Claims Executive

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10+ Claims Executive Interview Questions and Answers

Updated 20 Feb 2025

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Q1. Procedure how you do Survey ?? If there is scratch on headlight but insured demanding then what will you do and damages are relvant with cause of loss.

Ans.

The survey procedure involves assessing damages and determining their relevance to the cause of loss.

  • Conduct a thorough inspection of the damaged headlight

  • Document the scratch and its location

  • Review the policy terms and conditions to understand coverage

  • Assess the cause of loss and determine if the scratch is relevant

  • Consider any applicable deductibles or exclusions

  • Communicate with the insured to explain the findings and decision

  • Provide options for repair or replacement if nec...read more

Q2. Types of engines,which is better diesel or petrol,reson .basic components in car

Ans.

Diesel engines are more fuel-efficient and have higher torque, while petrol engines are smoother and quieter.

  • Diesel engines are more suitable for heavy-duty vehicles and long-distance driving.

  • Petrol engines are better for city driving and shorter distances.

  • Basic components in a car include engine, transmission, suspension, brakes, and steering.

  • Other components include fuel system, exhaust system, electrical system, and cooling system.

Q3. What is the difference cash less or zipser

Ans.

Cashless and Zipser are two different methods of payment for insurance claims.

  • Cashless refers to a payment method where the insured does not have to pay upfront and the insurance company settles the bill directly with the service provider.

  • Zipser, on the other hand, is not a commonly known term in the insurance industry. It might be a misspelling or a specific term used in a particular context.

  • Without further information, it is difficult to provide a detailed comparison betwee...read more

Q4. what you know about insurance in specificaly about health insurance

Ans.

Health insurance covers medical expenses incurred by the policyholder.

  • Health insurance provides financial protection against medical expenses.

  • It covers expenses related to hospitalization, surgery, and medical treatments.

  • Premiums are paid by the policyholder to the insurance company.

  • The policyholder can choose from different types of health insurance plans, such as HMO, PPO, and POS.

  • The policy may have deductibles, copayments, and coinsurance.

  • The Affordable Care Act (ACA) man...read more

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Q5. What you know about processs of reimbursement

Ans.

Reimbursement process involves submitting claims for payment of services or expenses incurred.

  • Reimbursement process starts with submitting a claim form with necessary documentation.

  • The claim is then reviewed by the insurance company or employer to determine eligibility.

  • Once approved, the reimbursement is processed and payment is issued to the claimant.

  • Examples of reimbursement include medical expenses, travel expenses, and work-related expenses.

Q6. Experience in automobiles because I done diploma in Automobiles

Ans.

I have a diploma in Automobiles and have gained experience through internships and personal projects.

  • I have completed a diploma in Automobiles which has given me a strong foundation in the field.

  • I have gained practical experience through internships at automobile companies.

  • I have also worked on personal projects such as restoring a vintage car.

  • I keep myself updated with the latest developments in the automobile industry through reading and attending workshops.

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Q7. what are motor add-on covers?

Ans.

Motor add-on covers are additional insurance options that provide extra protection for vehicles.

  • Motor add-on covers are optional insurance policies that can be added to a basic motor insurance policy.

  • These covers provide additional protection and benefits beyond the standard coverage.

  • Examples of motor add-on covers include zero depreciation cover, engine protection cover, roadside assistance cover, etc.

  • Zero depreciation cover ensures that the insured receives the full claim a...read more

Q8. Explain the member cashless claim mandatory documents?

Ans.

Member cashless claim mandatory documents include ID proof, policy card, and hospital pre-authorization form.

  • ID proof (such as Aadhar card, passport, or driver's license)

  • Policy card issued by the insurance company

  • Hospital pre-authorization form filled and signed by the treating doctor

  • Any other relevant medical documents like diagnostic reports or prescriptions

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Q9. What is the process in claim

Ans.

The claim process involves several steps to assess and settle insurance claims.

  • 1. Notification: The insured party notifies the insurance company about the claim.

  • 2. Documentation: The insured provides all necessary documents and information related to the claim.

  • 3. Investigation: The insurance company investigates the claim to determine its validity and coverage.

  • 4. Evaluation: The claim is evaluated based on policy terms, coverage limits, and applicable deductibles.

  • 5. Settlemen...read more

Q10. What you know about Health insurance ?

Ans.

Health insurance is a type of coverage that pays for medical and surgical expenses incurred by the insured.

  • Health insurance helps individuals and families cover the cost of medical treatments and services.

  • It can include coverage for doctor visits, hospital stays, prescription medications, and preventive care.

  • Health insurance plans can vary in terms of coverage, cost, and network of healthcare providers.

  • Employers often offer health insurance as part of their benefits package t...read more

Q11. How any types in claims?

Ans.

There are several types of claims including property, liability, auto, health, and workers' compensation.

  • Property claims involve damage to physical property such as homes or vehicles.

  • Liability claims involve someone being held responsible for causing harm or injury to another person.

  • Auto claims involve damage to vehicles and injuries sustained in car accidents.

  • Health claims involve medical expenses and treatments covered by insurance.

  • Workers' compensation claims involve injur...read more

Q12. what is insurance claim ?

Ans.

An insurance claim is a formal request made by a policyholder to an insurance company for coverage or compensation for a covered loss or policy event.

  • A claim is typically submitted by the policyholder or their representative to the insurance company.

  • The insurance company then investigates the claim to determine the validity and extent of coverage.

  • If the claim is approved, the insurance company will provide compensation or benefits to the policyholder as outlined in the policy...read more

Q13. What's cashless claim

Ans.

Cashless claim is a process where the insured does not have to pay for medical expenses upfront, as the insurance company directly settles the bill with the healthcare provider.

  • Insured can avail medical treatment without paying upfront

  • Insurance company directly settles the bill with healthcare provider

  • Usually applicable for network hospitals

  • Requires pre-authorization from the insurance company

Q14. Explain customer service need ?

Ans.

Customer service is essential for addressing customer needs, resolving issues, and building loyalty.

  • Customer service is important for addressing customer inquiries and concerns in a timely and efficient manner.

  • It helps in resolving issues and complaints to ensure customer satisfaction and retention.

  • Good customer service can lead to repeat business and positive word-of-mouth referrals.

  • It plays a key role in building customer loyalty and trust in the company.

  • Providing excellent...read more

Q15. What is claims in insurance

Ans.

Claims in insurance refer to requests made by policyholders to receive compensation for covered losses or damages.

  • Claims involve the process of investigating, evaluating, and settling insurance claims.

  • Policyholders submit claims to their insurance company after experiencing a covered loss or damage.

  • Insurance adjusters assess the validity of the claim and determine the amount of compensation to be paid.

  • Claims can be related to various types of insurance such as auto, home, hea...read more

Q16. parts of vehicle

Ans.

Various parts of a vehicle include engine, transmission, brakes, tires, and suspension.

  • Engine

  • Transmission

  • Brakes

  • Tires

  • Suspension

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