AIC 300 - CLAIMS IN AN EVOLVING WORLD
QUESTIONS WITH CORRECT ANSWERS 2025
Insurers usually send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail. - CORRECT ANSWER -B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not accepted.
As methods of communication evolve, it's important for claims professionals to remember that any wri
tten claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
Any written claims communication may be subpoenaed.
In which one of the following scenarios is a public adjuster most likely to become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
B. An insured is unable to afford legal representation to contest a claim.
C. A catastrophic disaster strikes, involving damage to many properties.
D. An insured's negotiations with the insurer on a complex claim are not going well. -
CORRECT ANSWER -
D. An insured's negotiations with the insurer on a complex claim are not going well.
If a claim is complex, or if settlement negotiations are not progressing with the insurer, the insured m
ay hire a public adjuster to protect his or her interests.
Which one of the following statements regarding third-party administrators (TPAs) is most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen not to self-insure.
B. TPAs handle claims, keep claims records, and perform statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms. - CORRECT ANSWER -
B. TPAs handle claims, keep claims records, and perform statistical analyses.
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of reports,
number of files opened, proper releases taken, and accuracy of data entry. Which one of Hugo's metr
ics is a qualitative audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry - CORRECT ANSWER -A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the others are quantitative.
Aaron works for a multi-
line insurer. He works with insurance producers and applicants to evaluate new business submissions a
nd conduct renewal underwriting. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter. - CORRECT ANSWER -D. Line underwriter.
Line underwriter. This describes the duties of a line underwriter, rather than a staff underwriter. There
is not enough information to determine which line of business is being written. A public underwriter
does not exist. Line underwriters evaluate new submissions and perform renewal underwriting, usually
by working directly with insurance producers and applicants. Staff underwriters, meanwhile, manage ris
k selection by working with line underwriters and coordinating decisions about products, pricing and g
uidelines.
The first key to communicating empathetically as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the claim.
D. Listening. - CORRECT ANSWER -D. Listening.
Claims professionals should first listen carefully to understand what the claimant is saying.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department for an
insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims. - CORRECT ANSWER -
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to investigate,
defend, and settle claims according to the terms specified in the insurance policy.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees from her
company, but also external experts with particular expertise. For example, as part of her investigation,
she hired an engineer to conduct a review of a machine that was involved in a personal injury. Katari
na is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative. - CORRECT ANSWER -D. Claim representative.
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel of exp
erts that the claims rep can select according to the investigation's needs.
,When Mehmet interviews witnesses as part of his claims investigation, he asks different types of quest
ions based on need, such as open-
ended, direct, indirect, 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 interviewee'
s own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading - CORRECT ANSWER -A. Open-ended
Open-ended questions can be used to clarify an interviewee's statements.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000. She has been ask
ed to complete an internal report summarizing all the file status information for distribution to manag
ement and updated as more information is received. The report Charlotte is completing is most likely
a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report. - CORRECT ANSWER -D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances large loss reports should
be prepared.
In which one of the following scenarios is the right of subrogation most likely to be employed by the i
nsurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An investigation reveals that the jewelry is
still in the insured's possession.
B. An investigation reveals that an insured set her own business on fire.
C. An insured files a claim for collision damage from a hit and run accident, when in fact he backed in
to a utility pole.
D. A claims rep discovers that their insured's car accident was caused by a road contractor who left e
quipment lying in the travel lanes of a highway. - CORRECT ANSWER -
D. A claims rep discovers that their insured's car accident was caused by a road contractor who left e
quipment lying in the travel lanes of a highway.
The right of subrogation allows an insurer to recover payment from a negligent third party.
In claims investigation, all bodily injury claims require
Select one:
A. Statements from all witnesses.
B. Multiple claims payments
C. An attorney.
D. A medical investigation. - CORRECT ANSWER -D. A medical investigation.
All bodily injury claims, including workers compensation claims, require a medical investigation.
Before making initial contact with an insured or claimant, a claims representative should
Select one:
, A. Research similar losses in the same geographical area.
B. Contact company counsel for a reservation of rights letter.
C. Prepare an approximate estimate based on similar losses.
D. Prepare a list of questions for the insured. - CORRECT ANSWER -
D. Prepare a list of questions for the insured.
Before making initial contact with an insured or claimant, a claims representative should prepare a list
of questions for the insured, along with information on how the claim will be handled.
Carolina is a claim representative handling a liability claim. She is speaking to the claimant over the ph
one and has informed him that his statements must be true under penalty of perjury. When complete
d, she sent a transcription of the conversation to the claimant for him to sign before a notary. Carolin
a has taken a(n)
Select one:
A. Affidavit.
B. Deposition.
C. Recorded statement.
D. Examination under oath. - CORRECT ANSWER -C. Recorded statement.
A recorded statement is taken by the claims rep over the phone or in person.
One of Juan's responsibilities as a claims representative is to prepare internal reports, such as prelimin
ary, interim, large loss, and captioned. Which one of the reports Juan prepares is required for claims
with reserves that exceed a specified threshold?
Select one:
A. Interim
B. Large loss
C. Preliminary
D. Captioned - CORRECT ANSWER -B. Large loss
Large loss reports are required by most insurers to summarize claims with reserves above a certain thr
eshold.
In the process of assigning a claim, an internal claims handler will often transfer information to the ins
urer's standard form, called the
Select one:
A. Standard claims handling (SCH) form.
B. Initial acknowledgment of notice (IAN) form.
C. Claim intake (CI) form.
D. First notice of loss (FNOL) form. - CORRECT ANSWER -D. First notice of loss (FNOL) form.
An internal claims handler will often transfer information to the insurer's standard form, called the firs
t notice of loss (FNOL) form.
Which one of the following methods of establishing case reserves is used most often when there are s
mall variations in loss size for a particular type of claim?
Select one:
A. Individual case method
B. Average value method
C. Formula method
D. Roundtable method - CORRECT ANSWER -B. Average value method
QUESTIONS WITH CORRECT ANSWERS 2025
Insurers usually send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail. - CORRECT ANSWER -B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not accepted.
As methods of communication evolve, it's important for claims professionals to remember that any wri
tten claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
Any written claims communication may be subpoenaed.
In which one of the following scenarios is a public adjuster most likely to become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
B. An insured is unable to afford legal representation to contest a claim.
C. A catastrophic disaster strikes, involving damage to many properties.
D. An insured's negotiations with the insurer on a complex claim are not going well. -
CORRECT ANSWER -
D. An insured's negotiations with the insurer on a complex claim are not going well.
If a claim is complex, or if settlement negotiations are not progressing with the insurer, the insured m
ay hire a public adjuster to protect his or her interests.
Which one of the following statements regarding third-party administrators (TPAs) is most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen not to self-insure.
B. TPAs handle claims, keep claims records, and perform statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms. - CORRECT ANSWER -
B. TPAs handle claims, keep claims records, and perform statistical analyses.
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of reports,
number of files opened, proper releases taken, and accuracy of data entry. Which one of Hugo's metr
ics is a qualitative audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry - CORRECT ANSWER -A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the others are quantitative.
Aaron works for a multi-
line insurer. He works with insurance producers and applicants to evaluate new business submissions a
nd conduct renewal underwriting. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter. - CORRECT ANSWER -D. Line underwriter.
Line underwriter. This describes the duties of a line underwriter, rather than a staff underwriter. There
is not enough information to determine which line of business is being written. A public underwriter
does not exist. Line underwriters evaluate new submissions and perform renewal underwriting, usually
by working directly with insurance producers and applicants. Staff underwriters, meanwhile, manage ris
k selection by working with line underwriters and coordinating decisions about products, pricing and g
uidelines.
The first key to communicating empathetically as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the claim.
D. Listening. - CORRECT ANSWER -D. Listening.
Claims professionals should first listen carefully to understand what the claimant is saying.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department for an
insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims. - CORRECT ANSWER -
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to investigate,
defend, and settle claims according to the terms specified in the insurance policy.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees from her
company, but also external experts with particular expertise. For example, as part of her investigation,
she hired an engineer to conduct a review of a machine that was involved in a personal injury. Katari
na is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative. - CORRECT ANSWER -D. Claim representative.
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel of exp
erts that the claims rep can select according to the investigation's needs.
,When Mehmet interviews witnesses as part of his claims investigation, he asks different types of quest
ions based on need, such as open-
ended, direct, indirect, 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 interviewee'
s own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading - CORRECT ANSWER -A. Open-ended
Open-ended questions can be used to clarify an interviewee's statements.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000. She has been ask
ed to complete an internal report summarizing all the file status information for distribution to manag
ement and updated as more information is received. The report Charlotte is completing is most likely
a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report. - CORRECT ANSWER -D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances large loss reports should
be prepared.
In which one of the following scenarios is the right of subrogation most likely to be employed by the i
nsurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An investigation reveals that the jewelry is
still in the insured's possession.
B. An investigation reveals that an insured set her own business on fire.
C. An insured files a claim for collision damage from a hit and run accident, when in fact he backed in
to a utility pole.
D. A claims rep discovers that their insured's car accident was caused by a road contractor who left e
quipment lying in the travel lanes of a highway. - CORRECT ANSWER -
D. A claims rep discovers that their insured's car accident was caused by a road contractor who left e
quipment lying in the travel lanes of a highway.
The right of subrogation allows an insurer to recover payment from a negligent third party.
In claims investigation, all bodily injury claims require
Select one:
A. Statements from all witnesses.
B. Multiple claims payments
C. An attorney.
D. A medical investigation. - CORRECT ANSWER -D. A medical investigation.
All bodily injury claims, including workers compensation claims, require a medical investigation.
Before making initial contact with an insured or claimant, a claims representative should
Select one:
, A. Research similar losses in the same geographical area.
B. Contact company counsel for a reservation of rights letter.
C. Prepare an approximate estimate based on similar losses.
D. Prepare a list of questions for the insured. - CORRECT ANSWER -
D. Prepare a list of questions for the insured.
Before making initial contact with an insured or claimant, a claims representative should prepare a list
of questions for the insured, along with information on how the claim will be handled.
Carolina is a claim representative handling a liability claim. She is speaking to the claimant over the ph
one and has informed him that his statements must be true under penalty of perjury. When complete
d, she sent a transcription of the conversation to the claimant for him to sign before a notary. Carolin
a has taken a(n)
Select one:
A. Affidavit.
B. Deposition.
C. Recorded statement.
D. Examination under oath. - CORRECT ANSWER -C. Recorded statement.
A recorded statement is taken by the claims rep over the phone or in person.
One of Juan's responsibilities as a claims representative is to prepare internal reports, such as prelimin
ary, interim, large loss, and captioned. Which one of the reports Juan prepares is required for claims
with reserves that exceed a specified threshold?
Select one:
A. Interim
B. Large loss
C. Preliminary
D. Captioned - CORRECT ANSWER -B. Large loss
Large loss reports are required by most insurers to summarize claims with reserves above a certain thr
eshold.
In the process of assigning a claim, an internal claims handler will often transfer information to the ins
urer's standard form, called the
Select one:
A. Standard claims handling (SCH) form.
B. Initial acknowledgment of notice (IAN) form.
C. Claim intake (CI) form.
D. First notice of loss (FNOL) form. - CORRECT ANSWER -D. First notice of loss (FNOL) form.
An internal claims handler will often transfer information to the insurer's standard form, called the firs
t notice of loss (FNOL) form.
Which one of the following methods of establishing case reserves is used most often when there are s
mall variations in loss size for a particular type of claim?
Select one:
A. Individual case method
B. Average value method
C. Formula method
D. Roundtable method - CORRECT ANSWER -B. Average value method
