Guidewire Updated ClaimCenter-Business-Analysts Exam Questions and Answers by caoimhe

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.

A complete Business Rule (specifically one designed to generate an Activity) consists of a Context (Trigger/Entity), a Condition (Logic), and an Action (Execution).

Missing Element: Actions (Option A):The scenario describes thetrigger("when they are entered"), theintent/condition("resulting from the storm"), and theparametersof the resulting activity (Target: 3 days, Escalation: 5 days). However, it fails to specify theActiondetails required to execute the rule: specifically,whothe activity should be assigned to (The Assignee) and the specific instruction tocreatethe activity instance. Without defining the Action (e.g., "Create Activity 'Review Catastrophe' and Assign to Claim Owner"), the rule cannot function.

Why other options are present:

TriggerEntity (B):Implied as the Claim (since the text says "whenthey[claims] are entered").

RuleCondition (C):While "resulting from the storm" is vague, it represents the business condition. TheAction(assignment) is the most glaring omission preventing the workflow from reaching a user.

AppliesTo (D):This generally refers to the root entity (Claim), which is identified.

In Guidewire ClaimCenter, assignment logic functions in a two-stage process: first Global Assignment (which finds the appropriate Group) and then Group Assignment (which finds the appropriate User within that group).1

TheDefault Group Claim Assignment Ruleis the specific logic set used to distribute claimswithina group once the group has already been identified. When this rule is configured with "available matching" (often referred to as criteria-based or attribute-based assignment), the system evaluates the users inside that group against specific criteria.

Workflow:The system filters the group's users to find those who are "available" (not on vacation) and then matches the claim against user attributes such asExpertise,Workload(current claim count), or specific skills.

Result:The claim is automatically assigned to the best-fitUserwithin that group.

Why other options are incorrect:

Option B (Geography/LOB):This describesGlobal Assignmentrules, which are responsible for routing the claim to the correct office or unit (Group), not the specific user.

Option C (Supervisor):Assigning to a supervisor is a fallback mechanism (often called "Assign to Supervisor") used when the system fails to find a matching user or when manual intervention is explicitly required. It is not the primary function of "available matching."

Option D (Root Group):Routing to the "Root Group" is a last-resort fallback when Global Assignment fails entirely to find any appropriate group.

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.