AIC 300 - Claims in an
Evolving World fully solved &
verified for
accuracy(guaranteed pass)
As methods of communication evolve, it's important for claims
professionals to remember that any written claims communication
may be
a. Replaced with verbal communication
b. Misinterpreted
c. Edited later
d. Subpoenaed - answer d. Subpoenaed
Soft fraud occurs when a claim is exaggerated and is also referred
to as
a. Opportunity fraud
b. Financial fraud
c. Reimbursement fraud
d. Victimless fraud - answer a. Opportunity fraud
In which one of the following scenarios is the right of subrogation
most likely to be employed by the insurer?
a. An insured files a homeowners claim for stolen jewelry. An
investigation reveals that the jewelry is still in the insured's
possession.
,b. A claims rep discovers that their insured's car accident was
caused by a road contractor who left equipment lying in the travel
lanes of a highway.
c. An investigation reveals that an insured set her own business on
fire.
d. An insured files a claim for collision damage from a hit and run
accident, when in fact he backed into a utility pole. - answer b. A
claims rep discovers that their insured's car accident was caused by
a road contractor who left equipment lying in the travel lanes of a
highway.
In which one of the following scenarios is a public adjuster most
likely to become involved?
a. A catastrophic disaster strikes, involving damage to many
properties.
b. An insurer finds it financially unfeasible to hire its own claims
staff in a given state.
c. An insured is unable to afford legal representation to contest a
claim.
d. An insured's negotiations with the insurer on a complex claim are
not going well. - answer d. An insured's negotiations with the
insurer on a complex claim are not going well.
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
a. Refer the case to the SIU.
b. Deny the claim.
c. Contact the police.
d. Continue with her investigation. - answer d. Continue with her
investigation
, Which one of the following methods of establishing case reserves is
used most often when there are small variations in loss size for a
particular type of claim?
a. Individual case method.
b. Formula method.
c. Average value method.
d. Roundtable method. - answer c. Average value method
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
a. Lower courts must follow precedents set by any other courts.
b. Lower courts must follow precedents set by higher courts.
c. Higher courts must follow precedents set by lower courts.
d. Higher courts must follow precedents set by any other counts. -
answer b. Lower courts must follow precedents set by higher courts
Which one of the following statements regarding state versions of
the NAIC model act is correct?
a. Only insureds may bring lawsuits against insurers.
b. Only claimants may bring lawsuits against insurers.
c. Some states allow insureds and claimants to bring lawsuits
against insurers, while others allow only insureds.
d. Both insureds and claimants may bring lawsuit against insurers. -
answer c. Some states allow insureds and claimants to bring
lawsuits against insurers, while others allow only insureds.
Evolving World fully solved &
verified for
accuracy(guaranteed pass)
As methods of communication evolve, it's important for claims
professionals to remember that any written claims communication
may be
a. Replaced with verbal communication
b. Misinterpreted
c. Edited later
d. Subpoenaed - answer d. Subpoenaed
Soft fraud occurs when a claim is exaggerated and is also referred
to as
a. Opportunity fraud
b. Financial fraud
c. Reimbursement fraud
d. Victimless fraud - answer a. Opportunity fraud
In which one of the following scenarios is the right of subrogation
most likely to be employed by the insurer?
a. An insured files a homeowners claim for stolen jewelry. An
investigation reveals that the jewelry is still in the insured's
possession.
,b. A claims rep discovers that their insured's car accident was
caused by a road contractor who left equipment lying in the travel
lanes of a highway.
c. An investigation reveals that an insured set her own business on
fire.
d. An insured files a claim for collision damage from a hit and run
accident, when in fact he backed into a utility pole. - answer b. A
claims rep discovers that their insured's car accident was caused by
a road contractor who left equipment lying in the travel lanes of a
highway.
In which one of the following scenarios is a public adjuster most
likely to become involved?
a. A catastrophic disaster strikes, involving damage to many
properties.
b. An insurer finds it financially unfeasible to hire its own claims
staff in a given state.
c. An insured is unable to afford legal representation to contest a
claim.
d. An insured's negotiations with the insurer on a complex claim are
not going well. - answer d. An insured's negotiations with the
insurer on a complex claim are not going well.
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
a. Refer the case to the SIU.
b. Deny the claim.
c. Contact the police.
d. Continue with her investigation. - answer d. Continue with her
investigation
, Which one of the following methods of establishing case reserves is
used most often when there are small variations in loss size for a
particular type of claim?
a. Individual case method.
b. Formula method.
c. Average value method.
d. Roundtable method. - answer c. Average value method
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
a. Lower courts must follow precedents set by any other courts.
b. Lower courts must follow precedents set by higher courts.
c. Higher courts must follow precedents set by lower courts.
d. Higher courts must follow precedents set by any other counts. -
answer b. Lower courts must follow precedents set by higher courts
Which one of the following statements regarding state versions of
the NAIC model act is correct?
a. Only insureds may bring lawsuits against insurers.
b. Only claimants may bring lawsuits against insurers.
c. Some states allow insureds and claimants to bring lawsuits
against insurers, while others allow only insureds.
d. Both insureds and claimants may bring lawsuit against insurers. -
answer c. Some states allow insureds and claimants to bring
lawsuits against insurers, while others allow only insureds.
