CCP Diary Management & File Review 3

Question 1

What should a claims adjuster do when they receive a file during reassignment that contains no diary entries?

Accepted Answer

Immediately set a diary, review the file status, and document outstanding actions

Answer

Upon receiving a diary-less file, the new adjuster must establish control by reviewing status and setting immediate follow-up dates.

Question 2

During a file review, an examiner finds that reserves have not been updated in six months despite new medical bills. What is the likely root cause?

Accepted Answer

Diary failures that led to missed reserve evaluation opportunities

Answer

When reserves are not updated despite new financial information, it typically traces back to inadequate diary controls and missed review triggers.

Question 3

A claims professional sets a 30-day diary for a workers' compensation file awaiting a physician's report. The report arrives in 10 days. What is the BEST practice?

Accepted Answer

Pull the diary forward and act on the report immediately

Answer

Best practice is to advance the diary and act on newly received information promptly rather than waiting for the original trigger date.

Question 4

Which document type is MOST important to include in the initial file review checklist for a commercial general liability claim?

Accepted Answer

Certificate of insurance and endorsements confirming coverage scope

Answer

Confirming coverage scope via the certificate and endorsements is foundational to any CGL claim review.

Question 5

What is the purpose of a 'critical path' diary system in complex claims?

Accepted Answer

To map key milestones and set diaries aligned with each phase of claim resolution

Answer

A critical path diary maps the major milestones of a complex claim and ensures timely action at each phase.

(CCP) Certified Claims Professional Practice Test

(CCP) Certified Claims Professional Practice Test

CCP Diary Management & File Review 3