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Succeed Insurance handles a small volume of asbestos claims in their legacy system. These claims can remain open for many years to cover medical costs to claimants due to illnesses caused by exposure to asbestos in the workplace.
Succeed has the following requirements for paying these claims with the New Check Wizard:
. No indemnity (claim cost) payments can be made until a medical assessment of the claimant is completed.
. Expense payments can be made to cover Succeed's costs to process the claim.
Which feature in the base product can be extended to support both of these requirements?
A. Transaction approval rules
B. Financial holds
C. Claim Maturity Level - Ability to pay
D. Authority Limits
Answer: C
Explanation:
250 to 350 words From Exact Extract of Guidewire ClaimCenter Business Analyst documentation:
The requirement to block specific types of payments (Indemnity) while allowing others (Expenses) based on the status of claim data (Medical Assessment) is best handled by Validation Rules at the Ability to Pay level.
* Ability to Pay (Option D):In Guidewire ClaimCenter, the "Ability to Pay" is a specificValidation Level. When a user attempts to issue a check, the system runs a set of validation rules to ensure the claim has reached a sufficient level of maturity and data completeness. This is the "gatekeeper" for payments.
* How it works for this scenario:A Business Analyst can define a validation rule at the "Ability to Pay" level that states:"If the Payment Type is Indemnity AND the Medical Assessment is incomplete, then raise an error."
* Why it fits:This logic perfectly satisfies both requirements.
* It blocks Indemnity payments if the assessment is missing.
* It implicitly allows Expense payments to proceed because the rule only checks for Indemnity payments.
Why other options are incorrect:
* Authority Limits (A)control theamountof money a user can approve, not the prerequisites for payment.
* Transaction Approval Rules (B)are used to route checks for supervisory review based on criteria, not to block them entirely due to missing data.
* Financial Holds (C)are generally applied to a whole claim or exposure to suspendallpayments (or broadly all payments of a certain category). While possible to configure, they are less flexible than Validation Rules for checking specific data fields like "Medical Assessment" dynamically during the check wizard process.
NEW QUESTION # 38
When capturing information about a damaged vehicle, Succeed Insurance requires that the total distance driven (miles/km) for the vehicle be captured as well. What is the best practice for a Business Analyst (BA) to determine if ClaimCenter already has a field to capture distance driven?
A. Check the full view of the Data Dictionary to see if a relevant field exists on the Vehicle entity.
B. Start Guidewire Studio, search for a Vehicle Incident screen and review it for a relevant field.
C. Log in to ClaimCenter and review the Vehicle Incident screen to see if there is a relevant field.
D. Review the Guidewire ClaimCenter Application Guide for information on creating a vehicle incident.
Answer: A
Explanation:
The Data Dictionary is the definitive reference tool for Business Analysts to explore the data model of a Guidewire application.
* Best Practice:To determine if a specific data point (like "distance driven" or "odometer reading") exists in the system's schema, the BA should consult theData Dictionary. This auto-generated documentation lists all entities (such as Vehicle or VehicleIncident) and their associated fields (columns), along with data types and descriptions. This confirms existence even if the field is not currently exposed on the user interface.
* Why Option B is better than A:Checking the UI (Option A) is unreliable because a field may exist in the database but be hidden, disabled, or not placed on the specific screen the BA is viewing.
* Why Option B is better than C:The Application Guide (Option C) describes standard features and workflows but does not provide a granular, technical list of every database column, nor does it reflect any custom schema extensions added by the implementation team.
* Why Option B is better than D:While Guidewire Studio (Option D) is a powerful tool thatcanverify this, it is primarily a developer environment. For a Business Analyst, the Data Dictionary is the intended, accessible "Source of Truth" artifact for data modeling questions without requiring IDE access or technical code navigation.
NEW QUESTION # 39
Succeed Insurance allows field Adjusters to write checks directly to the insured to cover damage costs for minor claims such as:
* Personal auto claims involving cracked windshields
* Homeowners claims involving minor glass breakage
The Adjuster uses the Manual Check Wizard to record the check number and amount against a reserve line.
Succeed requires Supervisor approval for all manual checks to ensure that the paper checks are verified against the payment information in ClaimCenter.
Which two limits or rules must be configured in ClaimCenter to ensure that these manual payments are sent to the correct person for approval? (Choose two.)
A. Authority limits
B. Transaction approval rules
C. Approval routing rules
D. TransactionSet validation rules
Answer: A,B
Explanation:
To enforce an approval workflow for a specific type of financial transaction (like "Manual Checks") regardless of the dollar amount, a Business Analyst must leverage both Authority Limits and Transaction Approval Rules.
* Authority Limits (D):These are the primary controls for financial exposure. While typically used for amounts (e.g., "Limit of $5,000"), they are the foundational mechanism that triggers the system's
"Pending Approval" state. For this scenario, an authority limit could be set to $0 for the specific payment method of "Manual Check" to force all such payments into the approval workflow.
* Transaction Approval Rules (C):These rules allow for more granular, logic-based approval triggers beyond simple amounts. Since the requirement specifies "all manual checks" (implying a condition based on themethodof payment, not just the amount), aTransaction Approval Ruleis the best practice configuration. The rule would be written to state:"If Payment Method is Manual, then Approval is Required."
* Why not A (Approval Routing)?While Approval Routing rules determinewhoreceives the request (the
"correct person"), the default behavior in ClaimCenter is to route approvals to the user's Supervisor.
Since the requirement is simply "Succeed requires Supervisor approval," the standard routing logic likely suffices without needing new custom configuration. The critical configuration needed is the trigger(C and D) to stop the payment in the first place.
NEW QUESTION # 40
Succeed Insurance is implementing a slightly modified version of ClaimCenter to suit its organization's needs.
The modification will include adding two new required fields to the standard user interface to capture the reporter's Preferred Language and Preferred Contact Time. This requirement is critical for Succeed to improve efficiency and the expediency of claims processing in its region.
Under which ClaimCenter theme will the User Story Card be found for documenting these requirements?
A. Settle/Close
B. Intake
C. Adjudicate
D. Special Services
Answer: B
Explanation:
In the Guidewire implementation methodology, User Stories are categorized into Themes that align with the high-level business processes of the claim lifecycle.
* Intake (Option A):TheIntaketheme covers theFirst Notice of Loss (FNOL)process and the "New Claim Wizard." The requirement specified is to capture data regarding the "Reporter" (the person reporting the loss) and their contact preferences. In ClaimCenter, Reporter information is collected at the very beginning of the New Claim Wizard (Step 1: Search/Create Policy and Reporter). Because this data entry occurs during the initial setup of the claim, the User Story governing these UI changes belongs to theIntaketheme.
* Context:Improving "expediency of claims processing" often relies on accurate data capture at the Intake stage so that downstream assignment and communication can be handled correctly from the start.
Why other options are incorrect:
* Adjudicate (B):This theme covers the investigation, evaluation, and negotiation phases that occurafter the claim is created.
* Settle/Close (D):This theme covers the payment issuance and final closure of the file.
* Special Services (C):This typically refers to Vendor Management or specialized sub-processes, not the core FNOL reporter data.
NEW QUESTION # 41
Losses incurred because of an accident with other vehicles can be very large. Because of the risk of large losses, all claims must include both a police report and the details of any passengers in the vehicle, whether they sustained injuries or not. The claim must show whether there were passengers in the vehicle at the time of the accident. Succeed wants the ability to include a very detailed description of the loss event information on intake of the claim.
When the claim is created, Succeed wants to flag the claim with a reminder for the Adjuster to contact the insured.
There should be reminders for the Adjuster to complete the following items for every new claim created:
. Review any photographs of the accident
. Contact and Interview each passenger
. Collect statements from each witness
. Record the vehicle's mileage
Which business requirement is based on assumptions?
A. All claims must include both a police report and the details of any passengers in the vehicle, whether they sustained injuries or not.
B. There should be reminders for the Adjuster to complete the following items for every new claim created: collect statements from each witness.
C. When the claim is created, we want to flag the claim with a reminder for the Adjuster to contact the insured.
D. There should be reminders for the Adjuster to complete the following items for every new claim created: review any photographs of the accident.
Answer: D
Explanation:
In the context of business requirements analysis, an assumption is a statement that is accepted as true or certain to happen without proof.
* Why A is the correct answer:The requirement to generate a reminder to "review any photographs" for everynew claim assumes that photographs will be available for every accident. In reality, photos are not always taken or provided at the First Notice of Loss (FNOL). Creating a mandatory task for an optional piece of evidence is based on the assumption of data availability.
* Why D is incorrect:"All claims must include a police report..." is aBusiness Ruleor constraint. It is a mandatory condition imposed by the business ("must include") rather than an assumption about what is currently present.
* Why B is incorrect:Contacting the insured is a standard, universal step in the claims process that applies to every claim, so it is not considered an assumption.
NEW QUESTION # 42
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