Weeks 12 & 13 Quiz (Premium Offset, Stop Pymts, Double Insured, Efw, Utility Claims, Pd Limit Reached) - August Quiz

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| By Jblack68
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Quizzes Created: 2 | Total Attempts: 203
| Attempts: 89
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  • 1/15 Questions

    Which of the following needs to be completed by the insured if the accident occurred in NYS which caused a fatality, personal injury or damage over $1,000 to the property of any one person?

    • S18
    • MV-296
    • MV-104
    • SVB
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About This Quiz

This quiz for August covers key operational procedures in insurance claims processing, including premium offsets, stop payments, and handling of double-insured files. It assesses understanding of specific protocols such as ARP shop payments and the timing for stop payment processing, enhancing proficiency in claims examination.

Weeks 12 & 13 Quiz (Premium Offset, Stop Pymts, Double Insured, Efw, Utility Claims, Pd Limit Reached) - August Quiz - Quiz

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  • 2. 

    Which letter is sent to the insured if the Property Damage limit will be exhausted?

    • S18

    • L5

    • EXL1

    • L42A

    Correct Answer
    A. EXL1
    Explanation
    EXL1 is the correct answer because it refers to the letter that is sent to the insured when the Property Damage limit will be exhausted. The other options do not indicate any specific letter or correspondence related to the exhaustion of the Property Damage limit.

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  • 3. 

    The S18 does not get sent on double-insured files; however, the L74A is generated under each claim if needed.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The statement is true because it states that the S18 does not get sent on double-insured files. This means that the S18 form, which is likely a specific document or process, is not required for cases where there is double insurance coverage. On the other hand, the statement also mentions that the L74A is generated under each claim if needed. This implies that the L74A form, which could be another document or process, is only generated when necessary. Therefore, the correct answer is true.

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  • 4. 

    Administrative fees are not a covered expense when a utility claim is presented.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Administrative fees are not considered as a covered expense when a utility claim is presented. This means that if someone files a claim for a utility expense, such as a water or electricity bill, any administrative fees associated with that bill will not be reimbursed or covered by the claim. Therefore, the statement "Administrative fees are not a covered expense when a utility claim is presented" is true.

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  • 5. 

    Premium Offsets are not taken when making a direct payment to an ARP shop. 

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Premium Offsets are not taken when making a direct payment to an ARP shop. This means that when a direct payment is made to an ARP shop, any premium offsets that may have been available are not applied or deducted from the payment. In other words, the payment made to the ARP shop is not reduced by any premium offsets that the individual may have. Therefore, the statement "Premium Offsets are not taken when making a direct payment to an ARP shop" is true.

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  • 6. 

    Currently, our BP is to ask for photos on campers, non-vehicle or truck claims (trailers, dump trucks, etc) as these cannot be submitted through the Quick Estimate link. 

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The given statement suggests that currently, the company is requesting photos for campers, non-vehicle, or truck claims such as trailers and dump trucks. These types of claims cannot be submitted through the Quick Estimate link. Therefore, the statement is true.

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  • 7. 

    What type of claims get pended to EFW for review? (check all that apply)

    • Files with 3 or more fraud indicators

    • Deer claims

    • Vandalism claims

    • Theft Claims

    • Fire claims

    Correct Answer(s)
    A. Files with 3 or more fraud indicators
    A. Vandalism claims
    A. Theft Claims
    A. Fire claims
    Explanation
    Claims that get pended to EFW for review include files with 3 or more fraud indicators, vandalism claims, theft claims, and fire claims.

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  • 8. 

    How long does NYCM wait before processing stop payments on checks not received by the customer assuming the address was correct at the time of payment.

    • 2 days

    • 5 days

    • 2 weeks

    • 1 month

    Correct Answer
    A. 2 weeks
    Explanation
    NYCM waits for 2 weeks before processing stop payments on checks not received by the customer assuming the address was correct at the time of payment. This is likely because they allow a reasonable amount of time for the customer to receive the check before taking action to stop the payment. Waiting for 2 weeks gives the customer ample time to receive the check and report any issues or non-receipt to NYCM.

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  • 9. 

    Before applying the premium offset, the Claims Examiner is to confirm with the ____________ department that payment has not be received.

    • Accounts Dept.

    • Underwriting Dept.

    • Claims Dept.

    • Re-insurance Dept.

    Correct Answer
    A. Accounts Dept.
    Explanation
    Before applying the premium offset, the Claims Examiner needs to confirm with the Accounts Department that payment has not been received. This is important because the premium offset is a process where any outstanding claims are deducted from the premium owed by the insured. By checking with the Accounts Department, the Claims Examiner ensures that the payment has not already been received, preventing any errors or double payments. The Accounts Department is responsible for managing the financial transactions and records of the company, including payments received.

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  • 10. 

    To satisfy Regulation 64, payments must be added to ISO when the damage to the vehicle is under $2,500 and the vehicle is current model year and the preceding 6 model years.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    To satisfy Regulation 64, payments must be added to ISO only when the damage to the vehicle is under $2,500 and the vehicle is a current model year or one of the preceding 6 model years. This means that if the damage exceeds $2,500 or the vehicle is older than the preceding 6 model years, payments do not need to be added to ISO to comply with Regulation 64.

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  • 11. 

    When should ISO be updated? (check all that apply)

    • Any time a payment is made for insd/clmt vehicle damage

    • New claimant info is received

    • Vehicle info is received

    • When NYCM is retaining insured's total loss vehicle

    Correct Answer(s)
    A. Any time a payment is made for insd/clmt vehicle damage
    A. New claimant info is received
    A. Vehicle info is received
    A. When NYCM is retaining insured's total loss vehicle
    Explanation
    ISO should be updated any time a payment is made for insured/claimant vehicle damage, when new claimant information is received, when vehicle information is received, and when NYCM is retaining insured's total loss vehicle.

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  • 12. 

    When requesting a stop payment on a check, a stop payment slip should be completed and submitted the same day the request is made.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The explanation for the answer "False" is that while it is important to request a stop payment on a check as soon as possible, it is not necessary to complete and submit a stop payment slip on the same day the request is made. The timeframe for submitting the stop payment slip may vary depending on the bank's policies, but it is typically within a few business days of the request.

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  • 13. 

    Which of the following is permissible by the examiner regarding utility claims? (check all that apply)

    • Pay 100% of the claim as soon as claim is received

    • Contact billing provider to negotiate the charges

    • Pay our insured's % of negligence as soon as claim is received

    • If negotiations fail, review with a supervisor for approval to send to Comsearch

    • Pay the administrative fee included in the demand

    Correct Answer(s)
    A. Contact billing provider to negotiate the charges
    A. If negotiations fail, review with a supervisor for approval to send to Comsearch
    Explanation
    The examiner is allowed to contact the billing provider to negotiate the charges and if the negotiations fail, they can review the case with a supervisor for approval to send it to Comsearch.

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  • 14. 

    Check all that apply regarding double insured files:

    • No deductibles are taken from any of the insureds involved

    • A second claim should be set up under the other insured's policy

    • The Certificate of Repair is generated under each file; however, may be sent under the "at fault" party's file. 

    • Add an IDMG note indicating the file is a double insured file.

    Correct Answer(s)
    A. No deductibles are taken from any of the insureds involved
    A. A second claim should be set up under the other insured's policy
    A. The Certificate of Repair is generated under each file; however, may be sent under the "at fault" party's file. 
    A. Add an IDMG note indicating the file is a double insured file.
    Explanation
    Double insured files refer to situations where there are multiple insurance policies that cover the same loss or damage. In such cases, no deductibles are taken from any of the insureds involved, meaning that none of the policyholders have to pay a deductible for their claim. Additionally, a second claim should be set up under the other insured's policy, ensuring that both policies are utilized to cover the loss. The Certificate of Repair is generated under each file, but it may be sent under the "at fault" party's file, indicating that the responsible party's insurance may handle the paperwork. Lastly, it is important to add an IDMG note indicating that the file is a double insured file, to ensure proper handling and coordination between the insurers involved.

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  • 15. 

    Be sure to send the L74A to the claimant when a summons & complaint has been received as the first notice of a loss.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The correct answer is False. The statement suggests that the L74A should be sent to the claimant when a summons and complaint has been received as the first notice of a loss. However, this is incorrect. The L74A form is typically used to report a loss to the insurance company, not to the claimant. Therefore, the correct action would be to send the L74A form to the insurance company, not the claimant.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 07, 2019
    Quiz Created by
    Jblack68
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