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Aic 300 Claims In An Evolving World Questions With Correct Answers..

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This document provides practice questions and correct answers for the AIC 300 course, focusing on claims handling in a modern insurance environment. It covers key concepts such as claims investigation, negotiation techniques, legal principles, fraud detection, and data analytics in insurance. The material includes real-world scenarios and explanations, making it useful for exam preparation and for understanding how claims processes evolve with technology and regulation.

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Claims may be paid in any of three ways: by check, by bank transfer or...


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By electronic funds transfer.




Claims rep Lily is negotiating a claim settlement with an unrepresented claimant and
wishes to smooth the process. She is matching her demeanor, tone, and mannerisms
to those of the claimant. Lily is using which one of the following negotiation
techniques?


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, Using traditional sales techniques.

A common technique is mirroring the behavior of the customer.




Samuel was seriously injured in a car accident caused by a drunk driver. His settlement
included payments for repairs to his vehicle, medical bills, pain and suffering, and lost
wages. Which one of the payments in Samuel's settlement is considered general
damages?


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Pain and Suffering.

Pain and suffering, disfigurement, loss of body function, and emotional
distress are all forms of general damages.




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 metrics is a qualitative audit factor?


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Proper Releases Taken.




One of Juan's responsibilities as a claims representative is to prepare internal reports,
such as preliminary, interim, large loss, and captioned. Which one of the reports Juan
prepares is required for claims with reserves that exceed a specified threshold?


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, Large Loss.

Large loss reports are required by most insurers to summarize claims with
reserves above a certain threshold.




In seeking to identify claims that will potentially develop into complex and more
costly claims, the data science team at Great Midsouthwest Insurance ranks a series of
attributes by their importance to the data model. Which one of the following terms
best describes the level of predictive power of each attribute?


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Information Gain.

Information gain is a measure of the predictive power of one or more
attributes.




Which one of the following best described the term 'professionalism' as it relates to
claims professionals?


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The behaviors necessary to implement an ethical decision.


Professionalism involves the behaviors and qualities necessary to
implement an ethical deecision.




In which one of the following scenarios is the right of subrogation most likely to be
employed by the insurer?

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