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A property and casualty insurerInsurance
Claims files where the model must decide cover, quantify the payout and explain the reasons in a letter the policyholder would understand.
Attach the policy wording and the claim documents. The decision must follow from the wording, not from general knowledge.
The ideal response states the decision, the clause it rests on, the amount, and a plain-English letter.
Ideas to get you started. Take one, change it, or write something else entirely. Storm damage with a maintenance exclusion in play. A business-interruption claim after a supplier fire. Theft with a forced-entry condition. Subsidence and a pre-existing-damage argument. A motor claim with a disputed named-driver condition.
A task the client would approve. Yours should be this complete.
Attached: a home insurance policy and a claim for water damage discovered eleven weeks after a pipe burst during the policyholder's absence. Decide cover, quantify, and draft the letter.
The claim is partly covered. The escape-of-water peril applies, but the unoccupancy condition (clause 6.2) reduces cover after 60 days…
Weights add up to 100.