Claims Management Software Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Claims Management Software flashcards as text
Which feature in claims management software automatically assigns incoming claims to adjusters based on workload and expertise?
Answer: Auto-assignment engine
An auto-assignment engine distributes claims intelligently based on adjuster capacity, skill set, and claim type.
What does an SLA (Service Level Agreement) tracking module in claims software primarily monitor?
Answer: Time-bound response and resolution deadlines
SLA tracking ensures claims are acknowledged, evaluated, and resolved within contractually or regulatorily mandated timeframes.
In a claims management system, what is the purpose of a 'diary' or 'bring-forward' function?
Answer: To schedule future follow-up actions on a claim
A diary or bring-forward function alerts adjusters to take specific actions on a claim at a future scheduled date.
Which integration capability allows claims software to pull real-time vehicle valuation data during auto claims processing?
Answer: API connection to third-party valuation services
API integrations with valuation services like CCC or Mitchell allow real-time vehicle value lookups directly within the claims platform.
What is the function of a 'coverage verification' module in claims management software?
Answer: It confirms whether a policy was active and applicable at the time of loss
Coverage verification cross-references policy records to confirm the claimant had active, applicable coverage when the loss occurred.
Which reporting capability helps a claims manager identify adjusters who consistently exceed their average handle time?
Answer: Adjuster performance dashboard
An adjuster performance dashboard aggregates metrics like average handle time, closure rates, and reserve accuracy per adjuster.
In claims software, what does 'subrogation flagging' automate?
Answer: Identifying claims where the insurer may recover costs from a responsible third party
Subrogation flagging uses rules-based logic to tag claims where recovery from a negligent third party is legally possible.