Download Guidewire Exam Questions and Answers: A Comprehensive Study Guide and more Exams Business Administration in PDF only on Docsity!
Guidewire part 2 179 Exam Test
Questions
Which of the following describes the unique approach Guidewire recommends for elaborating requirements when leveraging standard features? - Correct Answer
✔️ ✔️ Leverage functional requirements already available in user story cards
for standard Guidewire products as a starting point.
Who is responsible for driving the requirements elaboration workshop? - Correct
Answer ✔️ ✔️ Business Analyst (BA)
Identify the common pitfalls to avoid when elaborating requirements to maximize the value of Insurance Suite: - Correct Answer ✔️ ✔️ - Determining the
solution before the problem has been identified.
- Accepting a solution offered as a requirement
- Asking questions that do not solicit details
- Allowing personal filters to influence requirements or solutions
- Assuming the requirement is correct or needed
ClaimCenter internal user types - Correct Answer ✔️ ✔️ ClaimCenter is a
browser-based application that enables users to participate in claims processing.
The most common internal user types of ClaimCenter at a carrier are Claim Service
Representatives (CSRs) who create claims for the insured, Adjusters who manage the claims, and Supervisors who supervise and approve work.
The value proposition of ClaimCenter - Correct Answer ✔️ ✔️ ClaimCenter is
a claim-centric solution. All the data pertaining to a claim is centralized in the claim file. This includes information on policies, financials, diaries, documents, parties involved, litigation, and so on. ClaimCenter users have an integrated and holistic view of the claim.
ClaimCenter facilitates collaboration among claims workers. It provides one centralized location where all information needed to adjudicate the claim can be worked on and shared.
The New Claim Wizard (NCW) - Correct Answer ✔️ ✔️ The New Claim
Wizard is the starting point for creating claims in ClaimCenter. It guides the user through the creation of a claim.
Since it is Line of Business aware, the wizard adapts to the
rosuits tinat he winaidacaptules
only the data specific to the Line of Business claim type. For example, the data gathered for a property claim is different from the data required for an auto claim.
The Claim Summary has three sections. - Correct Answer ✔️ ✔️ - The Basics section shows how long the claim has been open and the target days for a claim of this type to be closed or completed. It also includes a description of the claim.
- The Financials section gives a high-level view of the current state of the financials for this claim. It shows the Gross incurred, which is a summary of the recorded exposures and reserve lines, as well as what has been paid on the claim to date.
- The High-Risk Indicators section shows any high-risk indicators such as in litigation, coverage in question, or other flags. An adjuster can quickly see if there are any issues that must be addressed.
Loss Details - Correct Answer ✔️ ✔️ During the adjudication process an adjuster may add information to the claim. The changes could range from adding a witness, to adding additional claimants. The Loss Details screen is where an adjuster would add or change details on the claim. Some of the information they may be changed or added on this screen are:
*Fault Rating - Used to determine who has the liability for the damage. This impacts who is responsible for paying losses
*Loss location - Used to record where the loss occurred and may impact whether the loss is a covered event.
*Notification and Contact - Who reported the claim, and who the carrier should contact about issues concerning the claim.
*Officials records - Any government officials, such as police officers, who were Involved in the loss and/or may have information about what occurred
dajuster may not nave me aumnoniv o create a transaction for $50,000 without a supervisor's approval. If a transaction requires additional approval, it is put in a pending approval state. If a transaction does not require approval, it is acted upon Immediately
Reassigning objects - Correct Answer ✔️ ✔️ When a claim is reassigned, all exposures and activities belonging to the original owner are also reassigned to the new owner. Any exposure or activity belonging to a user other than the clains owner remains with that user. In this example, the claim and the first exposure are reassigned to Isabel Harkin. The second exposure is not reassigned because Betty Baker was not the owner of the exposure.
What does an end user need to access a Guidewire application? - Correct
Answer ✔️ ✔️ A supported web browser and a valid username and password.
When a user attempts to log into ClaimCenter, what three pieces of information does the application attempt to determine? - Correct Answer ✔️ ✔️
Whether or not the user can be authenticated, what are the user's roles
(permissions), and what is the user's startup page.
What is one thing that determines what data is gathered on a claim intake screen? - Correct Answer ✔️ ✔️ The type of claim (personal auto,
homeowners, worker's comp.)
What is the purpose of an exposure? - Correct Answer ✔️ ✔️ An exposure is used to track potential payments on one coverage, for one claimant.
What are two mechanisms used to determine if a transaction requires approval? - Correct Answer ✔️ ✔️ Authority limits and transaction approval rules are
used to identify which transactions require approval.
Lesson objectives - Claims Maintenance - Correct Answer ✔️ ✔️ - Describe
the major parts of a claim
- Use the full search capability of ClaimCenter
- Describe the information available on theClaim Summary
- Navigate to Claim details from the ClaimSummary
- Describe what a supervisor does
Policy and coverages - Correct Answer ✔️ ✔️ In the insurance industry, a
Policy is a contract between the insurer and the insured. In the contract, the
information may be gathered at a later time, but ideally an intake process captures all information about the 'who' on a claim. Each contact involved in a claim must
have one or more roles on the claim, such as a reporter, claimant, witness, doctor, attorney, repair shop, and so on.
Contacts may be thought of as being involved in the loss, such
as an injured person or a company whose property has been lost or damaged, or involved in providing services related to the loss, such as auto service vendors, property restoration or repair vendors.
Incidents - Correct Answer ✔️ ✔️ In insurance terms, an incident is the 'what' that was lost or damaged. Incidents are typically captured when the claim is first created. Some information about incidents may need to be gathered later, but the ideal scenario involves an intake process where all the information about the what is captured. If an incident is defined as "an item that suffered damage", then in a claim where a person is hurt, the incident would be called a "body incident". However, the term
"injury incident" is commonly used in the industry and has been adopted by ClaimCenter.
Service requests - Correct Answer ✔️ ✔️ Service requests are created when
the claim is initiated and saved, or after initial claim creation. When services are created in ClaimCenter, they are automatically submitted to vendors through a vendor portal.
The service request can be for a
quote to compare prices. a service to be performed, or both a quote and service. The vendor can start work immediately, specify a time frame for completion, delay the request, or decline the request. Typically, a service is tied to an incident such as requesting locksmith services
for a lourolanzed home or requesting a vehicle damage assessment for one or more damaged vehicles. Each incident may have any number of services
Exposures - Correct Answer ✔️ ✔️ For many claims, a single loss
occurrence involves more than one coverage and more than one claimant. Exposures are the mechanism used by ClaimCenter to track the progress of each possible indemnity. An indemnity is a payment in compensation for a loss. In
are tied to specific actions. For example, when an auto claim is created. the business rules create an activity which is assigned to the claim owner to contact the insured.
Documents - Correct Answer ✔️ ✔️ A ClaimCenter document is either an electronic file or a physical piece of paper which contains information relevant to the claim.
Documents can be a First Report of Injury, Notification of Pending Inspection, Affidavit of Vehicle Theft, images of damage, and so on. ClaimCenter keeps electronic documents internally and retains information about where the physical document is stored.
Notes - Correct Answer ✔️ ✔️ A note is a detailed record of the actions or
thought process behind the processing of a claim
Notes enable users to record information about a claim and associate it with the relevant part of the claim. Notes can be attached to the claim itself, a contact on the claim, or an exposure without having to tie the note to a specific date or user.
For security, robust visibility rules
contro who can view or edit the note. Notes may be manually created by users or generated automatically by ClaimCenter.
Matters - Correct Answer ✔️ ✔️ A matter tracks information about a single
lawsuit or potential lawsuit related to a claim. Matters may have a very long life and are designed to track all aspects of a (potential) lawsuit. Matters track information such as case numbers, court dates, primary attorneys, and other details.
Reserve lines - Correct Answer ✔️ ✔️ A reserve line consists of the funds set
aside for one specific aspect of exposure processing. A reserve line contains both credits - money set aside to pay the exposure and debits - money paid out for the exposure. At any point in time, the value or size of the reserve line is the credits minus the debits. An exposure may have a single reserve or several reserve lines if there are multiple "sets" of money for different purposes. For example, an exposure for a collision coverage could have separate reserve lines for auto body damage and glass damage because the insurer tracks these two types of payments separately.
Checks - Correct Answer ✔️ ✔️ ClaimCenter uses the term
- This will open a command prompt window. Several messages related to ClaimCenter's startup appear in the window. When the steps are finished, you will see the following message in the command prompt window.
******ClaimCenter ready******
Leave the command window open (minimize if needed.
It is easy to miss the ready" message, because
ClaimCenter continues to process activities after displaying the notice. If you have waited three minutes or more without seeing the message, go to step 4 and open Chrome. The percentage will remain at 0%, it may be disregarded.
- Open Chrome from the bottom bar of the VM
- In the browser, connect to the following URL:
http://localhost:8080/cc/Claim
Center.do
- When you are finished working on training for the day, you must manually stop the application server.
To stop the ClaimCenter server, click the Stop ClaimCenter shortcut in the folder ClaimCenter Shortcuts This will open a command prompt window to shutdown ClaimCenter.
Basic organizational structure - Correct Answer ✔️ ✔️ Groups:
ClaimCenter organizes an insurer's employees (the people available to handle claims), through groups. Groups may have subgroups. For example, a parent group can have one or more child groups. Groups usually have users, the people who work on the claims. Groups are often defined to mirror the insurers' organizational structure For example, a main office has departments consisting of divisional offices that direct the local offices. Since groups are used in the assignment stage, they should be created to reflect how the insurer assigns work to its employees.
Users:
Users are people who are permitted to log into ClaimCenter.
They are involved with the process of settling claims. The goal of assignment is to assign work to users, which makes the users the owners of that work.
Groups - Correct Answer ✔️ ✔️ Groups generally consist of users that
perform similar tasks. For example, an Auto group consists of users who work on Auto-related claims. The groups are also hierarchical; each group must have only one parent. The exception is the top level or root organization. Groups are used in a variety of ways within ClaimCenter. They are used in automatic assignment logic, to help determine access to claim obiects. to supply supervisors with an overview of the assignments and tasks within the group, and to determine how approval activities are routed.
Groups have a type, for example, auto, workers' comp, subrogation, legal, and others, and may have one or more regions indicating the geographic areas they serve.
Group Type and Region can be used in the rules to determine how work is assigned.
Users in groups - Correct Answer ✔️ ✔️ Groups can only belong to one other group or have one parent.
Western Auto Adjusters can have only one parent. In this example, the parent is Western Regional Adjusters. However, a user can belong to multiple groups. For example, Leroy Martel and Irvin Hickman each belong to two groups. When a user
belongs to two or more groups, they may be assigned objects from all of the groups to which they belong.
In a typical implementation of ClaimCenter, the majority of the groups reflect the reporting structure of the insurer. For most groups, the individuals of the group are all assigned to the same department and all report to the same supervisor. There may be a small number of groups which do not conform to that reporting structure, and instead reflect a common job responsibility shared by two or more individuals in different departments. These groups are sometimes referred to as "virtual" groups. They do not represent any aspect of the reporting structure. In the example above, the Western Fraud Auto Adjusters group is a virtual group. It contains two individuals, both of whom belong to other groups.
Auto claims which appear to be fraudulent are assigned to this group, regardless of their complexity level.
Assignment - Correct Answer ✔️ ✔️ Assignment is the act of selecting an
owner for an assignable object. An object is assigned to a group and a user, whether it's automatically or manually assigned. In the base application, there are six (6) assignable objects: Claim, Exposure, Activity, Service, Matter, and Subrogation.
