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All of the following are a duty of an insurer in regards to claims on file and record documentation EXCEPT

1. maintaining claim data so that an insurer shall be able to provide the claim number, line of coverage, and other pertinent data.
2. recording the date the licensee received, date(s) the licensee processed and date the licensee transmitted or mailed every material and relevant document in the file.
3. maintaining any sales material, which had a material impact on the claims process.
4. maintaining claim files that are accessible, legible, and claim of duplication.

1 Answer

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Final answer:

The exception among the duties of the insurer regarding claims handling and documentation is maintaining sales material, which does not typically fall within the responsibilities of claims maintenance. Instead, insurers focus on managing accurate claim data, processing timelines, and maintaining legible records, while also managing premiums and claims as part of their major financial transactions.

Step-by-step explanation:

In the context of insurance companies' responsibilities regarding claims handling and record keeping, all listed duties are typically incumbent upon an insurer with one exception.

Insurers must indeed maintain precise claim data, record all pertinent dates for processing insurance claims, and keep claim files orderly and legible.

However, maintaining any sales material which had a material impact on the claims process is not commonly a duty of an insurer in maintaining claims files. While insurers do have to manage the administrative costs of processing and adjudicating claims, keeping sales materials on file is not typical unless such materials directly relate to the claims themselves.

This addresses the larger management of financial flows and costs within an insurance company, where premiums and claims payments represent the largest transactions, with administrative expenses and investment income playing significant but lesser roles.

Ultimately, the premiums collected must cover the claims paid, the administrative costs, and contribute to the company's profits.

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