2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
AIC 30 QUESTIONS AND CORRECT
ANSWERS | LATEST UPDATE
First Party Focus
✓ -:- Coverage and Amount of damage
Second Party
✓ -:- Insurance Company
First Party
✓ -:- Insured
Third Party
✓ -:- Claimant
Third Party Focus
✓ -:- Liability, Coverage, and Amount of damage
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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
Third Party Administrator (TPA)
✓ -:- an organization that provides admin services associated with risk
financing and insurance. They handle claims and risk management for self -
insured organizations
Independent Adjuster
✓ -:- handles claims for the insurer for a fee. Works for the insurer
Public Adjuster
✓ -:- an outside organization that is hired by the insured to represent the
insured in the claim for a fee. Works for the public
Quantitative Measures
✓ -:- can have actual numbers assigned, such as number of claims opened
and percentage of subrogation recovery
Qualitative Measures
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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- related to intangible measures. nothing concrete, did they do a good
job? do they have good negotiation skills?
Ethics
✓ -:- the study of what constitutes good and bad behavior, dealing with
the moral duty and obligation
Conflict of Interest
✓ -:- a situation that occurs when a decision makers personal interests
interfere to the extent that he/she makes decisions that adversely affect
the customer, claimant, or employer
Ex Parte Contract
✓ -:- contracts in which only 1 party is heard. discussing the c laim with
the represented person without benefit of their attorney being involved.
this is not illegal, but its not ethical.
Fraud
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, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- an intentional misrepresentation resulting in harm to another person
or organization
Code of Ethics
✓ -:- professional guidelines of behavior within an organization or
profession
N.A.I.C
✓ -:- The National Association of Insurance Commissioners
Model Laws
✓ -:- NAIC develops that they feel is an appropriate law related to
insurance/risk management
Model Laws - Goal
✓ -:- to standardize the laws related to insurance, to address issues
related to insurance
4|P a g e | G r a d e A + | 2 0 2 0 2 5
AIC 30 QUESTIONS AND CORRECT
ANSWERS | LATEST UPDATE
First Party Focus
✓ -:- Coverage and Amount of damage
Second Party
✓ -:- Insurance Company
First Party
✓ -:- Insured
Third Party
✓ -:- Claimant
Third Party Focus
✓ -:- Liability, Coverage, and Amount of damage
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
Third Party Administrator (TPA)
✓ -:- an organization that provides admin services associated with risk
financing and insurance. They handle claims and risk management for self -
insured organizations
Independent Adjuster
✓ -:- handles claims for the insurer for a fee. Works for the insurer
Public Adjuster
✓ -:- an outside organization that is hired by the insured to represent the
insured in the claim for a fee. Works for the public
Quantitative Measures
✓ -:- can have actual numbers assigned, such as number of claims opened
and percentage of subrogation recovery
Qualitative Measures
2|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- related to intangible measures. nothing concrete, did they do a good
job? do they have good negotiation skills?
Ethics
✓ -:- the study of what constitutes good and bad behavior, dealing with
the moral duty and obligation
Conflict of Interest
✓ -:- a situation that occurs when a decision makers personal interests
interfere to the extent that he/she makes decisions that adversely affect
the customer, claimant, or employer
Ex Parte Contract
✓ -:- contracts in which only 1 party is heard. discussing the c laim with
the represented person without benefit of their attorney being involved.
this is not illegal, but its not ethical.
Fraud
3|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- an intentional misrepresentation resulting in harm to another person
or organization
Code of Ethics
✓ -:- professional guidelines of behavior within an organization or
profession
N.A.I.C
✓ -:- The National Association of Insurance Commissioners
Model Laws
✓ -:- NAIC develops that they feel is an appropriate law related to
insurance/risk management
Model Laws - Goal
✓ -:- to standardize the laws related to insurance, to address issues
related to insurance
4|P a g e | G r a d e A + | 2 0 2 0 2 5
