AIC 300 CLAIMS IN AN EVOLVING WORLD
ACTUAL EXAM PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◉ Indemnify.
Answer: to restore a party that sustain a loss to the financial position
they had before. wont just pay anything - insurer's Claims
Department will conduct a good-faith investigation of a claim and
pay only legitimate claims that are covered by the policy.
◉ Claims and insurer primary goals.
Answer: 1. Keep promise -fair prompt and equitable service when
losses involve 1st or 3rd party claims. 2. support the insurer profit
goal
◉ 1st party insurance.
Answer: Property insurance is considered first-party insurance
because the insurer, or second party, makes payment for covered
losses directly to the policyholder, or first party.
◉ 3rd party insurance.
Answer: Liability insurance is considered third-party insurance
because the insurer makes payments on behalf of the policyholder to
,a claimant (third party) who is injured or whose property is
damaged by the policyholder.
◉ claims department structure.
Answer: headed by a senior claims officer reporting to CEO or CFO
◉ Insurance fraud costs how much per year.
Answer: Costs roughly $40 billion per year, excluding health
insurance
◉ third party administrators (TPAs).
Answer: an organization that administrative services associated
with risk financing and insurance. They are often associated with
large independent adjusting firms or with subsidiaries of insurers.
◉ TPAs job.
Answer: TPAs handle claims, keep claims records, and perform
statistical analyses.
◉ Claims representatives.
Answer: a person in charge of investigating, evaluating, and settling
claims
,◉ producers.
Answer: any of several kinds of personal (agents, brokers, sales
reps) who place insurance and surety business with insurers and
who represents insurers or insureds or both. who insurer goes to.
some even pay small claims
◉ public adjusters.
Answer: an outside organization or person hired by an insured to
represent in a claim in exchange for a fee. Some states have statutes
that govern the services public adjusters can provide. But, in
general, a public adjuster prepares an insured's claim and negotiates
the settlement with the staff claims representative or independent
adjuster.
◉ when are independent adjusters used.
Answer: used by insurers to handle claims in strategic locations,
when they don't need claims offices there. Could also be used to
handle field work, for specialized skills or when claims staff are too
busy.
◉ Line underwriters.
Answer: evaluate new submissions and perform renewal
underwriting, usually by working directly with insurance producers
and applicants
, ◉ Staff underwriters.
Answer: manage risk selection by working with line underwriters
and coordinating decisions about products, pricing, and guidelines
◉ Underwriter key activates.
Answer: 1. minimize adverse selection, 2. ensure adequate policy
surplus, 3. Enforce underwriting guidelines
◉ The Claims Department relies on underwriters for.
Answer: thorough, accurate data about the circumstances under
which coverage was written.
◉ Claims personnel help underwriters by.
Answer: ensuring that claims are paid fairly and according to their
respective policy. Proper, consistent, and efficient claims handling
enables underwriters to evaluate, select, and appropriately price
loss exposures.
◉ claims & premium audits.
Answer: claims information benefits the premium audit function by
verifying employment classifications. Premium auditors can provide
inventory values, contractors' equipment lists, and other facts that
are important to the claims function.
ACTUAL EXAM PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◉ Indemnify.
Answer: to restore a party that sustain a loss to the financial position
they had before. wont just pay anything - insurer's Claims
Department will conduct a good-faith investigation of a claim and
pay only legitimate claims that are covered by the policy.
◉ Claims and insurer primary goals.
Answer: 1. Keep promise -fair prompt and equitable service when
losses involve 1st or 3rd party claims. 2. support the insurer profit
goal
◉ 1st party insurance.
Answer: Property insurance is considered first-party insurance
because the insurer, or second party, makes payment for covered
losses directly to the policyholder, or first party.
◉ 3rd party insurance.
Answer: Liability insurance is considered third-party insurance
because the insurer makes payments on behalf of the policyholder to
,a claimant (third party) who is injured or whose property is
damaged by the policyholder.
◉ claims department structure.
Answer: headed by a senior claims officer reporting to CEO or CFO
◉ Insurance fraud costs how much per year.
Answer: Costs roughly $40 billion per year, excluding health
insurance
◉ third party administrators (TPAs).
Answer: an organization that administrative services associated
with risk financing and insurance. They are often associated with
large independent adjusting firms or with subsidiaries of insurers.
◉ TPAs job.
Answer: TPAs handle claims, keep claims records, and perform
statistical analyses.
◉ Claims representatives.
Answer: a person in charge of investigating, evaluating, and settling
claims
,◉ producers.
Answer: any of several kinds of personal (agents, brokers, sales
reps) who place insurance and surety business with insurers and
who represents insurers or insureds or both. who insurer goes to.
some even pay small claims
◉ public adjusters.
Answer: an outside organization or person hired by an insured to
represent in a claim in exchange for a fee. Some states have statutes
that govern the services public adjusters can provide. But, in
general, a public adjuster prepares an insured's claim and negotiates
the settlement with the staff claims representative or independent
adjuster.
◉ when are independent adjusters used.
Answer: used by insurers to handle claims in strategic locations,
when they don't need claims offices there. Could also be used to
handle field work, for specialized skills or when claims staff are too
busy.
◉ Line underwriters.
Answer: evaluate new submissions and perform renewal
underwriting, usually by working directly with insurance producers
and applicants
, ◉ Staff underwriters.
Answer: manage risk selection by working with line underwriters
and coordinating decisions about products, pricing, and guidelines
◉ Underwriter key activates.
Answer: 1. minimize adverse selection, 2. ensure adequate policy
surplus, 3. Enforce underwriting guidelines
◉ The Claims Department relies on underwriters for.
Answer: thorough, accurate data about the circumstances under
which coverage was written.
◉ Claims personnel help underwriters by.
Answer: ensuring that claims are paid fairly and according to their
respective policy. Proper, consistent, and efficient claims handling
enables underwriters to evaluate, select, and appropriately price
loss exposures.
◉ claims & premium audits.
Answer: claims information benefits the premium audit function by
verifying employment classifications. Premium auditors can provide
inventory values, contractors' equipment lists, and other facts that
are important to the claims function.
