AIC 300 - CLAIMS IN AN EVOLVING WORLD
QUESTIONS WITH CORRECT ANSWERS
2026
Insurers usually send denial letters 1 1 1 1
Select one: 1
A. By email to ensure prompt receipt by the insured.
1 1 1 1 1 1 1 1 1
B. By certified mail with a return receipt requested.
1 1 1 1 1 1 1 1
C. By overnight courier.
1 1 1
D. By registered mail. - CORRECT ANSWER -B. By certified mail with a return receipt requested.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Some will also send a copy via regular mail in case the certified letter is not accepted.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
As methods of communication evolve, it's important for claims professionals to remember that any
1 1 1 1 1 1 1 1 1 1 1 1 1
1wri tten claims communication may be
1 1 1 1 1
Select one: 1
A. Replaced with verbal communication.
1 1 1 1
B. Misinterpreted.
1
C. Edited later.
1 1
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
1 1 1 1 1 1
Any written claims communication may be subpoenaed.
1 1 1 1 1 1
In which one of the following scenarios is a public adjuster most likely to become
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1involved? Select one: 1 1
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B. An insured is unable to afford legal representation to contest a claim.
1 1 1 1 1 1 1 1 1 1 1 1
C. A catastrophic disaster strikes, involving damage to many properties.
1 1 1 1 1 1 1 1 1
D. An insured's negotiations with the insurer on a complex claim are not going well. -
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
CORRECT ANSWER -
1 1 1
D. An insured's negotiations with the insurer on a complex claim are not going well.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
If a claim is complex, or if settlement negotiations are not progressing with the insurer, the insured
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1m ay hire a public adjuster to protect his or her interests.
1 1 1 1 1 1 1 1 1 1 1
Which one of the following statements regarding third-party administrators (TPAs) is most accurate?
1 1 1 1 1 1 1 1 1 1 1 1
Select one:
1 1
A. TPAs are typically used by businesses that have chosen not to self-insure.
1 1 1 1 1 1 1 1 1 1 1 1
B. TPAs handle claims, keep claims records, and perform statistical analyses.
1 1 1 1 1 1 1 1 1 1
C. TPAs are generally found in an insurer's claims department.
1 1 1 1 1 1 1 1 1
D. TPAs are employed only by independent adjusting firms. - CORRECT ANSWER -
1 1 1 1 1 1 1 1 1 1 1 1
B. TPAs handle claims, keep claims records, and perform statistical analyses.
1 1 1 1 1 1 1 1 1 1
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of reports, number
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
of files opened, proper releases taken, and accuracy of data entry. Which one of Hugo's metr ics is
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
a qualitative audit factor?
1 1 1 1
,Select one:
1
A. Proper releases taken
1 1 1
B. Timeliness of reports
1 1 1
C. Number of files opened
1 1 1 1
D. Accuracy of data entry - CORRECT ANSWER -A. Proper releases taken
1 1 1 1 1 1 1 1 1 1 1
, Proper releases taken is a qualitative audit factor; the others are quantitative.
1 1 1 1 1 1 1 1 1 1 1
Aaron works for a multi- 1 1 1 1
line insurer. He works with insurance producers and applicants to evaluate new business submissions
1 1 1 1 1 1 1 1 1 1 1 1 1
1a nd conduct renewal underwriting. Aaron is a
1 1 1 1 1 1 1
Select one: 1
A. Staff underwriter.
1 1
B. Public underwriter.
1 1
C. Personal lines underwriter.
1 1 1
D. Line underwriter. - CORRECT ANSWER -D. Line underwriter.
1 1 1 1 1 1 1 1
Line underwriter. This describes the duties of a line underwriter, rather than a staff underwriter.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1There is not enough information to determine which line of business is being written. A public
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1underwriter does not exist. Line underwriters evaluate new submissions and perform renewal 1 1 1 1 1 1 1 1 1 1 1
1underwriting, usually by working directly with insurance producers and applicants. Staff underwriters, 1 1 1 1 1 1 1 1 1 1 1
1meanwhile, manage ris k selection by working with line underwriters and coordinating decisions 1 1 1 1 1 1 1 1 1 1 1 1
1about products, pricing and g uidelines. 1 1 1 1 1
The first key to communicating empathetically as a claims professional
1 1 1 1 1 1 1 1 1
is Select one:
1 1 1
A. A comprehensive understanding of relevant insurance policies.
1 1 1 1 1 1 1
B. Speaking calmly and clearly.
1 1 1 1
C. Being prepared with all documentation relating to the claim.
1 1 1 1 1 1 1 1 1
D. Listening. - CORRECT ANSWER -D. Listening.
1 1 1 1 1 1
Claims professionals should first listen carefully to understand what the claimant is saying.
1 1 1 1 1 1 1 1 1 1 1 1
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department for an
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
insurer. Mia considers LAE to be the
1 1 1 1 1 1 1
Select one: 1
A. Total amount of loss reserves of all claims.
1 1 1 1 1 1 1 1
B. Paid portion of claims.
1 1 1 1
C. Cost to investigate, defend, and settle claims.
1 1 1 1 1 1 1
D. Total incurred amount of claims. - CORRECT ANSWER -
1 1 1 1 1 1 1 1 1
C. Cost to investigate, defend, and settle claims.
1 1 1 1 1 1 1
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
investigate, defend, and settle claims according to the terms specified in the insurance policy.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
In her role with an insurer, Katarina has opportunity to collaborate with not only employees from her company,
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1but also external experts with particular expertise. For example, as part of her investigation, she
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1hired an engineer to conduct a review of a machine that was involved in a personal injury. Katari
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
na is a(n)
1 1 1
Select one: 1
A. Medical provider.
1 1
B. Expert Witness.
1 1
C. Premium auditor.
1 1
D. Claim representative. - CORRECT ANSWER -D. Claim representative.
1 1 1 1 1 1 1 1
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel of
1 1 1 1 1 1 1 1 1 1 1 1 1 1
exp erts that the claims rep can select according to the investigation's needs.
1 1 1 1 1 1 1 1 1 1 1 1 1
QUESTIONS WITH CORRECT ANSWERS
2026
Insurers usually send denial letters 1 1 1 1
Select one: 1
A. By email to ensure prompt receipt by the insured.
1 1 1 1 1 1 1 1 1
B. By certified mail with a return receipt requested.
1 1 1 1 1 1 1 1
C. By overnight courier.
1 1 1
D. By registered mail. - CORRECT ANSWER -B. By certified mail with a return receipt requested.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Some will also send a copy via regular mail in case the certified letter is not accepted.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
As methods of communication evolve, it's important for claims professionals to remember that any
1 1 1 1 1 1 1 1 1 1 1 1 1
1wri tten claims communication may be
1 1 1 1 1
Select one: 1
A. Replaced with verbal communication.
1 1 1 1
B. Misinterpreted.
1
C. Edited later.
1 1
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
1 1 1 1 1 1
Any written claims communication may be subpoenaed.
1 1 1 1 1 1
In which one of the following scenarios is a public adjuster most likely to become
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1involved? Select one: 1 1
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B. An insured is unable to afford legal representation to contest a claim.
1 1 1 1 1 1 1 1 1 1 1 1
C. A catastrophic disaster strikes, involving damage to many properties.
1 1 1 1 1 1 1 1 1
D. An insured's negotiations with the insurer on a complex claim are not going well. -
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
CORRECT ANSWER -
1 1 1
D. An insured's negotiations with the insurer on a complex claim are not going well.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
If a claim is complex, or if settlement negotiations are not progressing with the insurer, the insured
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1m ay hire a public adjuster to protect his or her interests.
1 1 1 1 1 1 1 1 1 1 1
Which one of the following statements regarding third-party administrators (TPAs) is most accurate?
1 1 1 1 1 1 1 1 1 1 1 1
Select one:
1 1
A. TPAs are typically used by businesses that have chosen not to self-insure.
1 1 1 1 1 1 1 1 1 1 1 1
B. TPAs handle claims, keep claims records, and perform statistical analyses.
1 1 1 1 1 1 1 1 1 1
C. TPAs are generally found in an insurer's claims department.
1 1 1 1 1 1 1 1 1
D. TPAs are employed only by independent adjusting firms. - CORRECT ANSWER -
1 1 1 1 1 1 1 1 1 1 1 1
B. TPAs handle claims, keep claims records, and perform statistical analyses.
1 1 1 1 1 1 1 1 1 1
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of reports, number
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
of files opened, proper releases taken, and accuracy of data entry. Which one of Hugo's metr ics is
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
a qualitative audit factor?
1 1 1 1
,Select one:
1
A. Proper releases taken
1 1 1
B. Timeliness of reports
1 1 1
C. Number of files opened
1 1 1 1
D. Accuracy of data entry - CORRECT ANSWER -A. Proper releases taken
1 1 1 1 1 1 1 1 1 1 1
, Proper releases taken is a qualitative audit factor; the others are quantitative.
1 1 1 1 1 1 1 1 1 1 1
Aaron works for a multi- 1 1 1 1
line insurer. He works with insurance producers and applicants to evaluate new business submissions
1 1 1 1 1 1 1 1 1 1 1 1 1
1a nd conduct renewal underwriting. Aaron is a
1 1 1 1 1 1 1
Select one: 1
A. Staff underwriter.
1 1
B. Public underwriter.
1 1
C. Personal lines underwriter.
1 1 1
D. Line underwriter. - CORRECT ANSWER -D. Line underwriter.
1 1 1 1 1 1 1 1
Line underwriter. This describes the duties of a line underwriter, rather than a staff underwriter.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1There is not enough information to determine which line of business is being written. A public
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1underwriter does not exist. Line underwriters evaluate new submissions and perform renewal 1 1 1 1 1 1 1 1 1 1 1
1underwriting, usually by working directly with insurance producers and applicants. Staff underwriters, 1 1 1 1 1 1 1 1 1 1 1
1meanwhile, manage ris k selection by working with line underwriters and coordinating decisions 1 1 1 1 1 1 1 1 1 1 1 1
1about products, pricing and g uidelines. 1 1 1 1 1
The first key to communicating empathetically as a claims professional
1 1 1 1 1 1 1 1 1
is Select one:
1 1 1
A. A comprehensive understanding of relevant insurance policies.
1 1 1 1 1 1 1
B. Speaking calmly and clearly.
1 1 1 1
C. Being prepared with all documentation relating to the claim.
1 1 1 1 1 1 1 1 1
D. Listening. - CORRECT ANSWER -D. Listening.
1 1 1 1 1 1
Claims professionals should first listen carefully to understand what the claimant is saying.
1 1 1 1 1 1 1 1 1 1 1 1
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department for an
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
insurer. Mia considers LAE to be the
1 1 1 1 1 1 1
Select one: 1
A. Total amount of loss reserves of all claims.
1 1 1 1 1 1 1 1
B. Paid portion of claims.
1 1 1 1
C. Cost to investigate, defend, and settle claims.
1 1 1 1 1 1 1
D. Total incurred amount of claims. - CORRECT ANSWER -
1 1 1 1 1 1 1 1 1
C. Cost to investigate, defend, and settle claims.
1 1 1 1 1 1 1
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
investigate, defend, and settle claims according to the terms specified in the insurance policy.
1 1 1 1 1 1 1 1 1 1 1 1 1 1
In her role with an insurer, Katarina has opportunity to collaborate with not only employees from her company,
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1but also external experts with particular expertise. For example, as part of her investigation, she
1 1 1 1 1 1 1 1 1 1 1 1 1 1
1hired an engineer to conduct a review of a machine that was involved in a personal injury. Katari
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
na is a(n)
1 1 1
Select one: 1
A. Medical provider.
1 1
B. Expert Witness.
1 1
C. Premium auditor.
1 1
D. Claim representative. - CORRECT ANSWER -D. Claim representative.
1 1 1 1 1 1 1 1
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel of
1 1 1 1 1 1 1 1 1 1 1 1 1 1
exp erts that the claims rep can select according to the investigation's needs.
1 1 1 1 1 1 1 1 1 1 1 1 1
