Answers | Latest Version (2024/2025)
Expert Verified
Indemnifyi-iCorrectiAnswer-
Toirestoreiaipartyiwhoihasisustainediailossitoitheisameifinancialipositioni
thatipartyiheldibeforeitheilossioccurred.
Third-partyiadministratori(TPA)i-iCorrectiAnswer-
Aniorganizationithatiprovidesiadministrativeiservicesiassociatediwithiris
kifinancingiandiinsurance.
Claimsirepresentativei-iCorrectiAnswer-
Aipersoniresponsibleiforiinvestigating,ievaluating,iandisettlingiclaims.
Publiciadjusteri-iCorrectiAnswer-
Anioutsideiorganizationioripersonihiredibyianiinsureditoirepresentitheiin
surediiniaiclaimiiniexchangeiforiaifee.
Premiumiauditi-iCorrectiAnswer-
Methodicaliexaminationiofiaipolicyholder'sioperations,irecords,iandibo
oksiofiaccountitoidetermineitheiactualiexposureiunitsiandipremiumiforii
nsuranceicoveragesialreadyiprovided.
,QuantitativeiAuditiFactorsi-iCorrectiAnswer-
Timelinessiofireports,ireservingiandipayments
QualitativeiAuditiFactorsi-iCorrectiAnswer-
Realisticireserving,iaccurateievaluationiofiinsured'siliabilityiandifollow-
upionisubrogationiopportunity
Lossiratioi-iCorrectiAnswer-
Airatioithatimeasuresilossesiandilossiadjustmentiexpensesiagainstiearne
dipremiumsiandithatireflectsitheipercentageiofipremiumsibeingiconsum
edibyilosses.
Lossiadjustmentiexpensei(LAE)i-iCorrectiAnswer-
Theiexpenseithatianiinsureriincursitoiinvestigate,idefend,iandisettleiclai
msiaccordingitoitheitermsispecifiediinitheiinsuranceipolicy.
Aaroniworksiforiaimulti-
lineiinsurer.iHeiworksiwithiinsuranceiproducersiandiapplicantsitoievalua
teinewibusinessisubmissionsiandiconductirenewaliunderwriting.iAaronii
sia
A.iPersonalilinesiunderwriter.
B.iLineiunderwriter.
C.iStaffiunderwriter.
D.iPubliciunderwriter.i-iCorrectiAnswer-B.iLineiunderwriter.
,Thisidescribesitheidutiesiofiailineiunderwriter,iratherithaniaistaffiunderw
riter.iThereiisinotienoughiinformationitoidetermineiwhichilineiofibusines
siisibeingiwritten.iAipubliciunderwriteridoesinotiexist.iLineiunderwritersi
evaluateinewisubmissionsiandiperformirenewaliunderwriting,iusuallyib
yiworkingidirectlyiwithiinsuranceiproducersiandiapplicants.iStaffiunder
writers,imeanwhile,imanageiriskiselectionibyiworkingiwithilineiunderwr
itersiandicoordinatingidecisionsiaboutiproducts,ipricingiandiguidelines.
Hugoiisiconductingianiauditiofiaibranchiofficeiclaimsioperation.iHeiisieval
uatingitimelinessiofireports,inumberiofifilesiopened,iproperireleasesitak
en,iandiaccuracyiofidataientry.iWhichioneiofiHugo'simetricsiisiaiqualitati
veiauditifactor?
A.iNumberiofifilesiopened
B.iTimelinessiofireports
C.iAccuracyiofidataientry
D.iProperireleasesitakeni-iCorrectiAnswer-D.iProperireleasesitaken
Whichioneiofitheifollowingistatementsiregardingithird-
partyiadministratorsi(TPAs)iisimostiaccurate?
A.iTPAsihandleiclaims,ikeepiclaimsirecords,iandiperformistatisticalianaly
ses.
B.iTPAsiareigenerallyifoundiinianiinsurer'siclaimsidepartment.
, C.iTPAsiareitypicallyiusedibyibusinessesithatihaveichoseninotitoiself-
insure.
D.iTPAsiareiemployedionlyibyiindependentiadjustingifirms.i-
iCorrectiAnswer-
A.iTPAsihandleiclaims,ikeepiclaimsirecords,iandiperformistatisticalianaly
ses.
StepsiofiMakingianiInitialiClaimsiAssessmenti-iCorrectiAnswer-
AcknowledgingiandiAssigningitheiClaim
IdentifyingitheiPolicy
ContactingitheiInsuredioritheiInsured'siRepresentative
Howidoirecordedistatementsiandiexaminationsiunderioathidiffer?i-
iCorrectiAnswer-
Aniexaminationiunderioathiisimoreiformalithaniairecordedistatement.iR
ecordedistatementsiareioftenitakenibyiclaimsirepresentatives,itypicallyi
byitelephone.iExaminationsiunderioathiareiusuallyiperformedibyianiatto
rneyiforitheiinsureriatitheiinsurer'siofficeioriaicourtireporter'sioffice.
Effectiveistatementsiexhibititheseiqualities:i-iCorrectiAnswer-
Coherence—Theistatementifollowsiailogicalisequence.
Completeness—Theistatementiisithorough.
Objectivity—
Theistatementicontainsifactsirelevantitoitheilossiexpressediinitheiintervi
ewee'siowniwords.