West Virginia Adjusters Practice Exam

The "claims handling process" refers to the comprehensive series of steps that insurance companies follow from the moment a claim is submitted until a final resolution or settlement is achieved. This includes initial claim receipt, assessment of the claim, investigation of the circumstances surrounding the claim, determination of coverage, documentation, negotiation, and ultimately, settlement or denial of the claim.

This definition captures the entirety of what is involved in managing claims. It underscores the importance of thoroughness in addressing each phase of the claim, ensuring that all necessary information is gathered and evaluated fairly to reach an equitable outcome for the claimant.

In contrast, focusing solely on the investigation stage limits the scope of understanding necessary for successful claims handling. Addressing exclusionary practices pertains to specific terms within an insurance policy, which may not directly involve the actionable process of handling a claim. Lastly, the underwriting process relates to the assessment of risk and premium setting for new policies, which is separate from the claims process that occurs after a claim has been filed.