Unit 1 - Claims Administration

Question 1

What claim terminology means “applying specific standards and/or procedures to determine the amount payable on a claim, if any”?

Answer 1

Adjudication

Question 2

What claim terminology means “Payment made in advance of final settlement of a claim”?

Answer 2

Advance Payment

Question 3

What claim terminology means “computer program that allows claims offices to adjudicate claims electronically and collects data for monthly reports so legal can brief CCs”?

Answer 3

WebAFCIMs

Question 4

What claim terminology means “a request by the claimant to reevaluate their claim”?

Answer 4

Appeal

Question 5

What claim terminology means “if someone other than the proper claimant presents a claim, evidence authorizing this action must be included in the claim file. Could be in the form of POA, court order, etc”?

Answer 5

Authority to execute a claim

Question 6

What claim terminology means “Any person or corp, including legal rep, with authority to act on a claimant’s behalf. Could be a family member, friend, or attorney”?

Answer 6

Authorized Agent

Question 7

What claim terminology means “any signed, written demand made upon or by the AF for the payment of a specific sum and doesn’t include any obligations that the AF acquires in the regular procurement of things”?

Answer 7

Claim

Question 8

What claim terminology means “the dominant or primary cause of an injury or loss”?

Answer 8

Proximate Cause

Question 9

What claim terminology means “an individual, partnership, corporation, state, territory, or country that files a claim”?

Answer 9

Claimant

Question 10

What claim terminology means “the last administrative decision to deny a claim”?

Answer 10

Final Denial

Question 11

What claim terminology means “the territorial area that an SJA is responsible for in the event a claim arises. AKA jurisdiction or AOR”?

Answer 11

Geographic Area of Claims Responsibility

Question 12

What claim terminology means “to pay or deny a claim, in full or in part”?

Answer 12

Settle

Question 13

What claim terminology means “any person authorized to settle a claim”?

Answer 13

Settlement Authority

Question 14

What claim terminology means “statutes set a maximum time period during which specific actions can be brought or rights enforced”?

Answer 14

Statute of Limitations

Question 15

What claim terminology means “a civil wrong in which one party causes personal injury or property damage to another and may be liable in damages”?

Answer 15

Tort

Question 16

Claims that must be promptly investigated are those that involve what 3 things?

Answer 16

• Death
• Personal Injury
• Damage/Loss of Property

Question 17

As a member of the legal office, can you refuse to accept a claim?

Answer 17

No

Question 18

As a member of the legal office, can you make promises to a claimant?

Answer 18

You should not

Question 19

In claims admin, who develops policies/procedures, directs training of legal psnl, ensure adequate resources, and denies claims against the AF?

Answer 19

TJAG

Question 20

In claims admin, who implements claims policies/procedures, overseas authoritative guidance on claims, conducts training, coordinates w/ other govt agencies, establishes base claims jurisdiction, and denies claims against the AF?

Answer 20

JACC

Question 21

In claims admin, who refers unsettled G-claims to the Dept of Treasury, recommends settlement of tort claims above their authority, investigates/takes final action on tort claims not assigned to base SJAs, and sees process through on all MCRP claims?

Answer 21

JACC

Question 22

In claims admin, who adjudicates personal trans and property claims?

Answer 22

CSC (Claims Svc Center)

Question 23

In claims admin, who provides general supvn of claims activities w/in their cmds and protects AF by ensuring compliance w/ claims policies?

Answer 23

MAJCOM/NAF SJAs and NGB JA

Question 24

In claims admin, who is the primary investigative authority over AOR, investigates/takes final action on claims w/in settlement authority, and assists JACC w/ investigations?

Answer 24

Base SJAs

Question 25

In claims admin, who maintains a vigorous claims pgm, promptly notifies JACC when there’s a potential f/ significant liability or adverse publicity, and ensures Article 139/UCMJ claims are completed?

Answer 25

Base SJAs

Question 26

In claims admin, who is responsible f/ inspections, interviews, investigations, file management, settlement recommendations, and manages WebAFCIMS?

Answer 26

Paralegals

Question 27

In claims admin, who is responsible f/ identifying/providing/reviewing claims forms, inspections, and community outreach?

Answer 27

Claims Psnl

Question 28

Meritorious claims are paid in an amount that ________ the claimant to the position they were before the accident/incident.

Answer 28

Restores

Question 29

Who must be notified when a liable party is unwilling or unable to pay a claim to the govt?

Answer 29

JACC