AIC 300 CLAIMS IN AN EVOLVING WORLD QUESTIONS WITH CORRECT ANSWERS 2025

AIC 300 - CLAIMS IN AN EVOLVING WORLD
QUESTIONS WITH CORRECT ANSWERS 2025
InsurersMusuallyMsendMdenialMletters
SelectMone:
A.MByMemailMtoMensureMpromptMreceiptMbyMtheMinsured.
B.MByMcertifiedMmailMwithMaMreturnMreceiptMrequested.
C.MByMovernightMcourier.
D.MByMregisteredMmail.M-MCORRECTMANSWERM-B.MByMcertifiedMmailMwithMaMreturnMreceiptMrequested.

SomeMwillMalsoMsendMaMcopyMviaMregularMmailMinMcaseMtheMcertifiedMletterMisMnotMaccepted.

AsMmethodsMofMcommunicationMevolve,Mit'sMimportantMforMclaimsMprofessionalsMtoMrememberMthatManyMwri
ttenMclaimsMcommunicationMmayMbe
SelectMone:
A.MReplacedMwithMverbalMcommunication.
B.MMisinterpreted.
C.MEditedMlater.
D.MSubpoenaed.M-MCORRECTMANSWERM-D.MSubpoenaed.

AnyMwrittenMclaimsMcommunicationMmayMbeMsubpoenaed.

InMwhichMoneMofMtheMfollowingMscenariosMisMaMpublicMadjusterMmostMlikelyMtoMbecomeMinvolved?
SelectMone:
A.MAnMinsurerMfindsMitMfinanciallyMunfeasibleMtoMhireMitsMownMclaimsMstaffMinMaMgivenMstate.
B.MAnMinsuredMisMunableMtoMaffordMlegalMrepresentationMtoMcontestMaMclaim.
C.MAMcatastrophicMdisasterMstrikes,MinvolvingMdamageMtoMmanyMproperties.
D.MAnMinsured'sMnegotiationsMwithMtheMinsurerMonMaMcomplexMclaimMareMnotMgoingMwell.M-
MCORRECTMANSWERM-

D.MAnMinsured'sMnegotiationsMwithMtheMinsurerMonMaMcomplexMclaimMareMnotMgoingMwell.

IfMaMclaimMisMcomplex,MorMifMsettlementMnegotiationsMareMnotMprogressingMwithMtheMinsurer,MtheMinsuredMm
ayMhireMaMpublicMadjusterMtoMprotectMhisMorMherMinterests.

WhichMoneMofMtheMfollowingMstatementsMregardingMthird-partyMadministratorsM(TPAs)MisMmostMaccurate?
SelectMone:
A.MTPAsMareMtypicallyMusedMbyMbusinessesMthatMhaveMchosenMnotMtoMself-insure.
B.MTPAsMhandleMclaims,MkeepMclaimsMrecords,MandMperformMstatisticalManalyses.
C.MTPAsMareMgenerallyMfoundMinManMinsurer'sMclaimsMdepartment.
D.MTPAsMareMemployedMonlyMbyMindependentMadjustingMfirms.M-MCORRECTMANSWERM-
B.MTPAsMhandleMclaims,MkeepMclaimsMrecords,MandMperformMstatisticalManalyses.

HugoMisMconductingManMauditMofMaMbranchMofficeMclaimsMoperation.MHeMisMevaluatingMtimelinessMofMreports,
MnumberMofMfilesMopened,MproperMreleasesMtaken,MandMaccuracyMofMdataMentry.MWhichMoneMofMHugo'sMmetr

icsMisMaMqualitativeMauditMfactor?
SelectMone:
A.MProperMreleasesMtaken
B.MTimelinessMofMreports
C.MNumberMofMfilesMopened
D.MAccuracyMofMdataMentryM-MCORRECTMANSWERM-A.MProperMreleasesMtaken

,ProperMreleasesMtakenMisMaMqualitativeMauditMfactor;MtheMothersMareMquantitative.

AaronMworksMforMaMmulti-
lineMinsurer.MHeMworksMwithMinsuranceMproducersMandMapplicantsMtoMevaluateMnewMbusinessMsubmissionsMa
ndMconductMrenewalMunderwriting.MAaronMisMa
SelectMone:
A.MStaffMunderwriter.
B.MPublicMunderwriter.
C.MPersonalMlinesMunderwriter.
D.MLineMunderwriter.M-MCORRECTMANSWERM-D.MLineMunderwriter.

LineMunderwriter.MThisMdescribesMtheMdutiesMofMaMlineMunderwriter,MratherMthanMaMstaffMunderwriter.MThere
MisMnotMenoughMinformationMtoMdetermineMwhichMlineMofMbusinessMisMbeingMwritten.MAMpublicMunderwriterM

doesMnotMexist.MLineMunderwritersMevaluateMnewMsubmissionsMandMperformMrenewalMunderwriting,MusuallyM
byMworkingMdirectlyMwithMinsuranceMproducersMandMapplicants.MStaffMunderwriters,Mmeanwhile,MmanageMris
kMselectionMbyMworkingMwithMlineMunderwritersMandMcoordinatingMdecisionsMaboutMproducts,MpricingMandMg
uidelines.

TheMfirstMkeyMtoMcommunicatingMempatheticallyMasMaMclaimsMprofessionalMis
SelectMone:
A.MAMcomprehensiveMunderstandingMofMrelevantMinsuranceMpolicies.
B.MSpeakingMcalmlyMandMclearly.
C.MBeingMpreparedMwithMallMdocumentationMrelatingMtoMtheMclaim.
D.MListening.M-MCORRECTMANSWERM-D.MListening.

ClaimsMprofessionalsMshouldMfirstMlistenMcarefullyMtoMunderstandMwhatMtheMclaimantMisMsaying.

MiaMtracksMlossMadjustmentMexpenseM(LAE)MasMpartMofMherMmanagementMofMtheMclaimsMdepartmentMforMan
Minsurer.MMiaMconsidersMLAEMtoMbeMthe

SelectMone:
A.MTotalMamountMofMlossMreservesMofMallMclaims.
B.MPaidMportionMofMclaims.
C.MCostMtoMinvestigate,Mdefend,MandMsettleMclaims.
D.MTotalMincurredMamountMofMclaims.M-MCORRECTMANSWERM-
C.MCostMtoMinvestigate,Mdefend,MandMsettleMclaims.

CostMtoMinvestigate,Mdefend,MandMsettleMclaims.MLAEMisMtheMexpenseMthatManMinsurerMincursMtoMinvestigate,M
defend,MandMsettleMclaimsMaccordingMtoMtheMtermsMspecifiedMinMtheMinsuranceMpolicy.

InMherMroleMwithManMinsurer,MKatarinaMhasMopportunityMtoMcollaborateMwithMnotMonlyMemployeesMfromMherM
company,MbutMalsoMexternalMexpertsMwithMparticularMexpertise.MForMexample,MasMpartMofMherMinvestigation,
MsheMhiredManMengineerMtoMconductMaMreviewMofMaMmachineMthatMwasMinvolvedMinMaMpersonalMinjury.MKatari

naMisMa(n)
SelectMone:
A.MMedicalMprovider.
B.MExpertMWitness.
C.MPremiumMauditor.
D.MClaimMrepresentative.M-MCORRECTMANSWERM-D.MClaimMrepresentative.

ClaimMrepsMcollaborateMwithMmoreMthanMotherMinsurerMemployees.MManyMinsurersMemployMaMpanelMofMexp
ertsMthatMtheMclaimsMrepMcanMselectMaccordingMtoMtheMinvestigation'sMneeds.

, WhenMMehmetMinterviewsMwitnessesMasMpartMofMhisMclaimsMinvestigation,MheMasksMdifferentMtypesMofMquest
ionsMbasedMonMneed,MsuchMasMopen-
ended,Mdirect,Mindirect,MandMleading.MWhichMtypeMofMquestionMshouldMMehmetMaskMwhenMheMwantsMtoMset
MtheMintervieweeMatMeaseMandMheMisMlookingMforMexplanationMorMelaborationMofMdetailsMinMtheMinterviewee'

sMownMwords?
SelectMone:
A.MOpen-ended
B.MDirect
C.MIndirect
D.MLeadingM-MCORRECTMANSWERM-A.MOpen-ended

Open-endedMquestionsMcanMbeMusedMtoMclarifyManMinterviewee'sMstatements.

CharlotteMisMhandlingMaMnewMclaimMandMsheMhasMsetMtheMinitialMreservesMatM$1,000,000.MSheMhasMbeenMask
edMtoMcompleteManMinternalMreportMsummarizingMallMtheMfileMstatusMinformationMforMdistributionMtoMmanag
ementMandMupdatedMasMmoreMinformationMisMreceived.MTheMreportMCharlotteMisMcompletingMisMmostMlikelyM
a
SelectMone:
A.MStatusMreport.
B.MSummarizedMreport.
C.MPreliminaryMreport.
D.MLargeMlossMreport.M-MCORRECTMANSWERM-D.MLargeMlossMreport.

MostMinsurersMhaveMguidelinesMoutliningMwhenMandMunderMwhatMcircumstancesMlargeMlossMreportsMshouldM
beMprepared.

InMwhichMoneMofMtheMfollowingMscenariosMisMtheMrightMofMsubrogationMmostMlikelyMtoMbeMemployedMbyMtheMi
nsurer?
SelectMone:
A.MAnMinsuredMfilesMaMhomeownersMclaimMforMstolenMjewelry.MAnMinvestigationMrevealsMthatMtheMjewelryMisM
stillMinMtheMinsured'sMpossession.
B.MAnMinvestigationMrevealsMthatManMinsuredMsetMherMownMbusinessMonMfire.
C.MAnMinsuredMfilesMaMclaimMforMcollisionMdamageMfromMaMhitMandMrunMaccident,MwhenMinMfactMheMbackedMin
toMaMutilityMpole.
D.MAMclaimsMrepMdiscoversMthatMtheirMinsured'sMcarMaccidentMwasMcausedMbyMaMroadMcontractorMwhoMleftMe
quipmentMlyingMinMtheMtravelMlanesMofMaMhighway.M-MCORRECTMANSWERM-
D.MAMclaimsMrepMdiscoversMthatMtheirMinsured'sMcarMaccidentMwasMcausedMbyMaMroadMcontractorMwhoMleftMe
quipmentMlyingMinMtheMtravelMlanesMofMaMhighway.

TheMrightMofMsubrogationMallowsManMinsurerMtoMrecoverMpaymentMfromMaMnegligentMthirdMparty.

InMclaimsMinvestigation,MallMbodilyMinjuryMclaimsMrequire
SelectMone:
A.MStatementsMfromMallMwitnesses.
B.MMultipleMclaimsMpayments
C.MAnMattorney.
D.MAMmedicalMinvestigation.M-MCORRECTMANSWERM-D.MAMmedicalMinvestigation.

AllMbodilyMinjuryMclaims,MincludingMworkersMcompensationMclaims,MrequireMaMmedicalMinvestigation.

BeforeMmakingMinitialMcontactMwithManMinsuredMorMclaimant,MaMclaimsMrepresentativeMshould
SelectMone: