Top 20 Interview Questions & Answers for Claims Associate Roles – 2025

Are you ready to ace your next interview for a claims associate position? This guide provides a comprehensive list of up-to-date questions and answers that will help you showcase your knowledge, skills, and experience in the insurance industry. From behavioral questions to technical knowledge assessments, these questions cover all aspects of the claims associate role.

General Questions

• 1. Tell me about your experience in the insurance industry.
  Answer: I have been working in the insurance industry for the past five years, primarily in claims handling. I have experience in processing various types of claims, including property, casualty, and medical. I have also worked with different insurance programs and policies, giving me a well-rounded understanding of the industry.
• 2. How do you handle high-pressure situations?
  Answer: In my experience, remaining calm and focused is crucial in high-pressure situations. I make sure to assess the situation, prioritize tasks, and communicate effectively with other team members and clients. My ability to remain level-headed under pressure has allowed me to handle challenging situations successfully.
• 3. How do you prioritize and manage your workload?
  Answer: I prioritize my workload based on urgency, importance, and deadlines. I make a to-do list and use tools, such as a daily planner or project management software, to stay organized and on top of my tasks. I also ensure to communicate with team members and ask for help or delegate tasks if needed.
• 4. How do you stay updated with the latest industry developments and changes?
  Answer: I believe continuous learning is important in any field, and I stay updated with the latest industry developments and changes through attending workshops, industry conferences, and networking events. I also make sure to regularly read industry publications and follow industry experts on social media.
• 5. Why do you want to work for our company?
  Answer: I have researched your company and have found it to be a leader in the insurance industry, specifically in providing excellent customer service and efficient claims handling. I am drawn to this company because I am aligned with its values and I believe my skills and experience would be a great fit for the organization.

Behavioral Questions

• 6. Tell me about a time you had to handle a difficult client or customer.
  Answer: In a previous role, I had a client who was extremely frustrated with the claims process. I listened to their concerns, empathized with their situation, and provided regular updates on the status of their claim. I also went above and beyond to ensure their claim was processed as quickly and efficiently as possible. My efforts resulted in the client leaving positive feedback for our company.
• 7. Can you give an example of a time you had to effectively communicate with a team member to resolve a problem?
  Answer: In my previous job, we experienced a delay in processing claims due to an issue with the company's software. I quickly identified the issue and communicated it with my team lead, who then escalated it to our IT department. I also collaborated with my team members to find temporary solutions while the issue was being resolved. Our teamwork allowed us to quickly address the problem and minimize the impact on clients.
• 8. Tell me about a time you made a mistake on the job.
  Answer: While working as a claims specialist, I misinterpreted an insurance policy and refused a client's claim. However, when the client provided additional information, I realized my mistake and immediately took responsibility for it. I apologized to the client and ensured their claim was processed quickly and accurately. I also used this experience as a learning opportunity to prevent similar mistakes in the future.
• 9. How do you handle conflicting priorities and deadlines?
  Answer: I have encountered situations where I had multiple deadlines and conflicting priorities. I handled it by analyzing the tasks based on urgency and importance and communicating with my team and superiors. I also made sure to stay organized and delegate tasks when necessary to meet all deadlines successfully.
• 10. Tell me about a time you had to adapt to a change in a work process.
  Answer: In my previous role, there was a shift in the claims handling process due to the implementation of new software. I adapted to this change by attending training sessions, asking questions, and familiarizing myself with the new system. I also shared my knowledge with my colleagues, which helped ease the transition and streamline our work processes.

Situational Questions

• 11. What would you do if a client's claim was denied, and they became angry and refused to listen to your explanation?
  Answer: First, I would remain calm and empathize with the client's frustration. Then, I would try to understand the root cause of their anger and address their concerns. I would explain the reasons for the denial and provide clear and helpful information on how they can dispute the decision and provide additional evidence for their claim. I would also take note of their feedback and involve my supervisor if needed.
• 12. How would you handle a situation where there is a discrepancy in a client's claim and their policy?
  Answer: I would first review the claim and policy carefully and identify where the discrepancy lies. Then, I would reach out to the client and explain the issue and ask for any additional documentation that may clarify the discrepancy. If needed, I would also work with my team lead and the client's insurance agent to resolve the issue and provide a satisfactory outcome for the client.
• 13. What would you do if a claim was taking longer than expected to process?
  Answer: I would start by reviewing the claim and identifying any possible roadblocks that may be causing the delay. Then, I would communicate with relevant team members and superiors to address the issue and find ways to expedite the process. If needed, I would also reach out to the client and provide transparent and regular updates on the status of their claim.
• 14. How would you handle a situation where a client is requesting a policy update or change that is not within their coverage?
  Answer: First, I would carefully review the client's policy and determine if the requested change is within their coverage or not. If it is not, I would explain the policy terms to the client and provide alternative solutions that may better suit their needs. I would also involve their insurance agent if needed.
• 15. What would you do if you received a claim with incomplete or missing information?
  Answer: I would reach out to the client or insurance agent and request the missing information. If it is not possible to obtain the information, I would utilize my research skills and work with relevant team members to gather the necessary information to process the claim accurately and effectively.

Technical Questions

• 16. What is subrogation, and how does it relate to claims handling?
  Answer: Subrogation is the process of one party, usually an insurance company, recovering a claim payout from the responsible party. In claims handling, we utilize subrogation to recover costs from third parties in cases where an insured is not at fault.
• 17. What is a deductible, and how does it affect a claim?
  Answer: A deductible is the amount of money that an insured must pay before their insurance company starts covering the costs of a claim. It affects a claim as it reduces the amount of compensation that the insurance company will pay out.
• 18. How do you determine the extent of damage in a property or casualty claim?
  Answer: I use a variety of methods to determine the extent of damage, including visual inspections, reviewing policy coverage, and consulting with relevant experts. I also collect and analyze all necessary documentation and evidence to make a fair and accurate assessment.
• 19. What is the difference between replacement cost and actual cash value in property insurance claims?
  Answer: Replacement cost is the amount it would cost to replace or repair a damaged item with a similar one at its current market value. Actual cash value takes into account depreciation and is the amount it would cost to replace the item at its current value, taking age and wear and tear into account.
• 20. How do you handle fraudulent claims?
  Answer: I first review the claim carefully and look for red flags or inconsistencies. If I suspect fraud, I would escalate it to my supervisor and provide all necessary evidence and information. If fraud is confirmed, I would handle the case according to the laws and regulations in place and involve relevant authorities if needed.