Certified Professional in Health Care Risk Management (CPHRM) Practice Exam 2026 - Free CPHRM Practice Questions and Study Guide

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What does an IBNR estimate include?

Only known claims previously reported

Expected future premium costs

Estimates for further development of paid losses

The estimate of Incurred But Not Reported (IBNR) claims primarily involves projections related to future development of claims that have already been incurred but not yet reported. This includes accounting for claims that have occurred during a specific period but have not yet been formally reported to the insurer or healthcare organization. The IBNR estimation is essential for ensuring that a healthcare entity can adequately reserve funds to cover future liabilities arising from these unreported claims, thereby aligning with sound risk management practices.

Options that focus solely on known claims or specific accounted losses do not capture the intent of IBNR estimations, which inherently consider future uncertainties and developments. Similarly, estimates for future premium costs are not relevant to IBNR calculations as they pertain to expected revenues rather than claims liabilities. Finally, final calculations of adjudicated claims pertain to claims that are already processed, thus falling outside the scope of IBNR which focuses on recognizing potential future exposures arising from claims that are not yet reported.

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Final calculations of adjudicated claims

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