ClaimCenter-Business-Analysts Sample Questions Answers

250 to 350 words From Exact Extract of Guidewire ClaimCenter Business Analyst documentation:

To satisfy the requirements for the new "Rideshare" coverage product, the Business Analyst must map the described risks to the correct Exposure Types in the ClaimCenter data model.

Risk: Injury to a first-party driver:In insurance terminology, "First Party" refers to the insured (the driver). Coverage for injuries sustained by the driver themselves is typically handled byMedical Payments(MedPay) or Personal Injury Protection (PIP). Among the choices provided,Rideshare Medical Payments (Option C)is the correct exposure type to cover medical costs for the driver regardless of fault. (Option E, Liability Bodily Injury, would cover injuries toothersthat the driver hit).

Risk: Damaged personal property of third-party passengers:This refers to liability for damage to property belonging to others. While typically "Property Damage Liability," the specific option provided that fits this description isRideshare Personal Property Protection (Option B). This exposure would be configured to capture details about the damaged items (e.g., luggage, electronics) belonging to the passengers.

Why other options are incorrect:

Option E (Liability Bodily Injury):This is for Third Party injuries (e.g., pedestrians or people in other cars), not the First Party driver.

Option D (Under Insured Motorist):This applies when the Rideshare driver is hit by someone else who doesn't have enough insurance. The prompt focuses on the risksofthe driver working, not the financial failure of others.

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 occurafterthe 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.

250 to 350 words From Exact Extract of Guidewire ClaimCenter Business Analyst documentation:

In the lifecycle of a check within Guidewire ClaimCenter, the Requested status indicates that the payment instruction has been successfully handed off to the downstream check writing or electronic funds transfer system. Once a check reaches this status, it is considered a committed financial transaction and is locked from further editing.

Why Option A is incorrect:You cannot edit a check that is in "Requested" status. The "Edit" button will likely be disabled or the fields locked because the data has already left the system.

Why Option C is incorrect:A "Stop" payment is typically reserved for scenarios where a physical check has been lost, stolen, or destroyedafterit was printed and mailed. While a Stop Payment does prevent the check from being cashed, it is a specific banking process often involving fees.

Why Option D is Correct:To correct an administrative error (such as the wrong amount) for a check that has been processed but not yet negotiated (cashed), the standard procedure is toVoidthe check. Voiding the check in ClaimCenter performs two critical functions:

It reverses the financial T-accounts (reserves and payments) associated with the transaction, ensuring the claim financials are accurate.

It updates the status to "Voided," effectively cancelling the payment in the system.

After voiding the incorrect check ($1,200), the Adjuster must then create anew checkfor the correct amount ($950) to pay the claimant.

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.

This scenario involves checking financial Authority Limits and determining the correct Approval Routing hierarchy in Guidewire ClaimCenter.

Check Authority Limits:First, compare the transaction amount against the user's specific limits.

The payment is for "repairs to the insured's home," which is classified asClaim Cost(Indemnity).

According to the provided Authority Limit Profile, the Adjuster has a "Payment amount" limit of$5,000for Claim Cost.

The transaction amount is$6,500.

Since$6,500 > $5,000, the limit is exceeded, meaning the paymentrequires approval(Ruling out Option B).

Determine Routing:When a financial transaction requires approval, ClaimCenter routes the approval activity to the supervisor of the group to which the user belongs.

The Adjuster is a member ofProperty - Team A.

According to the Organization chart provided, the Supervisor for "Property - Team A" isSupervisor D.

Therefore, the system will generate an approval activity and assign it specifically to Supervisor D. Supervisor C is the manager of theparentgroup (Western Property Group), so the activity would only go to them if Supervisor Dalsolacked the authority to approve the $6,500, requiring further escalation. However, the initial routing is always to the immediate supervisor.

Why other options are incorrect:

Option A:Supervisor C is the "Grand-boss" (Supervisor of the parent group), not the immediate supervisor.

Option B:The amount ($6,500) clearly exceeds the defined limit ($5,000), so automatic processing is impossible.

Option C:Supervisor A is at the top of the hierarchy (Succeed Insurance), far removed from the initial approval step.

To determine if a transaction requires approval, we must compare the proposed transaction against the Adjuster's Authority Limits and the current financial state of the claim.

Current State:Total Reserves = $3,000 ($2,500 Indemnity + $500 Expense). Total Paid = $0.

Adjuster Limits:

Claim Total Reserves Limit: $5,000

Payments Exceed Reserves Limit: $500

Evaluation of Options:

Option B (No Approval Required):Making a $2,000 payment against the "Claim Cost - Auto body" reserve.

The available reserve is $2,500. Since $2,000 < $2,500, the payment does not exceed the reserve.

The total payments on the claim would be $2,000, which is well below the "Claim payments to date" limit of $5,000.

Option D (No Approval Required):Increasing the Expense reserve to $550.

This increases the total claim reserves from $3,000 to $3,050 ($2,500 + $550).

Since $3,050 is below the Adjuster's "Claim total reserves" limit of $5,000, no approval is triggered.

Why other options require approval:

Option A:A payment of $1,100 against a $500 reserve means the payment exceeds the reserve by$600. The Adjuster's limit for "Payments exceed reserves" is only$500. Since $600 > $500, approval is required.

Option C:Increasing the Auto body reserve to $6,000 would raise the total claim reserves to$6,500($6,000 + $500). This exceeds the Adjuster's "Claim total reserves" limit of $5,000, triggering an approval.

In Guidewire implementation methodology (Agile/SurePath), Traceability is maintained through specific unique identifiers that link the code and test cases back to the business definition.

Unique Requirement Numbers (Option E):Every granular business requirement is assigned a unique ID (e.g., CC-FNOL-001). If a defect or issue arises during testing or production, the BA uses this number to find the exact text of the requirement that was implemented. This helps determine if the issue is a "bug" (code doesn't match requirement) or a "gap" (requirement was missing or wrong).

Unique Story Card Number (Option A):User Stories act as containers for requirements. The Story Card Number (e.g., Story-105) links the individual requirements to the broader feature context. Tracing back to the Story Card allows the BA to review the original scope, the UI mockups, and the Acceptance Criteria associated with that feature to understand the "Root Cause" of the misunderstanding or failure.

Why other options are incorrect:

Option B (Caution points):These are process diagrams notes, useful for training but not for system traceability.

Option C (Change History):While useful for seeingwhoedited a document, it does not provide the structural link between a system error and the business definition like the IDs do.

Option D (Approver Notes):These confirm sign-off but rarely contain the functional detail needed to diagnose a root cause.

In the Guidewire delivery methodology, the "Determine Requirements" phase (often part of Inception or Elaboration) focuses on understanding the business need and mapping it to the software capabilities.

Lead an Elaboration Workshop (A):TheElaboration Workshopis the primary forum where BAs engage with stakeholders (like the Greeley operations team) to discuss the specific needs for the new "hail damage" product. This is where the raw requirements are gathered, discussed, and refined.

Recommend Base Product Features (B):A critical responsibility of the Guidewire BA is to maximize product value by reducing unnecessary customization. When determining requirements for "reimbursement" and "hail damage," the BA should immediately demonstrate and recommend how ClaimCenter's out-of-the-box Coverage, Exposure, and Incident features can handle this scenario. This aligns the customer's expectations with the standard software capabilities, expediting the implementation.

Why not C or D?Authoring user stories (C) and defining typelists (D) areoutputsortasksthat occurafterthe requirements have been determined and the solution approach (Standard vs. Custom) has been agreed upon.

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" foreverynew 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.

ClaimCenter uses a logic-based process called Segmentation to categorize claims and Assignment to route them.

Complexity (Points):The "Total Loss Points" score of38is significantly high. In standard configuration, high scores (typically indicating severe damage or total loss potential) trigger aHigh Complexitysegmentation.

Assignment (Geography):The accident occurred inChicago (Midwest). The assignment rules will match the geography (Midwest) with the complexity (High/Complex). Therefore, it routes to theMidwest Complex Auto Adjusters Group.

Workplan (Activity):The specific note regarding an "expert inspection" translates into a generatedActivity(likely "Assign Vehicle Inspection" or similar) added to the claim's workplan.

Why other options are incorrect:

A & D (Low/Mid Complexity):A score of 38 is too high for "Low Complexity" (which is usually for simple fender benders). Assigning a complex claim to a "Low Complexity" group would violate standard routing logic.

C (Supervisor):Modern ClaimCenter configurations prefer Straight-Through Processing (STP) to a working group. Routing to a Supervisor is generally a fallback for exceptions, whereas this is a standard high-severity scenario that should go directly to the specialized adjusters.

To fully document a requirement that involves both a User Interface change (updating a value on a screen) and a Data Model change (adding a new typecode), the standard Guidewire Story Card tabs required are:

Document Control:Captures the metadata (Author, Version, Owner) to track the requirement's history.

UI Mockup:visually illustrateswhereon the screen the "Loss Cause" field is located and how the dropdown should appear to the Adjuster.

UI Fields:Defines the specific behavior of the field (e.g., Is it mandatory? Is it editable during adjudication? What is the label?).

Typelist:This is critical for this specific scenario. It lists the actual Code, Name, and Description of thenew typecodebeing added to the "Loss Cause" typelist.

Business Acceptance:Defines the testable criteria (Acceptance Criteria) to verify that the adjuster can successfully select the new value and save the claim.

Why Option B is correct:It is the only option that includesboththe visual requirements (Mockup/Fields) and the data requirement (Typelist) alongside the standard control and testing tabs (Document Control/Business Acceptance).

In Guidewire implementation methodology (such as SurePath), traceability and organization are maintained through strict naming conventions.

Naming Convention (Option C):A unique identification number is assigned to every User Story Card to create a consistent naming structure:Product - Theme - Subtheme - ID. (For example: CC - FNOL - Vehicle - 001).

Purpose:This convention allows Business Analysts, Developers, and QA testers to easily reference, search, and trace requirements across different tools (e.g., from the Story Card in Excel/Jira to the code in Studio and the test cases in the testing suite).

Why not A, B, or D?Time estimation (A) uses "Story Points," not the ID. Burndown charts (B) track velocity/points, not criteria IDs. Backlogs (D) are organized byBusiness Value/Priority, not just numerically by ID.