AIC 300 CORRECT TEST PAPER ANSWERS AND
QUESTIONS SET A+
✔✔Linnea is an attorney who is preparing to defend an insurer in a workers
compensation case. Discovery produced several documents that are being presented
as witnesses statements, but the witnesses admit in the statements to not actually
seeing the accident. Linnea would like to omit these statements from the proceedings,
so she is filing a - ✔✔Motion in limine
✔✔Chloe is an insurer defense attorney who is preparing a trial strategy. She has
researched a court decision that was made in a similar case and is basing the defense
on that precedent. Chloe is relying on the principle of stare decisis, which is that -
✔✔Lower courts must follow precedents set by higher courts
✔✔The claims litigation process begins with the receipt of - ✔✔A summons and
complaint
✔✔Riko is an experienced settlement negotiator. When negotiating with claimant
representatives, she uses techniques such as timing settlements effectively, enticing a
reasonable demand, making concessions cautiously, and leaning on the evaluation.
She understands that her current claimant is eager to receive money, so she is delaying
the negotiations as long as possible. Which negotiation technique is Riko using? -
✔✔Timing settlements effectively
✔✔Kira, a claims representative, receives a summons and complaint from an insured.
In reviewing the facts, she has doubts that the insured's applicable policy will provide
coverage. She should work with counsel and request a managerial review in order to
issue - ✔✔A reservation of rights letter
✔✔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? -
✔✔Using traditional sales techniques
,✔✔Rin works for an insurer designing and using techniques to process large amounts
of data from various sources and providing knowledge based on the analysis of that
data. Rin is a(n) - ✔✔Data scientist
✔✔Which one of the following explains why a computer recursively applies a model? -
✔✔To analyze different splits in the values of attributes
✔✔Part of the continuous cycle of data mining is preparing the data to eliminate missing
or inaccurate information. This process is called - ✔✔Cleaning
✔✔Which one of the following is a data mining technique an insurer applies when it
knows what - ✔✔Classification
✔✔Hanna is in IT and works on data analytics projects for an insurer. These projects
involve analyzing large amounts of data to help underwriting to select risks and price
policies. Hanna knows that collaboration between data science, IT, underwriting, and
actuary is critical to the success of these projects. In Hanna's experience, as soon as
the need for a data project arises, the key to collaborating effectively is to engage which
one of the following teams as soon as possible? - ✔✔Data science
✔✔Greatview Insurance wants to predict which auto liability claims will most likely go to
litigation, so it can assign them to experienced adjusters early in the process. There are
certain known indicators of litigation that Greatview wants to use in the data mining
process. Which one of the following data mining techniques would Greatview's analyst
most likely use? - ✔✔Classification
✔✔The first step in the data mining process is to - ✔✔Understand what a business
wants to achieve
✔✔Carla is investigating a claim for a stolen car. The insured provided a copy of the
police report, but she notices that the account in the police report differs from the
insured's version of events. At this point, Carla should - ✔✔Continue with her
investigation
✔✔Benjamin is with the SIU department of an insurer. His company developed
technology to identify patterns related to fraudulent claims activity. He is using a
program to analyze claims data to identify similarities or connections that might indicate
fraud. Benjamin is utilizing - ✔✔Data mining
✔✔Soft fraud occurs when a claim is exaggerated and is also referred to as -
✔✔Opportunity fraud
, ✔✔As a claims representative, Beatrice is on the front lines for protecting her employer
from insurance fraud. Beatrice should understand that insurance fraud - ✔✔Costs
roughly $40 billion per year, excluding health insurance
✔✔Larissa is an auto claim adjuster. Traditionally, she has relied on police reports and
witness testimony in her decision making. Recent technological developments give her
access to the driver's driving habits, including acceleration, speed, and braking. This
data available to Larissa is known as - ✔✔Telematics
✔✔Soft fraud, also called opportunity fraud, occurs when - ✔✔A legitimate claim is
exaggerated
✔✔Which one of the following best describes the term 'professionalism' as it relates to
claims professionals? - ✔✔The behaviors necessary to implement an ethical decision
✔✔One of Julio's expectations as a claims representative is good-faith claims handling.
He keeps insureds informed about the claim because they have that expectation and
because they are most likely to make a complaint about bad-faith claim handling. He
also wishes to participate in the defense and in discussions about the possibility of
settlement. For these reasons, Julio - ✔✔Maintains regular and prompt communication
✔✔For an excess liability claim to be filed, a final judgment or settlement must have
been entered against the insured, and - ✔✔The amount of the judgment must be in
excess of the insured's policy limit
✔✔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? - ✔✔Timely contact with all
parties to a claim
✔✔Which one of the following statements regarding state versions of the NAIC model
act is correct? - ✔✔Some states allow insureds and claimants to bring lawsuits against
insurers, while others allow only insureds
✔✔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 - ✔✔Debatable reasonable basis defense
QUESTIONS SET A+
✔✔Linnea is an attorney who is preparing to defend an insurer in a workers
compensation case. Discovery produced several documents that are being presented
as witnesses statements, but the witnesses admit in the statements to not actually
seeing the accident. Linnea would like to omit these statements from the proceedings,
so she is filing a - ✔✔Motion in limine
✔✔Chloe is an insurer defense attorney who is preparing a trial strategy. She has
researched a court decision that was made in a similar case and is basing the defense
on that precedent. Chloe is relying on the principle of stare decisis, which is that -
✔✔Lower courts must follow precedents set by higher courts
✔✔The claims litigation process begins with the receipt of - ✔✔A summons and
complaint
✔✔Riko is an experienced settlement negotiator. When negotiating with claimant
representatives, she uses techniques such as timing settlements effectively, enticing a
reasonable demand, making concessions cautiously, and leaning on the evaluation.
She understands that her current claimant is eager to receive money, so she is delaying
the negotiations as long as possible. Which negotiation technique is Riko using? -
✔✔Timing settlements effectively
✔✔Kira, a claims representative, receives a summons and complaint from an insured.
In reviewing the facts, she has doubts that the insured's applicable policy will provide
coverage. She should work with counsel and request a managerial review in order to
issue - ✔✔A reservation of rights letter
✔✔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? -
✔✔Using traditional sales techniques
,✔✔Rin works for an insurer designing and using techniques to process large amounts
of data from various sources and providing knowledge based on the analysis of that
data. Rin is a(n) - ✔✔Data scientist
✔✔Which one of the following explains why a computer recursively applies a model? -
✔✔To analyze different splits in the values of attributes
✔✔Part of the continuous cycle of data mining is preparing the data to eliminate missing
or inaccurate information. This process is called - ✔✔Cleaning
✔✔Which one of the following is a data mining technique an insurer applies when it
knows what - ✔✔Classification
✔✔Hanna is in IT and works on data analytics projects for an insurer. These projects
involve analyzing large amounts of data to help underwriting to select risks and price
policies. Hanna knows that collaboration between data science, IT, underwriting, and
actuary is critical to the success of these projects. In Hanna's experience, as soon as
the need for a data project arises, the key to collaborating effectively is to engage which
one of the following teams as soon as possible? - ✔✔Data science
✔✔Greatview Insurance wants to predict which auto liability claims will most likely go to
litigation, so it can assign them to experienced adjusters early in the process. There are
certain known indicators of litigation that Greatview wants to use in the data mining
process. Which one of the following data mining techniques would Greatview's analyst
most likely use? - ✔✔Classification
✔✔The first step in the data mining process is to - ✔✔Understand what a business
wants to achieve
✔✔Carla is investigating a claim for a stolen car. The insured provided a copy of the
police report, but she notices that the account in the police report differs from the
insured's version of events. At this point, Carla should - ✔✔Continue with her
investigation
✔✔Benjamin is with the SIU department of an insurer. His company developed
technology to identify patterns related to fraudulent claims activity. He is using a
program to analyze claims data to identify similarities or connections that might indicate
fraud. Benjamin is utilizing - ✔✔Data mining
✔✔Soft fraud occurs when a claim is exaggerated and is also referred to as -
✔✔Opportunity fraud
, ✔✔As a claims representative, Beatrice is on the front lines for protecting her employer
from insurance fraud. Beatrice should understand that insurance fraud - ✔✔Costs
roughly $40 billion per year, excluding health insurance
✔✔Larissa is an auto claim adjuster. Traditionally, she has relied on police reports and
witness testimony in her decision making. Recent technological developments give her
access to the driver's driving habits, including acceleration, speed, and braking. This
data available to Larissa is known as - ✔✔Telematics
✔✔Soft fraud, also called opportunity fraud, occurs when - ✔✔A legitimate claim is
exaggerated
✔✔Which one of the following best describes the term 'professionalism' as it relates to
claims professionals? - ✔✔The behaviors necessary to implement an ethical decision
✔✔One of Julio's expectations as a claims representative is good-faith claims handling.
He keeps insureds informed about the claim because they have that expectation and
because they are most likely to make a complaint about bad-faith claim handling. He
also wishes to participate in the defense and in discussions about the possibility of
settlement. For these reasons, Julio - ✔✔Maintains regular and prompt communication
✔✔For an excess liability claim to be filed, a final judgment or settlement must have
been entered against the insured, and - ✔✔The amount of the judgment must be in
excess of the insured's policy limit
✔✔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? - ✔✔Timely contact with all
parties to a claim
✔✔Which one of the following statements regarding state versions of the NAIC model
act is correct? - ✔✔Some states allow insureds and claimants to bring lawsuits against
insurers, while others allow only insureds
✔✔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 - ✔✔Debatable reasonable basis defense
