AIC 300 - Claims in an Evolving World EXAM 2025 COMPLETE EXAM
AIC 300 - Claims in an Evolving World
QUESTIONS AND ACCURATE ANSWERS |ALREADY PASSED!!
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1. Insurers usually send denial letters B. By certified mail with a return receipt request-
Select one: ed.
A. By email to ensure prompt receipt
by the insured. Some will also send a copy via regular mail in case
B. By certified mail with a return re- the certified letter is not accepted.
ceipt requested.
C. By overnight courier.
D. By registered mail.
2. As methods of communication evolve, D. Subpoenaed.
it's important for claims professionals
to remember that any written claims Any written claims communication may be sub-
communication may be poenaed.
Select one:
A. Replaced with verbal communica-
tion.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
3. In which one of the following scenarios D. An insured's negotiations with the insurer on a
is a public adjuster most likely to be- complex claim are not going well.
come involved?
Select one: If a claim is complex, or if settlement negotiations
A. An insurer finds it financially unfea- are not progressing with the insurer, the insured
sible to hire its own claims staff in a may hire a public adjuster to protect his or her
given state. interests.
B. An insured is unable to afford legal
representation to contest a claim.
C. A catastrophic disaster strikes, in-
volving damage to many properties.
D. An insured's negotiations with the
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
insurer on a complex claim are not go-
ing well.
4. Which one of the following statements B. TPAs handle claims, keep claims records, and
regarding third-party administrators perform statistical analyses.
(TPAs) is most accurate?
Select one:
A. TPAs are typically used by business-
es that have chosen not to self-insure.
B. TPAs handle claims, keep claims
records, and perform statistical analy-
ses.
C. TPAs are generally found in an insur-
er's claims department.
D. TPAs are employed only by indepen-
dent adjusting firms.
5. Hugo is conducting an audit of a A. Proper releases taken
branch office claims operation. He is
evaluating timeliness of reports, num- Proper releases taken is a qualitative audit factor;
ber of files opened, proper releas- the others are quantitative.
es taken, and accuracy of data entry.
Which one of Hugo's metrics is a qual-
itative audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
6. Aaron works for a multi-line insurer. He D. Line underwriter.
works with insurance producers and
Line underwriter. This describes the duties of a
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
applicants to evaluate new business line underwriter, rather than a staff underwriter.
submissions and conduct renewal un- There is not enough information to determine
derwriting. Aaron is a which line of business is being written. A pub-
Select one: lic underwriter does not exist. Line underwriters
A. Staff underwriter. evaluate new submissions and perform renew-
B. Public underwriter. al underwriting, usually by working directly with
C. Personal lines underwriter. insurance producers and applicants. Staff un-
D. Line underwriter. derwriters, meanwhile, manage risk selection by
working with line underwriters and coordinating
decisions about products, pricing and guidelines.
7. The first key to communicating empa- D. Listening.
thetically as a claims professional is
Select one: Claims professionals should first listen carefully to
A. A comprehensive understanding of understand what the claimant is saying.
relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documenta-
tion relating to the claim.
D. Listening.
8. Mia tracks loss adjustment expense C. Cost to investigate, defend, and settle claims.
(LAE) as part of her management of
the claims department for an insurer. Cost to investigate, defend, and settle claims. LAE
Mia considers LAE to be the is the expense that an insurer incurs to investi-
Select one: gate, defend, and settle claims according to the
A. Total amount of loss reserves of all terms specified in the insurance policy.
claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and set-
tle claims.
D. Total incurred amount of claims.
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
9. In her role with an insurer, Katarina D. Claim representative.
has opportunity to collaborate with
not only employees from her compa- Claim reps collaborate with more than other in-
ny, but also external experts with par- surer employees. Many insurers employ a panel
ticular expertise. For example, as part of experts that the claims rep can select according
of her investigation, she hired an engi- to the investigation's needs.
neer to conduct a review of a machine
that was involved in a personal injury.
Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative.
10. When Mehmet interviews witnesses as A. Open-ended
part of his claims investigation, he asks
different types of questions based on Open-ended questions can be used to clarify an
need, such as open-ended, direct, in- interviewee's statements.
direct, and leading. Which type of
question should Mehmet ask when he
wants to set the interviewee at ease
and he is looking for explanation or
elaboration of details in the intervie-
wee's own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
11.
AIC 300 - Claims in an Evolving World
QUESTIONS AND ACCURATE ANSWERS |ALREADY PASSED!!
Study online at https://quizlet.com/_97r6u0
1. Insurers usually send denial letters B. By certified mail with a return receipt request-
Select one: ed.
A. By email to ensure prompt receipt
by the insured. Some will also send a copy via regular mail in case
B. By certified mail with a return re- the certified letter is not accepted.
ceipt requested.
C. By overnight courier.
D. By registered mail.
2. As methods of communication evolve, D. Subpoenaed.
it's important for claims professionals
to remember that any written claims Any written claims communication may be sub-
communication may be poenaed.
Select one:
A. Replaced with verbal communica-
tion.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
3. In which one of the following scenarios D. An insured's negotiations with the insurer on a
is a public adjuster most likely to be- complex claim are not going well.
come involved?
Select one: If a claim is complex, or if settlement negotiations
A. An insurer finds it financially unfea- are not progressing with the insurer, the insured
sible to hire its own claims staff in a may hire a public adjuster to protect his or her
given state. interests.
B. An insured is unable to afford legal
representation to contest a claim.
C. A catastrophic disaster strikes, in-
volving damage to many properties.
D. An insured's negotiations with the
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
insurer on a complex claim are not go-
ing well.
4. Which one of the following statements B. TPAs handle claims, keep claims records, and
regarding third-party administrators perform statistical analyses.
(TPAs) is most accurate?
Select one:
A. TPAs are typically used by business-
es that have chosen not to self-insure.
B. TPAs handle claims, keep claims
records, and perform statistical analy-
ses.
C. TPAs are generally found in an insur-
er's claims department.
D. TPAs are employed only by indepen-
dent adjusting firms.
5. Hugo is conducting an audit of a A. Proper releases taken
branch office claims operation. He is
evaluating timeliness of reports, num- Proper releases taken is a qualitative audit factor;
ber of files opened, proper releas- the others are quantitative.
es taken, and accuracy of data entry.
Which one of Hugo's metrics is a qual-
itative audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
6. Aaron works for a multi-line insurer. He D. Line underwriter.
works with insurance producers and
Line underwriter. This describes the duties of a
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
applicants to evaluate new business line underwriter, rather than a staff underwriter.
submissions and conduct renewal un- There is not enough information to determine
derwriting. Aaron is a which line of business is being written. A pub-
Select one: lic underwriter does not exist. Line underwriters
A. Staff underwriter. evaluate new submissions and perform renew-
B. Public underwriter. al underwriting, usually by working directly with
C. Personal lines underwriter. insurance producers and applicants. Staff un-
D. Line underwriter. derwriters, meanwhile, manage risk selection by
working with line underwriters and coordinating
decisions about products, pricing and guidelines.
7. The first key to communicating empa- D. Listening.
thetically as a claims professional is
Select one: Claims professionals should first listen carefully to
A. A comprehensive understanding of understand what the claimant is saying.
relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documenta-
tion relating to the claim.
D. Listening.
8. Mia tracks loss adjustment expense C. Cost to investigate, defend, and settle claims.
(LAE) as part of her management of
the claims department for an insurer. Cost to investigate, defend, and settle claims. LAE
Mia considers LAE to be the is the expense that an insurer incurs to investi-
Select one: gate, defend, and settle claims according to the
A. Total amount of loss reserves of all terms specified in the insurance policy.
claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and set-
tle claims.
D. Total incurred amount of claims.
, AIC 300 - Claims in an Evolving World
Study online at https://quizlet.com/_97r6u0
9. In her role with an insurer, Katarina D. Claim representative.
has opportunity to collaborate with
not only employees from her compa- Claim reps collaborate with more than other in-
ny, but also external experts with par- surer employees. Many insurers employ a panel
ticular expertise. For example, as part of experts that the claims rep can select according
of her investigation, she hired an engi- to the investigation's needs.
neer to conduct a review of a machine
that was involved in a personal injury.
Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative.
10. When Mehmet interviews witnesses as A. Open-ended
part of his claims investigation, he asks
different types of questions based on Open-ended questions can be used to clarify an
need, such as open-ended, direct, in- interviewee's statements.
direct, and leading. Which type of
question should Mehmet ask when he
wants to set the interviewee at ease
and he is looking for explanation or
elaboration of details in the intervie-
wee's own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
11.
