AIC 30 Exam Questions And Answers (Verified And Updated)

AIC 30 Exam Questions And Answers (Verified And Updated) First Party Focus - answerCoverage and Amount of damage Second Party - answerInsurance Company First Party - answerInsured Third Party - answerClaimant Third Party Focus - answerLiability, Coverage, and Amount of damage Third Party Administrator (TPA) - answeran organization that provides admin services associated with risk financing and insurance. They handle claims and risk management for self- insured organizations Independent Adjuster - answerhandles claims for the insurer for a fee. Works for the insurer Public Adjuster - answeran outside organization that is hired by the insured to represent the insured in the claim for a fee. Works for the public Quantitative Measures - answercan have actual numbers assigned, such as number of claims opened and percentage of subrogation recovery Qualitative Measures - answerrelated to intangible measures. nothing concrete, did they do a good job? do they have good negotiation skills? Ethics - answerthe study of what constitutes good and bad behavior, dealing with the moral duty and obligation Conflict of Interest - answera situation that occurs when a decision makers personal interests interfere to the extent that he/she makes decisions that adversely affect the customer, claimant, or employer Ex Parte Contract - answercontracts in which only 1 party is heard. discussing the claim with the represented person without benefit of their attorney being involved. this is not illegal, but its not ethical. Fraud - answeran intentional misrepresentation resulting in harm to another person or organization Code of Ethics - answerprofessional guidelines of behavior within an organization or profession N.A.I.C - answerThe National Association of Insurance Commissioners Model Laws - answerNAIC develops that they feel is an appropriate law related to insurance/risk management Model Laws - Goal - answerto standardize the laws related to insurance, to address issues related to insurance Unfair Claims Settlement Practice Act - answerto prevent insurance companies from taking unfair advantage of the insured/claimants Reservations of Rights Letter - answeran insurer's letter that specifies coverage issues and informs the insured that the insurer is handling a claim with the understanding that the insurer may later deny coverage should the facts warrant it. Waiver - answerthe intentional/unintentional relinquishing (give up) of a known right. (written, verbally, or by actions taken) Estoppel - answera legal principal that prohibits a party from asserting a claim or a right once it has been waived and the other party relied upon that information to their detriment. Non Waiver Agreement - answera signed agreement indicating that during the course of the investigation, neither the insurer nor the insured waives their rights under the policy, the insured is to sign and return the agreement Legal Liability - answerthe legally enforceable obligation for a person or organization to pay a sum of money (damages) to another person or organization Statutory Law - answerthe formal law or statutes enacted by legislative bodies such as congress, the state legislature, the Senate, or the town council Negligence - answerthe failure to exercise due care that a reasonable person would do in a similar situation to avoid harming others Four Parts of Negligence - answer- a duty owed to protect (or not go out of your way to harm) another party. - a breach of that duty - damage or injury occurs, - the damage or injury was a direct result of the breach of the duty. Contributory Negligence - answera common-law principal that prevents a person who has been harmed from recovering damages if that person's own negligence in any way contributed to the harm