VERIFIED ANSWERS
Accuracy - In model performance evaluation, a model's correct predictions divided by its
total predictions
Actuary - A person who uses mathematical methods to analyze insurance data for various
purposes, such as to develop insurance rates or set claim reserves
Algorithm - An operational sequence used to solve mathematical problems and to create
computer programs
Allegation - A claim made in the complaint by the plaintiff, specifying what the plaintiff
expects to prove to obtain a judgement against the defendant
Average value method - A case reserving method that establishes a predetermined dollar
amount of reserve for each claim as it is reported
Big data - Sets of data that are too large to be gathered and analyzed by traditional
methods
Blockchain - A distributed digital ledger that facilitates secure transactions without the
need for a third party
Claims representative - A person responsible for investigating, evaluating, and settling
claims
Classification tree - A supervised learning technique that uses a structure similar to a tree
to segment data according to known attributes to determine the value of a categorical target
variable
Coinsurance clause - A clause that required the insured to carry insurance equal to at
least a specified percentage of the insured property's value
Combination of nodes - A representation of data attributes in a classification tree
Comparative negligence - A common-law principle that requires both parties to a loss to
share the financial burden of the bodily injury or property damage according to their respective
degrees of fault
Compensatory damages - A payment awarded by a court to reimburse a victim for actual
harm
,Complaint - The allegations made by a plaintiff in a lawsuit
Complex claim - A claim that contains one or more characteristics that cause it to cost
more than the average claim
Concealment - An intentional failure to disclose a material fact
Contributory Negligence - A common-law principle that prevents a person who has been
harmed from recovering damages if that person's own negligence contributed in any way to the
harm
Cross Industry Standard Process for Data Mining (CRISP DM) - An accepted standard for
the steps in any data mining process used to provide business solutions
Data mining - The analysis of large amounts of data to find new relationships and
patterns that will assist in developing business solutions
Data science - An interdisciplinary field involving the design and use of techniques to
process very large amounts of data from a variety of sources and to provide knowledge based
on the data
Direct loss - A reduction in the value of property that results directly and often
immediately from damage to that property
Discovery - A pretrial exchange of all relevant information between the plaintiff and
defendant
Domain knowledge - Information related to the context of the information a data
scientist is working with
Ethics - The study of what constitutes good and bad behavior, dealing with moral duty
and obligation
Expert System method - A method of setting reserves with a software application that
estimates losses and loss adjustment expenses
Federal Rules of Civil Procedure - A set of rules established to ensure that civil actions
and procedures move through the United States district courts as quickly as possible
First notice of loss (FNOL) - The initial report notifying the insurer of a claim
Formula method - A method of setting claims reserves be using a mathematical formula
General damages - A monetary award to compensate a victim for losses, such as pain and
suffering, that do not involve specific, measurable expenses
Hard fraud - Actions that are undertaken deliberately to defraud
,Holdout data - In the model training process, existing data with a known target variable
that is not used as part of the training data
Indemnify - To restore a party who has sustained a loss to the same financial position
that party held before the loss occurred
Indirect loss - A loss that arises as a result of damage to property, other than the direct
loss to the property
Individual case method - A method of setting reserves based on the claim's
circumstances and the claims representative's experience in handling similar claims
Information gain - A measure of the predictive power of one or more attributes
Insurable interest - An interest in the subject of an insurance policy that is not unduly
remote and that would cause the interested party to suffer financial loss if an insured event
occurred
Insurance fraud - Any deliberate deception committed against an insurer or an insurance
producer for the purpose of unwarranted financial gain
Internet of Things (IoT) - A network of objects that transmit data to each other and to
central hubs through the internet
Leaf node - A terminal node of a classification tree that is used to classify an instance
based on its attributes
Lift - In model performance evaluation, the percentage of positive predictions made by
the model divided by the percentage of positive predictions that would be made in the absence
of the model
Loss adjustment expense (LAE) - The expense that an insurer incurs to investigate,
defend, and settle claims according to the terms specified in the insurance policy
Loss ratio - A ratio that measures losses and loss adjustment expenses against earned
premiums and that reflects the percentage of premiums being consumed by losses
Machine learning - Artificial intelligence in which computers continually teach
themselves to make better decisions based on previous results and new data
Material fact - A fact that is significant to a decision or matter at hand
Misrepresentation - A false statement of a material fact on which a party relies
Motion to dismiss - A request that a court terminate an action because of settlement,
voluntary withdrawal, or procedural defect
, Motion in limine - A pretrial request that certain evidence be excluded from the trial
Motion for summary judgment - A pretrial request asking the court to enter a judgement
when no material facts are in dispute and the moving party is entitled to judgment as a matter
of law
Precision - In model performance evaluation, a model's correct positive predictions
divided by its total positive predictions
Predictive model - A model used to predict an unknown outcome by means of a defined
target variable
Premium Audit - Methodical examination of a policyholder's operations, records, and
books of account to determine the actual exposure units and premium for insurance coverages
already provided
Pro rata contribution - An approach to other insurance by which the insurers contribute
to the loss payment in proportion to which they contribute to the total amount of coverage
purchased (their limits of liability)
Producer - Any of several kinds of insurance personnel who place insurance and surety
business with insurers and who represent either insurers or insureds, or both
Public Adjuster - An outside organization or person hired by an insured to represent the
insured in a claim in exchange for a fee
Punitive damages (exemplary damages) - A payment awarded by a court to punish a
defendant for a reckless, malicious, or deceitful act to deter similar conduct; the award need
not bear any relation to a party's actual damages
Recursively - Successively applying a model
Reserve - The amount the insurer estimates and sets aside to pay on an existing claim
Root node - The first node in a classification tree
Roundtable method - A method of setting reserves by using the consensus of two or
more claims personnel who have independently evaluated the claims file
Service of process - The delivery of a summons and complaint to a defendant by an
authorized person
Soft fraud, or opportunity fraud - Fraud that occurs when a legitimate claim is
exaggerated