AIC 300 CLAIMS IN AN EVOLVING WORLD
FINAL COMPREHENSIVE ASSESSMENT TEST
PAPER QUESTIONS AND SOLUTIONS
⩥ D. Subpoenaed.
Any written claims communication may be subpoenaed.
Answer: As methods of communication evolve, it's important for claims
professionals to remember that any written claims communication may
be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
⩥ 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 may hire a public adjuster to protect his or
her interests.
,Answer: 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.
⩥ B. TPAs handle claims, keep claims records, and perform statistical
analyses.
Answer: 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.
⩥ A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the others are
quantitative.
Answer: 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?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
⩥ 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 risk selection by
working with line underwriters and coordinating decisions about
products, pricing and guidelines.
Answer: Aaron works for a multi-line insurer. He works with insurance
producers and applicants to evaluate new business submissions and
conduct renewal underwriting. Aaron is a
Select one:
, A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
⩥ D. Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying.
Answer: 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.
⩥ 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.
FINAL COMPREHENSIVE ASSESSMENT TEST
PAPER QUESTIONS AND SOLUTIONS
⩥ D. Subpoenaed.
Any written claims communication may be subpoenaed.
Answer: As methods of communication evolve, it's important for claims
professionals to remember that any written claims communication may
be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
⩥ 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 may hire a public adjuster to protect his or
her interests.
,Answer: 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.
⩥ B. TPAs handle claims, keep claims records, and perform statistical
analyses.
Answer: 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.
⩥ A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the others are
quantitative.
Answer: 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?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
⩥ 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 risk selection by
working with line underwriters and coordinating decisions about
products, pricing and guidelines.
Answer: Aaron works for a multi-line insurer. He works with insurance
producers and applicants to evaluate new business submissions and
conduct renewal underwriting. Aaron is a
Select one:
, A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
⩥ D. Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying.
Answer: 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.
⩥ 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.
