AIC 300 - CLAIMS IN AN EVOLVING
WORLD 100% ACCURATE
Adam manages a claims department for an insurer. He measures the department's
performance by best practices, claims audits, customer satisfaction data, and loss ratio.
Which one of Adam's measures refers to a system of identified internal practices that
claims representatives perform to produce superior performance?
A. Claims audits
B. Best practices
C. Loss ratio
D. Customer satisfaction data - ANSWER B. Best practices
Best practices generally refers to a system of identified internal practices that are
shared with claims reps and produce superior performance.
DaJuan, a claims representative, sets a low case reserve for a seemingly simple claim.
A few weeks later it becomes apparent that the initial reserve was too low, and he
increases it in order to issue payments. More bills related to the claim arrive a few
months later, and he increases the reserve again. This process is known as
Select one:
A. Readjusting.
B. Stairstepping
C. Reopening.
D. Incremental reserving. - ANSWER B. Stairstepping.
Correct. The process of repeatedly increasing the reserve for a claim is called
stairstepping.
Olivia is careful to keep proper claim status notes when she handles a claim. For
example, she makes sure to only include neutral, objective comments about the parties
involved. This is because claim notes
Select one:
A. Are potentially discoverable in a trial.
B. Continue for as long as the claim is open.
C. Present a chronology of the life of the claim.
D. Must be able to speak for themselves. - ANSWER A. Are potentially discoverable in
a trial.
Correct. Are potentially discoverable in a trial. Seemingly innocuous comments can be
devastating when read to a jury.
Ciara is going to college with the goal of working as a data scientist for an insurer. She
will need a strong foundation in mathematics and statistics, computer programming,
, domain knowledge, and data science. Which one of Ciara's skills will require her to
understand the insurance profession to which the data is being applied?
Select one:
A. Mathematics and statistics
B. Data science
C. Computer programming
D. Domain knowledge - ANSWER Domain knowledge
...is the understanding of the discipline, profession, or activity to which the data is being
applied.
rin helps her employer, a multi-line insurer, to determine actual exposure and premium
for coverage. She does this by conducting detailed examinations of policyholder
operations, records, and accounting. Erin is a(n)
Select one:
A. Underwriter
B. Premium auditor.
C. Claims adjuster.
D. Producer. - ANSWER Premium auditor.
Premium auditors provide inventory values, contractors' equipment lists, and other facts
that are important to the claims function.
Erik is a claims manager for Taunton Insurance. He is leading a team of property claims
representatives responding to a recent tornado in Kentucky. Before sending the
representatives into the field, Erik has decided to use Internet of Things (IoT)
technology to assess the damage and danger in the area. Which one of the following
IoT devices would Erik most likely use in this situation?
Select one:
A. Drones
B. Telematics
C. Smartphones
D. Sensors - ANSWER Drones
Erik would most likely use drones to take photos or videos of the difficult-to-reach area
and assess the damage and danger. By using the drones, he can assess the danger
without risking the safety of the claims representatives. Telematics devices are used in
automobiles to create a picture of driving patterns.
Mustafa is a data scientist who is working with a team of underwriting, IT, and actuary to
develop a predictive analytics model. The main goal of the project is to translate the
insights gained from the model they develop into business action. In Mustafa's
experience, the team member that can provide the bridge between the analytics and the
business is
Select one:
A. Underwriting.
WORLD 100% ACCURATE
Adam manages a claims department for an insurer. He measures the department's
performance by best practices, claims audits, customer satisfaction data, and loss ratio.
Which one of Adam's measures refers to a system of identified internal practices that
claims representatives perform to produce superior performance?
A. Claims audits
B. Best practices
C. Loss ratio
D. Customer satisfaction data - ANSWER B. Best practices
Best practices generally refers to a system of identified internal practices that are
shared with claims reps and produce superior performance.
DaJuan, a claims representative, sets a low case reserve for a seemingly simple claim.
A few weeks later it becomes apparent that the initial reserve was too low, and he
increases it in order to issue payments. More bills related to the claim arrive a few
months later, and he increases the reserve again. This process is known as
Select one:
A. Readjusting.
B. Stairstepping
C. Reopening.
D. Incremental reserving. - ANSWER B. Stairstepping.
Correct. The process of repeatedly increasing the reserve for a claim is called
stairstepping.
Olivia is careful to keep proper claim status notes when she handles a claim. For
example, she makes sure to only include neutral, objective comments about the parties
involved. This is because claim notes
Select one:
A. Are potentially discoverable in a trial.
B. Continue for as long as the claim is open.
C. Present a chronology of the life of the claim.
D. Must be able to speak for themselves. - ANSWER A. Are potentially discoverable in
a trial.
Correct. Are potentially discoverable in a trial. Seemingly innocuous comments can be
devastating when read to a jury.
Ciara is going to college with the goal of working as a data scientist for an insurer. She
will need a strong foundation in mathematics and statistics, computer programming,
, domain knowledge, and data science. Which one of Ciara's skills will require her to
understand the insurance profession to which the data is being applied?
Select one:
A. Mathematics and statistics
B. Data science
C. Computer programming
D. Domain knowledge - ANSWER Domain knowledge
...is the understanding of the discipline, profession, or activity to which the data is being
applied.
rin helps her employer, a multi-line insurer, to determine actual exposure and premium
for coverage. She does this by conducting detailed examinations of policyholder
operations, records, and accounting. Erin is a(n)
Select one:
A. Underwriter
B. Premium auditor.
C. Claims adjuster.
D. Producer. - ANSWER Premium auditor.
Premium auditors provide inventory values, contractors' equipment lists, and other facts
that are important to the claims function.
Erik is a claims manager for Taunton Insurance. He is leading a team of property claims
representatives responding to a recent tornado in Kentucky. Before sending the
representatives into the field, Erik has decided to use Internet of Things (IoT)
technology to assess the damage and danger in the area. Which one of the following
IoT devices would Erik most likely use in this situation?
Select one:
A. Drones
B. Telematics
C. Smartphones
D. Sensors - ANSWER Drones
Erik would most likely use drones to take photos or videos of the difficult-to-reach area
and assess the damage and danger. By using the drones, he can assess the danger
without risking the safety of the claims representatives. Telematics devices are used in
automobiles to create a picture of driving patterns.
Mustafa is a data scientist who is working with a team of underwriting, IT, and actuary to
develop a predictive analytics model. The main goal of the project is to translate the
insights gained from the model they develop into business action. In Mustafa's
experience, the team member that can provide the bridge between the analytics and the
business is
Select one:
A. Underwriting.
