AIC 300 - Claims in an Evolving World EXAM
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
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Terms in this set (105)
Insurers usually send denial letters B. By certified mail with a return receipt requested.
Select one:
A. By email to ensure prompt receipt Some will also send a copy via regular mail in case
by the insured. the certified letter is not accepted.
B. By certified mail with a return
receipt requested.
C. By overnight courier.
D. By registered mail.
,As methods of communication D. Subpoenaed.
evolve, it's important for claims
professionals to remember that any Any written claims communication may be
written claims communication may be subpoenaed.
Select one:
A. Replaced with verbal
communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
In which one of the following D. An insured's negotiations with the insurer on a
scenarios is a public adjuster most complex claim are not going well.
likely to become involved?
Select one: If a claim is complex, or if settlement negotiations
A. An insurer finds it financially are not progressing with the insurer, the insured may
unfeasible to hire its own claims staff hire a public adjuster to protect his or her interests.
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.
,Which one of the following B. TPAs handle claims, keep claims records, and
statements regarding third-party perform statistical analyses.
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.
Hugo is conducting an audit of a A. Proper releases taken
branch office claims operation. He is
evaluating timeliness of reports, Proper releases taken is a qualitative audit factor;
number of files opened, proper the others are quantitative.
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
, Aaron works for a multi-line insurer. D. Line underwriter.
He works with insurance producers
and applicants to evaluate new Line underwriter. This describes the duties of a line
business submissions and conduct underwriter, rather than a staff underwriter. There is
renewal underwriting. Aaron is a not enough information to determine which line of
Select one: business is being written. A public underwriter does
A. Staff underwriter. not exist. Line underwriters evaluate new
B. Public underwriter. submissions and perform renewal underwriting,
C. Personal lines underwriter. usually by working directly with insurance producers
D. Line underwriter. and applicants. Staff underwriters, meanwhile,
manage risk selection by working with line
underwriters and coordinating decisions about
products, pricing and guidelines.
The first key to communicating D. Listening.
empathetically as a claims
professional is Claims professionals should first listen carefully to
Select one: understand what the claimant is saying.
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.
Mia tracks loss adjustment expense C. Cost to investigate, defend, and settle claims.
(LAE) as part of her management of
the claims department for an insurer. Cost to investigate, defend, and settle claims. LAE is
Mia considers LAE to be the the expense that an insurer incurs to investigate,
Select one: defend, and settle claims according to the terms
A. Total amount of loss reserves of all specified in the insurance policy.
claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and
settle claims.
D. Total incurred amount of claims.
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
Play your way to mastery with fun games
Match Blocks Charms NEW
Terms in this set (105)
Insurers usually send denial letters B. By certified mail with a return receipt requested.
Select one:
A. By email to ensure prompt receipt Some will also send a copy via regular mail in case
by the insured. the certified letter is not accepted.
B. By certified mail with a return
receipt requested.
C. By overnight courier.
D. By registered mail.
,As methods of communication D. Subpoenaed.
evolve, it's important for claims
professionals to remember that any Any written claims communication may be
written claims communication may be subpoenaed.
Select one:
A. Replaced with verbal
communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
In which one of the following D. An insured's negotiations with the insurer on a
scenarios is a public adjuster most complex claim are not going well.
likely to become involved?
Select one: If a claim is complex, or if settlement negotiations
A. An insurer finds it financially are not progressing with the insurer, the insured may
unfeasible to hire its own claims staff hire a public adjuster to protect his or her interests.
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.
,Which one of the following B. TPAs handle claims, keep claims records, and
statements regarding third-party perform statistical analyses.
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.
Hugo is conducting an audit of a A. Proper releases taken
branch office claims operation. He is
evaluating timeliness of reports, Proper releases taken is a qualitative audit factor;
number of files opened, proper the others are quantitative.
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
, Aaron works for a multi-line insurer. D. Line underwriter.
He works with insurance producers
and applicants to evaluate new Line underwriter. This describes the duties of a line
business submissions and conduct underwriter, rather than a staff underwriter. There is
renewal underwriting. Aaron is a not enough information to determine which line of
Select one: business is being written. A public underwriter does
A. Staff underwriter. not exist. Line underwriters evaluate new
B. Public underwriter. submissions and perform renewal underwriting,
C. Personal lines underwriter. usually by working directly with insurance producers
D. Line underwriter. and applicants. Staff underwriters, meanwhile,
manage risk selection by working with line
underwriters and coordinating decisions about
products, pricing and guidelines.
The first key to communicating D. Listening.
empathetically as a claims
professional is Claims professionals should first listen carefully to
Select one: understand what the claimant is saying.
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.
Mia tracks loss adjustment expense C. Cost to investigate, defend, and settle claims.
(LAE) as part of her management of
the claims department for an insurer. Cost to investigate, defend, and settle claims. LAE is
Mia considers LAE to be the the expense that an insurer incurs to investigate,
Select one: defend, and settle claims according to the terms
A. Total amount of loss reserves of all specified in the insurance policy.
claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and
settle claims.
D. Total incurred amount of claims.
