CRISC · Question #377
An application development team has a backlog of user requirements for a new system that will process insurance claim payments for customers. Which of the following should be the MOST important…
The correct answer is C. Impact to the accuracy of claim calculation. For a system processing insurance claim payments, the most critical risk-based consideration for user requirements is the potential impact on the accuracy of claim calculations.
Question
An application development team has a backlog of user requirements for a new system that will process insurance claim payments for customers. Which of the following should be the MOST important consideration for a risk-based review of the user requirements?
Options
- ANumber of claims affected by the user requirements
- BNumber of customers impacted
- CImpact to the accuracy of claim calculation
- DLevel of resources required to implement the user requirements
How the community answered
(59 responses)- A8% (5)
- B14% (8)
- C75% (44)
- D3% (2)
Why each option
For a system processing insurance claim payments, the most critical risk-based consideration for user requirements is the potential impact on the accuracy of claim calculations.
The number of claims affected is important for scaling, but the *impact per claim* (accuracy) is a more fundamental risk concern for a financial system.
The number of customers impacted is an important measure of scope, but the *nature* of the impact (e.g., inaccurate payments) is a more direct risk to the business than just the count of affected individuals.
The accuracy of claim calculations is paramount for an insurance claim payment system because errors can lead to direct financial losses for the organization (overpayments), legal liabilities, reputational damage, and customer dissatisfaction due to underpayments or incorrect processing. Any user requirement that could compromise this accuracy introduces significant financial and operational risk.
The level of resources required relates to project management and budget, which is a business constraint, but not the *most important* risk consideration for the core function of a financial system regarding accuracy.
Concept tested: Risk assessment of financial system requirements
Source: null
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