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
Which of the following is an example of a 'hard' diary as opposed to a 'soft' diary?
Answer: A court-ordered response deadline that cannot be extended without judicial approval
A hard diary is tied to a fixed, non-negotiable deadline such as a court date or statute of limitations, unlike a soft diary which is a flexible reminder.
What is the primary function of a 'roundtable' or 'unit review' in claims management?
Answer: To collectively review selected files for quality, strategy alignment, and reserve adequacy
Roundtable reviews bring together adjusters and supervisors to evaluate file quality, reserve appropriateness, and claims strategy on selected cases.
An adjuster discovers during a file review that a subrogation opportunity was identified 18 months ago but never pursued. What is the FIRST step?
Answer: Assess whether the subrogation statute of limitations has run before taking any action
Before pursuing or abandoning subrogation, the adjuster must determine whether the applicable statute of limitations still permits recovery.
When reviewing a file for reserve adequacy, which factor should the adjuster weigh MOST heavily for a future medical cost projection?
Answer: Medical cost inflation trends, treatment plan prognosis, and life care plan projections
Accurate future medical reserves require analysis of medical inflation, the treating physician's prognosis, and, for severe injuries, a life care plan.
Which diary management practice is specifically designed to prevent 'file aging' on open claims?
Answer: Implementing maximum diary intervals so files are reviewed at least every 30, 60, or 90 days
Maximum diary interval policies ensure no file sits unreviewed beyond a set period, preventing neglect and file aging.
A file review on a homeowner's claim shows the adjuster failed to document the basis for a depreciation calculation. What is the risk?
Answer: The depreciation may be challenged as arbitrary, exposing the insurer to bad faith allegations
Undocumented depreciation decisions create a bad faith exposure if challenged, as the insurer cannot demonstrate a reasoned basis for the deduction.
In a claims file review, what does 'three-point contact' documentation refer to?
Answer: Contact with the insured, claimant, and witness within a set timeframe of opening the claim
Three-point contact requires documented outreach to the insured, claimant, and a witness (or reporting party) early in the claim handling process.