Diary Management & File Review 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 Diary Management & File Review flashcards as text
What is the best practice when an adjuster goes on extended leave and has open files with active diaries?
Answer: Transfer files to a covering adjuster who reviews all diaries and sets appropriate follow-ups
File transfer protocols require the covering adjuster to review all active diaries and ensure no deadlines are missed during the absence.
Which of the following is a key indicator that a file is ready for closure review?
Answer: All payments have been issued, all liens resolved, and a signed release obtained
A file is closure-ready when all financial obligations are met, liens satisfied, and a binding release executed.
How does the 'SMART' framework apply to diary management in claims?
Answer: Diary entries should be Specific, Measurable, Achievable, Relevant, and Time-bound
Applying SMART criteria to diary entries ensures each follow-up is clearly defined, actionable, and tied to a concrete deadline.
During a file review on a property damage claim, the adjuster notes the insured submitted a sworn proof of loss that has not been reviewed in 45 days. What is the MOST urgent concern?
Answer: Many states impose a statutory deadline for the insurer to accept or reject a proof of loss, which may have been missed
State insurance codes commonly mandate that insurers respond to a sworn proof of loss within a specified period, and missing that deadline can trigger statutory penalties.
What is the significance of documenting 'action taken' versus 'action pending' in a diary note?
Answer: It distinguishes completed steps from outstanding obligations, clarifying the file's current status for any reviewer
Separating completed actions from pending ones gives any reviewer an instant, accurate picture of where the claim stands and what still needs to happen.
An examiner conducting a quality review rates a file as 'unsatisfactory' due to reserve discrepancies. Which corrective action is MOST appropriate?
Answer: Meet with the adjuster to review the basis for reserves, correct the reserve, and document the reason for the change
Reserve discrepancies require direct adjuster coaching, an updated reserve with documented rationale, and corrective action documentation.
Which of the following is the MOST appropriate use of a 'follow-up' diary in a denied claim file?
Answer: To monitor for any appeal, suit, or regulatory complaint filed by the claimant after denial
Even after denial, a follow-up diary ensures the insurer is prepared to respond to any appeal, lawsuit, or regulatory complaint within required timeframes.