10+ Claims Executive Interview Questions and Answers

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

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.

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

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

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.

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

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

A claim handler processes insurance claims, ensuring accurate assessment and timely resolution for policyholders.

• Review and assess claims submitted by policyholders for validity and coverage.

• Investigate claims by gathering necessary documentation, such as medical records or police reports.

• Communicate with clients to explain the claims process and gather additional information.

• Negotiate settlements with clients or third parties based on policy terms and conditions.

• Maintain det...read more

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

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

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

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

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

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

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

• Engine

• Transmission

• Brakes

• Tires

• Suspension