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>> ClaimCenter-Business-Analysts Exam Guide <<
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NEW QUESTION # 36
Succeed Insurance needs the ability to associate a primary hospital with an injury incident if the injured party received treatment. When treatment is needed, the primary hospital name should display on the injury incident screen along with other details about the injury and treatment received.
The primary hospital should be added to the injury incident in one of the following ways:
. Select the name from a list of medical care organizations already associated with the claim.
. Enter the contact details directly in the incident.
. Search the Address Book from the incident to locate a hospital.
Which two requirements must be documented to associate the primary hospital with the claim? (Choose two.)
Answer: B,D
Explanation:
To implement the functionality of associating a specific contact (the "Primary Hospital") with an entity (the
"Injury Incident") in Guidewire ClaimCenter, two core configuration components are required:
* A new primary hospital role (Option B):In ClaimCenter, the relationship between a Contact and a Claim (or Incident) is defined by aRole. While the contact itself might be a "Medical Care Organization" (existing subtype), thecontextof its relationship to this specific incident is that it is the
"Primary Hospital". Defining this role allows the system to distinguish this hospital from other medical providers on the same claim.
* A new field on the incident screen (Option C):To allow the user to select, add, or view this contact, a UI element (specifically aClaim Contact Pickeror Input widget) must be added to the Injury Incident screen. This field will be configured to store the relationship and allows the user to perform the required actions: selecting from existing contacts (filtered by the role), entering new ones, or searching the Address Book.
Why other options are incorrect:
* A (New Subtype):The base product already includes the MedicalCareOrg contact subtype, which is sufficient to store hospital data. Creating a new subtype is unnecessary unless the data structure (fields) of a hospital is fundamentally different from other medical providers.
* D (Address Book Field):Contacts in the Address Book are typically identified by tags or their Subtype, not by adding a custom field just to identify them as a vendor/hospital.
NEW QUESTION # 37
An auto claim is owned by Adjuster1. The Customer Service Representative (CSR) that created the claim owns one follow-up activity on the claim. An Injury Specialist owns an injury exposure on the claim. All these persons are members of Auto Team 1.
The Team Lead determines that Adjuster1 is overworked and reassigns the claim to Adjuster2, a member of Auto Team 2.
Which three people now have access to the claim? (Choose three.)
Answer: B,C,E
Explanation:
250 to 350 words From Exact Extract of Guidewire ClaimCenter Business Analyst documentation:
In Guidewire ClaimCenter, access to a claim file is determined by Access Control Lists (ACLs), which are dynamically updated based on user roles and ownership. A user is granted access to a claim if they own the claim itself, or if they own a sub-object within that claim, such as an Activity or an Exposure.
* Adjuster2 (Option E):Upon reassignment, Adjuster2 becomes the newClaim Owner. The owner of the claim record always has full view and edit access to the claim.
* CSR (Option C):The CSR retains ownership of a specificActivity(the follow-up task). In the ClaimCenter security model, owning an open activity on a claim grants the user "view" access to the parent claim so they can perform the necessary work to complete their task. Reassigning the claim header does not automatically reassign the activities owned by other users.
* Injury Specialist (Option D):This user owns anExposure(a distinct financial sub-record for a specific coverage feature). Similar to activities, owning an exposure grants access to the parent claim. The reassignment of the main claim file from Adjuster1 to Adjuster2 does not strip the Injury Specialist of their ownership of the specific injury exposure.
Why Adjuster1 loses access:Adjuster1 was the previous owner. Once ownership is transferred to Adjuster2 (who is in a different group, "Auto Team 2"), Adjuster1 no longer meets the criteria for ownership access.
Unless Adjuster1 is explicitly added to the ACL manually or has "Super User" privileges (not stated), they lose the automatic access rights associated with being the owner.
NEW QUESTION # 38
Succeed Insurance has a strategic initiative to offer pay-as-you-drive personal auto insurance to compete with other large carriers. Customers who choose these policies must either own a vehicle that is equipped with a monitoring device or agree to install a device provided by Succeed. The monitoring device collects information about how the drivers of a covered vehicle drive, including how fast they drive, how hard they brake, and how many miles/kilometers the vehicle travels within a policy period.
This information is logged, and premiums are based on how the insured's driving behavior is categorized.
When a claim is reported, the log files must be obtained to analyze the information captured by the monitoring device at the time of the incident.
Succeed plans to collect and evaluate the Vehicle Monitoring Log files in the first implementation phase, which is scheduled for release in 60 days. The project sponsors have instructed the implementation team to use base product functionality over customization. Integration should be leveraged where possible to avoid manual data entry.
No payments can be made on the claim until a flag indicating that the Vehicle Monitoring Log file has been processed has been set to 'Yes'.
Which feature of the base product prevents payments from being made on the claim?
Answer: A
Explanation:
In Guidewire ClaimCenter, the Ability to Pay validation level is the specific "gatekeeper" designed to verify that a claim is mature enough and has sufficient data to allow financial transactions to be issued.
* Validation Levels:ClaimCenter uses validation levels (e.g., Load, New Loss, Ability to Pay) to enforce data integrity at different stages of the claim lifecycle.
* Blocking Payments:When a user attempts to create a check, the system triggers the rules associated with theAbility to Paylevel. If any rule at this level fails (returns an error), the system prevents the payment wizard from completing.
* Scenario Application:The Business Analyst can define a rule at the "Ability to Pay" level that checks the condition:"If Policy Type is Pay-as-you-drive AND Log Processed Flag is NOT 'Yes', then throw an error."This fulfills the requirement to strictly block payments ("No payments can be made") rather than just route them for approval.
Why other options are incorrect:
* Authority Limits (B)control theamountof money a user can approve, not the prerequisites (like data flags) for making a payment.
* Transaction Validation requiring approval (C)would route the payment to a supervisor, but it implies the paymentcouldbe made if approved. The requirement states "No payments can be made," implying a hard system stop, which validation rules provide.
* Send to External System (D)validates data just before it leaves the system (e.g., for check printing), which is often too late in the workflow for business-logic stops like reviewing a log file.
NEW QUESTION # 39
Succeed Insurance had an embarrassing event last month that had potential legal ramifications. One of their Customer Service Representatives (CSR) shared details of a celebrity's personal auto claim on social media.
Fortunately for Succeed, the celebrity decided not to pursue legal actions as long as Succeed agreed to resolve the potential for future occurrences within the next 30 days.
Succeed executives immediately reacted to the situation by establishing new guidelines regarding claim security. The Business Analyst (BA) assigned to the project researched ClaimCenter base product capabilities and held several requirements gathering sessions designed to document their strategy. The new requirements indicate that only authorized users should be looking at celebrity claims.
Which two features should be used to meet the new requirements? (Choose two.)
Answer: A,D
Explanation:
To restrict access to sensitive claims (such as those involving celebrities) so that "only authorized users" can view them, a Business Analyst must utilize the Claim Security features in Guidewire.
* Specify Claim Security Types (Option A):The first step is to define the classification of the claim.
The system uses the ClaimSecurityType typelist. The BA would add a new typekey (e.g., "Celebrity" or
"High Profile") or use an existing one (e.g., "Sensitive") to flag these specific claims.
* Create/Assign Access Profiles (Option E):Access control in Guidewire is managed throughAccess Profiles(sometimes referred to within Role configurations). An Access Profile maps specificSecurity Levels(like the "Celebrity" type defined above) to permissions. To meet the requirement, the BA defines an Access Profile that grants "View" permission for the "Celebrity" security type and assigns this profileonlyto the authorized users (or roles). Users without this specific Access Profile will be unable to search for or view the claim.
Why other options are incorrect:
* Authority Profiles (B):In Guidewire terminology, "Authority" refers strictly toFinancial Authority (limits on reserves and payments), not data access visibility.
* Hide secure fields (C):This refers toField Level Security(masking specific data like a Tax ID). The requirement is to restrict access to theentire claim, not just specific fields.
* Tracking rules (D):While "Claim Access Auditing" (tracking history) is often enabled for sensitive claims, it is a detective control, not a preventive one. The requirement specifies that unauthorized users should not be looking at the claim at all, which requires the Access Profiles (preventive control).
NEW QUESTION # 40
Whenever the Total Loss Calculator determines that a vehicle is a total loss, Succeed Insurance wants to create a custom history event with the exposure name and total loss score.
Which step in the claim setup process flow must be completed before the history event can be created?
Answer: A
Explanation:
250 to 350 words From Exact Extract of Guidewire ClaimCenter Business Analyst documentation:
In Guidewire ClaimCenter workflow analysis and configuration, defining the correct sequence of operations is critically dependent on Data Availability and Data Dependency.
The specific requirement here dictates that the custom history event must capture theTotal Loss Score. In the context of the ClaimCenter object model and process flow, the Total Loss Score is anoutputvalue generated specifically by theTotal Loss Calculatorengine. Before this calculator runs, the score attribute is effectively null or non-existent.
Therefore, to satisfy the business requirement, the step that writes the history event must be placedafterthe step that generates the data it needs to record.
* Process Logic:If the Business Analyst were to place the history event creation stepbeforethe Total Loss Calculator (Option B) orbeforethe Vehicle Incident (Option D), the system would attempt to write a record containing a score that has not yet been calculated. This would result in either a system error or a history event with a blank/zero value, failing to meet the business requirement.
* Dependency Chain:The workflow dependency is: Vehicle Data Entry -> Total Loss Calculation -> Score Generation -> History Event Creation.
* Implementation Note:In a typical Guidewire implementation, this logic is often handled via "Event Fired" rules or specific "Exit Points" in the workflow. The system waits for the confirmation that the Total Loss calculation service has successfully returned a result. Once that transaction is committed and the score is persisted on the Vehicle or Exposure entity, the subsequent rule to generate the History Event can trigger successfully.
Consequently,Option Cis the only viable placement in the process flow. It ensures that the prerequisite action (calculation) is complete and the required data payload (the score) is available for the subsequent action (logging the history event).
NEW QUESTION # 41
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