claims exceeding a reserve threshold
- To generate policy renewal notices
Correct answer: To schedule periodic reviews of reserve adequacy and flag files for supervisory attention
A reserve diary prompts adjusters and supervisors to revisit open reserves at set intervals to ensure they remain adequate as claim facts develop.
Question 6: Which type of software helps an adjuster identify when a claimant's injury treatment costs deviate from established medical guidelines?
- Medical bill review (MBR) or bill audit software (Correct answer)
- Subrogation recovery platform
- Contents replacement cost estimator
- Litigation management software
Correct answer: Medical bill review (MBR) or bill audit software
Medical bill review software compares submitted healthcare charges against fee schedules and clinical guidelines to detect overbilling or unbundled procedures.
Question 7: A digital claims file contains a chain-of-custody log. Why is maintaining an unbroken chain of custody important in claims software?
- It ensures evidence admissibility and protects against allegations of file tampering in disputed claims (Correct answer)
- It speeds up payment processing by routing files automatically
- It generates replacement cost values for contents
- It synchronizes data between the adjuster's tablet and the server
Correct answer: It ensures evidence admissibility and protects against allegations of file tampering in disputed claims
An unbroken chain of custody demonstrates that digital evidence has not been altered, which is essential if the claim proceeds to litigation or arbitration.
CA Digital Tools & Software 3
What does an integrated payment portal within a claims system allow insurers to do that traditional check processing does not?