AIC 300 CLAIMS IN AN EVOLVING WORLD
END OF COURSE STUDY GUIDE LATEST
UPDATED ACTUAL TESTED QUESTIONS
AND CORRECT ANSWERS
⩥ Third-party administrator (TPA).
Answer: An organization that provides administrative services
associated with risk financing and insurance.
⩥ Claims representative.
Answer: A person responsible for investigating, evaluating, and settling
claims.
⩥ Public adjuster.
Answer: An outside organization or person hired by an insured to
represent the insured in a claim in exchange for a fee.
⩥ Premium audit.
Answer: Methodical examination of a policyholder's operations, records,
and books of account to determine the actual exposure units and
premium for insurance coverages already provided.
⩥ Quantitative Audit Factors.
,Answer: Number of files open, timeliness of reports, reserving and
payments
⩥ Qualitative Audit Factors.
Answer: Realistic reserving, accurate evaluation of insured's liability
and follow-up on subrogation opportunity, proper information
⩥ Loss ratio.
Answer: A ratio that measures losses and loss adjustment expenses
against earned premiums and that reflects the percentage of premiums
being consumed by losses.
⩥ Loss adjustment expense (LAE).
Answer: The expense that an insurer incurs to investigate, defend, and
settle claims according to the terms specified in the insurance policy.
⩥ Steps of Making an Initial Claims Assessment.
Answer: Acknowledging and Assigning the Claim
Identifying the Policy
Contacting the Insured or the Insured's Representative
⩥ How do recorded statements and examinations under oath differ?.
Answer: An examination under oath is more formal than a recorded
statement. Recorded statements are often taken by claims
, representatives, typically by telephone. Examinations under oath are
usually performed by an attorney for the insurer at the insurer's office or
a court reporter's office.
⩥ Effective statements exhibit these qualities:.
Answer: Coherence—The statement follows a logical sequence.
Completeness—The statement is thorough.
Objectivity—The statement contains facts relevant to the loss expressed
in the interviewee's own words.
⩥ Seven-Part Method.
Answer: 1. Permission and introduction—date, time, and location of the
interview, names of the parties involved in the interview, and an
affirmation from the interviewee that the interview is given with
permission
2. Identification—identifying information about the person being
interviewed, such as name, address, phone number, and driver's license
number
3. Setting—answers to questions such as who was involved in the loss,
what was involved in the loss, when the loss occurred, where the loss
occurred, and why the loss occurred
4. Incident—a step-by-step description of how the loss occurred
END OF COURSE STUDY GUIDE LATEST
UPDATED ACTUAL TESTED QUESTIONS
AND CORRECT ANSWERS
⩥ Third-party administrator (TPA).
Answer: An organization that provides administrative services
associated with risk financing and insurance.
⩥ Claims representative.
Answer: A person responsible for investigating, evaluating, and settling
claims.
⩥ Public adjuster.
Answer: An outside organization or person hired by an insured to
represent the insured in a claim in exchange for a fee.
⩥ Premium audit.
Answer: Methodical examination of a policyholder's operations, records,
and books of account to determine the actual exposure units and
premium for insurance coverages already provided.
⩥ Quantitative Audit Factors.
,Answer: Number of files open, timeliness of reports, reserving and
payments
⩥ Qualitative Audit Factors.
Answer: Realistic reserving, accurate evaluation of insured's liability
and follow-up on subrogation opportunity, proper information
⩥ Loss ratio.
Answer: A ratio that measures losses and loss adjustment expenses
against earned premiums and that reflects the percentage of premiums
being consumed by losses.
⩥ Loss adjustment expense (LAE).
Answer: The expense that an insurer incurs to investigate, defend, and
settle claims according to the terms specified in the insurance policy.
⩥ Steps of Making an Initial Claims Assessment.
Answer: Acknowledging and Assigning the Claim
Identifying the Policy
Contacting the Insured or the Insured's Representative
⩥ How do recorded statements and examinations under oath differ?.
Answer: An examination under oath is more formal than a recorded
statement. Recorded statements are often taken by claims
, representatives, typically by telephone. Examinations under oath are
usually performed by an attorney for the insurer at the insurer's office or
a court reporter's office.
⩥ Effective statements exhibit these qualities:.
Answer: Coherence—The statement follows a logical sequence.
Completeness—The statement is thorough.
Objectivity—The statement contains facts relevant to the loss expressed
in the interviewee's own words.
⩥ Seven-Part Method.
Answer: 1. Permission and introduction—date, time, and location of the
interview, names of the parties involved in the interview, and an
affirmation from the interviewee that the interview is given with
permission
2. Identification—identifying information about the person being
interviewed, such as name, address, phone number, and driver's license
number
3. Setting—answers to questions such as who was involved in the loss,
what was involved in the loss, when the loss occurred, where the loss
occurred, and why the loss occurred
4. Incident—a step-by-step description of how the loss occurred
