Practice Free ClaimCenter-Business-Analysts ClaimCenter Business Analyst - Mammoth Proctored Exam Exam Questions Answers With Explanation

According to the Guidewire ClaimCenter Business Analyst documentation, ClaimCenter’s line of business (LOB) framework is intentionally designed to support extensibility through configuration rather than structural changes to core policy or loss classification elements. When an insurer needs to support specialized insured property—such as professional audio, lighting, and staging equipment—the recommended approach is to enhance the coverage configuration.

ClaimCenter models policy coverage using a hierarchy ofCoverageTypeandCoverage Subtypetypelists. CoverageType codes represent high-level coverage categories defined by the policy, while Coverage Subtype codes allow insurers to further refine and classify coverage details. These coverage elements are then associated withExposureTypecodes, which drive claim processing behavior such as exposure creation, reserving, payment handling, and reporting.

By adding appropriate CoverageType and Coverage Subtype codes for equipment and gear coverage and mapping them to ExposureType codes, ClaimCenter can automatically create accurate exposures during claim intake. This approach ensures adjusters can efficiently process claims while maintaining consistent workflows and financial controls. It also supports meaningful analytics and reporting without altering the base product structure.

The Guidewire documentation advises against introducing newLossTypeorPolicyTypecodes unless the insurer is defining an entirely new policy or loss classification. LossType codes describe how a loss occurred (for example, theft or accidental damage), not the nature of the insured property. PolicyType changes are similarly broad and unnecessary for extending coverage within an existing LOB.

Therefore, optionBaligns with Guidewire best practices by extending ClaimCenter’s coverage and exposure configuration to meet the organization’s needs while preserving the integrity of the standard LOB model.

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.

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).

The Team Tab is the dedicated workspace in ClaimCenter designed for Supervisors and Managers to oversee the workload and performance of their direct reports (groups).

Efficiency:From theTeam Activitiesscreen, a supervisor can view all activities assigned to users within their group in a single list.

Functionality:This screen provides built-in filtering (e.g., "Overdue" or "Due Today") and bulk processing capabilities. The Supervisor can select multiple activities currently owned by different adjusters (the ones with five or six items), click theAssignbutton, and reassign them all to the target Adjuster (the one with only one item) in a single action.

Why it fits:This meets the requirement to "review the distribution" (viewing the team's load) and "reassign" efficiently from one central location.

Why other options are incorrect:

Queued Activities (A)displays items that are sitting in a queue waiting to be picked up; it does not display activities already owned by individual users.

Search Activities (B)allows finding activities but is less efficient because it requires setting up complex search criteria to find the specific group's items, whereas the Team tab is pre-filtered to the supervisor's hierarchy.

Desktop Activities (C)displays the activities assigned to thecurrent user(the Supervisor themselves), not the activities owned by their subordinates.

Here are the 100% verified answers for Question 14 and Question 15 based on Guidewire ClaimCenter Business Analyst documentation.

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.

To correctly document a Typelist in a User Story Card, the Business Analyst must understand both the data structure (Codes vs. Names) and the configuration state (New vs. Modified).

Code Validity:In Guidewire, aTypecode(the value stored in the database) must be a unique identifier for each option in the list.

Option Bcorrectly lists distinct codes: email, mail, and phone.

Options A and Care incorrect because they list theTypelist Name(PreferredContactMethod) as theCodefor every single row. You cannot have multiple entries with the same primary key (Code) in one list.

Configuration State (New vs. Modified):The PreferredContactMethod typelist is a standardBase Productfeature in Guidewire ClaimCenter. It already exists out-of-the-box.

Option Bcorrectly identifies the Status as"Modified". When you add values to or configure an existing base typelist, you document it as "Modified".

Option Dis incorrect because it lists the Status as"New". This would imply creating a brand new custom typelist (e.g., MyCustomList_Ext), which is not necessary for standard contact methods.

Therefore,Option Bis the only version that has valid, unique codes and the correct configuration status.

Claim Assignment in Guidewire ClaimCenter follows a two-step logic: Global Assignment (finding the right Group) and Group Assignment (finding the right User).

Group Identification (Global Assignment):The first step relies on the geography of the loss. According to the provided organization table, theSoutheastern Auto Adjustersgroup is responsible for "Georgia,Florida, Alabama, South Carolina, North Carolina." Since the accident occurred inTampa, Florida, the Global Assignment rule will route the claim to the Southeastern Auto Adjusters group.

User Assignment (Group Assignment):The prompt specifies the use of "automatic assignment... regardless of complexity." In ClaimCenter's base configuration, the standard method for distributing claims automatically within a group isRound Robin(or Cyclical) assignment. This method assigns the claim to the next available adjuster in the list, ensuring an even distribution of volume without complex weighting calculations.

Why other options are incorrect:

Option B (Midwest):Incorrect geography. The Midwest group covers IL, MI, OH, IN, WI, not Florida.

Option C (Weighted Workload):While "Dynamic Assignment" (workload balancing) is a feature, the standard "automatic assignment" described implies a simple cyclical rotation (Round Robin). Weighted assignment is a more advanced configuration typically used when complexityisa factor (e.g., assigning fewer claims to junior adjusters).

Option D (Supervisor):Assigning to a Supervisor is a manual fallback or "Assign to Supervisor" rule, usually triggered when no suitable adjuster is available or for complex exceptions. It is not the primary path for standard automatic assignment.

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).

In the standard Guidewire ClaimCenter User Interface architecture, high-priority alerts and claim indicators are displayed in two primary locations to ensure visibility:

The Info Bar (Option D):This is the persistent strip located at the top of the claim file (just below the Tab Bar). It remains visible regardless of which specific claim sub-screen (Medical, Financials, Notes) the user is navigating. It is designed specifically to host "High Risk Indicators" such as Litigation, Fatalities, Coverage issues, and in this scenario, a "Lien" indicator. This ensures the adjuster is aware of the critical status immediately upon opening the claim.

The Screen Area (Option A):Specifically, theClaim Status(or Summary) screen—which resides in the main Screen Area—contains a dedicated section for "Claim Indicators." Here, the icon is displayed along with a text description and potential toggle status (On/Off). The prompt explicitly mentions the requirement to "add a new high-risk indicator to the Claim Status screen," confirming the Screen Area as the second location.

Why other options are incorrect:

Sidebar (B):The sidebar (left panel) is used for the "Actions" menu and navigation links (steps) to move between screens. It does not typically host status icons for the claim object itself.

Workspace (C):While "Workspace" can refer to the application frame, in UI terminology, it often refers to the specific worksheets (bottom pane) or the container, not the specific UI element for indicators.

Tab Bar (E):The Tab Bar is for high-level navigation (Claim, Desktop, Administration, Search) and does not display claim-specific data icons.

Guidewire ClaimCenter is designed to handle First Notice of Loss (FNOL) scenarios where the policy system is unavailable or the specific policy cannot be immediately located. The correct standard procedure is to create an Unverified Policy claim.

Unverified Policy Workflow:The New Claim Wizard allows the user to select "Unverified Policy" if a search returns no results. This allows the CSR to proceed with capturing critical accident details (Loss Details, Vehicles, Injuries) and providing service to the customer immediately.

Reconciliation:Later, once the correct policy number is found or the policy system comes back online, the claim can be updated. The "Unverified Policy" feature specifically supports the "Select Policy" step of the wizard to ensure claims are not blocked by administrative data issues.

Customer Experience:Option A (asking the customer to call back) is poor service and contrary to ClaimCenter's design philosophy. Option D is incorrect because a verified policy isnota hard blocking requirement for creating a draft claim in this specific workflow.