AIC 300 CLAIMS IN AN EVOLVING WORLD
TERMINAL CERTIFICATION EVALUATION
COMPLETE QUESTIONS WITH FULL
SOLUTION ALREADY PASSED
⩥ The first key to communicating empathetically as a claims
professional is...
Answer: Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying.
⩥ The Office of Foreign Assets Control requires claims payors to check
payees against a database of...
Answer: Known terrorists & drug traffickers
⩥ Mia tracks loss adjustment expense (LAE) as part of her management
of the claims department for an insurer. Mia considers LAE to be the...
Answer: Cost to investigate, defend & settle claims
⩥ In which one of the following scenarios is a public adjuster most
likely to become involved?
,Answer: 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.
⩥ When Mehmet interviews witnesses as part of his claim investigation,
he asks different types of questions 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?
Answer: Open-Ended.
Open-Ended questions can be used to clarify an interviewee's
statements.
⩥ Tobias is a claims representative who understands the importance of
good-faith claims handling, including fair evaluation, good-faith
negotiation, complete and accurate documentation, and timely contact
with all parties to a claim. Which one of Tobias' good-faith claims
handling practices helps his employer because the parties will be more
likely to remember details of the loss accurately?
Answer: Timely contact with all parties to a claim.
, Timely contact with all parties to a claim helps ensure that parties will
be more likely to remember details of the loss accurately.
⩥ 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?
Answer: Information Gain.
Information gain is a measure of the predictive power of one or more
attributes.
⩥ Not long after Valteri issued a denial and closed the claim, the insured
sued for coverage and alleged bad-faith claim handling against the
insurer. Valteri was able to demonstrate for his superiors that he had
made a good-faith investigation and determined that the claim was not
covered by the policy. The insurer maintains that Valteri had reasonable
justification in fact for denying the claim. The insurer is employing the...
Answer: Debatable reasonable basis defense.
Debatable reasonable basis defense. The insurer may establish that
defense that it has a reasonable basis for questioning whether a claim
was covered.
TERMINAL CERTIFICATION EVALUATION
COMPLETE QUESTIONS WITH FULL
SOLUTION ALREADY PASSED
⩥ The first key to communicating empathetically as a claims
professional is...
Answer: Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying.
⩥ The Office of Foreign Assets Control requires claims payors to check
payees against a database of...
Answer: Known terrorists & drug traffickers
⩥ Mia tracks loss adjustment expense (LAE) as part of her management
of the claims department for an insurer. Mia considers LAE to be the...
Answer: Cost to investigate, defend & settle claims
⩥ In which one of the following scenarios is a public adjuster most
likely to become involved?
,Answer: 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.
⩥ When Mehmet interviews witnesses as part of his claim investigation,
he asks different types of questions 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?
Answer: Open-Ended.
Open-Ended questions can be used to clarify an interviewee's
statements.
⩥ Tobias is a claims representative who understands the importance of
good-faith claims handling, including fair evaluation, good-faith
negotiation, complete and accurate documentation, and timely contact
with all parties to a claim. Which one of Tobias' good-faith claims
handling practices helps his employer because the parties will be more
likely to remember details of the loss accurately?
Answer: Timely contact with all parties to a claim.
, Timely contact with all parties to a claim helps ensure that parties will
be more likely to remember details of the loss accurately.
⩥ 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?
Answer: Information Gain.
Information gain is a measure of the predictive power of one or more
attributes.
⩥ Not long after Valteri issued a denial and closed the claim, the insured
sued for coverage and alleged bad-faith claim handling against the
insurer. Valteri was able to demonstrate for his superiors that he had
made a good-faith investigation and determined that the claim was not
covered by the policy. The insurer maintains that Valteri had reasonable
justification in fact for denying the claim. The insurer is employing the...
Answer: Debatable reasonable basis defense.
Debatable reasonable basis defense. The insurer may establish that
defense that it has a reasonable basis for questioning whether a claim
was covered.
