AIC 30 Exam Questions| Already
Answered| GRADED A+
First Party Focus - ANSWER-Coverage and Amount of damage
Second Party - ANSWER-Insurance Company
First Party - ANSWER-Insured
Third Party - ANSWER-Claimant
Third Party Focus - ANSWER-Liability, Coverage, and Amount of damage
Third Party Administrator (TPA) - ANSWER-an organization that provides admin services associated with
risk financing and insurance. They handle claims and risk management for self-insured organizations
Independent Adjuster - ANSWER-handles claims for the insurer for a fee. Works for the insurer
Public Adjuster - ANSWER-an outside organization that is hired by the insured to represent the insured
in the claim for a fee. Works for the public
Quantitative Measures - ANSWER-can have actual numbers assigned, such as number of claims opened
and percentage of subrogation recovery
Qualitative Measures - ANSWER-related to intangible measures. nothing concrete, did they do a good
job? do they have good negotiation skills?
Ethics - ANSWER-the study of what constitutes good and bad behavior, dealing with the moral duty and
obligation
, Conflict of Interest - ANSWER-a 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 - ANSWER-contracts 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 - ANSWER-an intentional misrepresentation resulting in harm to another person or organization
Code of Ethics - ANSWER-professional guidelines of behavior within an organization or profession
N.A.I.C - ANSWER-The National Association of Insurance Commissioners
Model Laws - ANSWER-NAIC develops that they feel is an appropriate law related to insurance/risk
management
Model Laws - Goal - ANSWER-to standardize the laws related to insurance, to address issues related to
insurance
Unfair Claims Settlement Practice Act - ANSWER-to prevent insurance companies from taking unfair
advantage of the insured/claimants
Reservations of Rights Letter - ANSWER-an 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 - ANSWER-the intentional/unintentional relinquishing (give up) of a known right. (written,
verbally, or by actions taken)
Estoppel - ANSWER-a 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.
Answered| GRADED A+
First Party Focus - ANSWER-Coverage and Amount of damage
Second Party - ANSWER-Insurance Company
First Party - ANSWER-Insured
Third Party - ANSWER-Claimant
Third Party Focus - ANSWER-Liability, Coverage, and Amount of damage
Third Party Administrator (TPA) - ANSWER-an organization that provides admin services associated with
risk financing and insurance. They handle claims and risk management for self-insured organizations
Independent Adjuster - ANSWER-handles claims for the insurer for a fee. Works for the insurer
Public Adjuster - ANSWER-an outside organization that is hired by the insured to represent the insured
in the claim for a fee. Works for the public
Quantitative Measures - ANSWER-can have actual numbers assigned, such as number of claims opened
and percentage of subrogation recovery
Qualitative Measures - ANSWER-related to intangible measures. nothing concrete, did they do a good
job? do they have good negotiation skills?
Ethics - ANSWER-the study of what constitutes good and bad behavior, dealing with the moral duty and
obligation
, Conflict of Interest - ANSWER-a 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 - ANSWER-contracts 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 - ANSWER-an intentional misrepresentation resulting in harm to another person or organization
Code of Ethics - ANSWER-professional guidelines of behavior within an organization or profession
N.A.I.C - ANSWER-The National Association of Insurance Commissioners
Model Laws - ANSWER-NAIC develops that they feel is an appropriate law related to insurance/risk
management
Model Laws - Goal - ANSWER-to standardize the laws related to insurance, to address issues related to
insurance
Unfair Claims Settlement Practice Act - ANSWER-to prevent insurance companies from taking unfair
advantage of the insured/claimants
Reservations of Rights Letter - ANSWER-an 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 - ANSWER-the intentional/unintentional relinquishing (give up) of a known right. (written,
verbally, or by actions taken)
Estoppel - ANSWER-a 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.
