CCP Diary Management & File Review 2 — Questions and Answers
Question 1: When a diary entry is missed and a deadline passes unnoticed, which corrective action should the adjuster take FIRST?
- Close the file immediately
- Document the missed diary, assess any prejudice to the claim, and notify a supervisor (Correct answer)
- Backdate the diary entry to reflect the original date
- Transfer the file to another adjuster without notation
Correct answer: Document the missed diary, assess any prejudice to the claim, and notify a supervisor
The adjuster must document the oversight, evaluate any harm caused, and escalate per company protocol.
Question 2: Which of the following best describes a 'suspense diary' in claims handling?
- A diary used only for denied claims
- A future-dated reminder to follow up on a specific action or response (Correct answer)
- A log of all payments made on a file
- A record of claimant contact attempts
Correct answer: A future-dated reminder to follow up on a specific action or response
A suspense diary is a tickler system that prompts the adjuster to act on a file by a specified future date.
Question 3: During a file review, the examiner notices coverage was never formally confirmed in writing. What is the appropriate response?
- Assume coverage exists and continue adjusting
- Issue a denial immediately
- Obtain a coverage confirmation letter or reservation of rights letter before proceeding (Correct answer)
- Close the file pending policyholder response
Correct answer: Obtain a coverage confirmation letter or reservation of rights letter before proceeding
Coverage must be formally documented via confirmation or a reservation of rights before further claim handling.
Question 4: How often should diary intervals typically be set for a litigated claim compared to a routine property claim?
- More frequently, due to court deadlines and attorney activity (Correct answer)
- Less frequently, because attorneys handle all activity
- At the same interval as non-litigated claims
- Only at the time of trial
Correct answer: More frequently, due to court deadlines and attorney activity
Litigated claims have court schedules, discovery deadlines, and attorney filings that require shorter, more frequent diary intervals.
Question 5: A file review reveals the adjuster has not documented any contact with the claimant in 90 days. What does this most likely indicate?
- The claim is ready for closure
- A diary control failure or lack of proactive claims management (Correct answer)
- The claimant is represented by counsel
- The claim is subrogated
Correct answer: A diary control failure or lack of proactive claims management
A 90-day gap in contact documentation suggests inadequate diary management and failure to proactively advance the claim.
Question 6: Which metric is MOST useful when supervisors conduct periodic file reviews to evaluate adjuster performance?
- Number of claims denied
- Reserve adequacy and diary compliance rate (Correct answer)
- Total payments made
- Number of new claims opened
Correct answer: Reserve adequacy and diary compliance rate
Reserve accuracy and diary compliance directly reflect the quality of a file's management and the adjuster's technical skill.
Question 7: What is the primary risk of setting diary intervals that are too long on a bodily injury claim?
- Overpayment of the claim
- Missed statute of limitations, delayed treatment updates, or stale evidence (Correct answer)
- Duplicate payments to the claimant
- Excess reserves on the file
Correct answer: Missed statute of limitations, delayed treatment updates, or stale evidence
Infrequent diaries on bodily injury files risk missing critical deadlines and allowing evidence or medical records to become outdated.
CCP Diary Management & File Review 2
When a diary entry is missed and a deadline passes unnoticed, which corrective action should the adjuster take FIRST?