AIC 300 EXAMINATION QUESTIONS AND 100%
VERIFIED ANSWERS
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of
reports, number of files opened, proper releases taken, and accuracy of data entry. Which one
of Hugo's metrics is a qualitative audit factor? - Proper releases taken
The first key to communicating empathetically as a claims professional is - Listening.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department
for an insurer. Mia considers LAE to be the - Cost to investigate, defend, and settle claims.
As methods of communication evolve, it's important for claims professionals to remember that
any written claims communication may be - Subpoenaed.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees
from her company, but also external experts with particular expertise. For example, as part of
her investigation, she hired an engineer to conduct a review of a machine that was involved in a
personal injury. Katarina is a(n) - Claim representative.
In which one of the following scenarios is a public adjuster most likely to become involved? -
An insured's negotiations with the insurer on a complex claim are not going well.
Aaron works for a multi-line insurer. He works with insurance producers and applicants to
evaluate new business submissions and conduct renewal underwriting. Aaron is a - Line
underwriter.
Which one of the following statements regarding third-party administrators (TPAs) is most
accurate? - TPAs handle claims, keep claims records, and perform statistical analyses.
In claims investigation, all bodily injury claims require - A medical investigation.
Before making initial contact with an insured or claimant, a claims representative should -
Prepare a list of questions for the insured.
Carolina is a claim representative handling a liability claim. She is speaking to the claimant over
the phone and has informed him that his statements must be true under penalty of perjury.
When completed, she sent a transcription of the conversation to the claimant for him to sign
before a notary. Carolina has taken a(n) - Recorded statement.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000. She has
been asked to complete an internal report summarizing all the file status information for
distribution to management and updated as more information is received. The report Charlotte
is completing is most likely a - Large loss report.
,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? - Average value
method
When Mehmet interviews witnesses as part of his claims investigation, he asks different types
of questions based on need, such as open-ended, direct, indirect, and leading. Which type of
question should Mehmet ask when he wants to set the interviewee at ease and he is looking for
explanation or elaboration of details in the interviewee's own words? - Open-ended
In which one of the following scenarios is the right of subrogation most likely to be employed by
the insurer? - 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.
To determine whether an insurer typically underreserves or overreserves claims, actuaries
compare the insurer's paid losses to - The insurer's case reserves.
In the process of assigning a claim, an internal claims handler will often transfer information to
the insurer's standard form, called the - First notice of loss (FNOL) form.
One of Juan's responsibilities as a claims representative is to prepare internal reports, such as
preliminary, interim, large loss, and captioned. Which one of the reports Juan prepares is
required for claims with reserves that exceed a specified threshold? - Large loss
Mitsuki was severely injured when the safety latch on an amusement park ride failed and she
was thrown from the ride. In her lawsuit with the amusement park, Mitsuki was awarded
payment for pain and suffering, emotional distress, disfigurement, and loss of earnings. Which
one of Mitsuki's awards is considered special damages? - Loss of earnings
Andrew is a claims representative investigating whether coverage applies to a new claim. To
help ensure that he considers every facet of the policy before determining coverage, he might
use - The DICE method.
Although most policies are occurrence forms, covering claims that occur during the policy
period, some are claims-made forms. Which one of the following types of loss is most likely to
involve a claims-made form? - A medical malpractice claim.
Claims may be paid in any of three ways: by check, by bank transfer or - By electronic
funds transfer.
The Office of Foreign Assets Control requires claims payors to check payees against a database
of - Known terrorists and drug traffickers.
Samuel was seriously injured in a car accident caused by a drunk driver. His settlement included
payments for repairs to his vehicle, medical bills, pain and suffering, and lost wages. Which one
,of the payments in Samuel's settlement is considered general damages? - Pain and
suffering
Claims rep Lily is negotiating a claim settlement with an unrepresented claimant and wishes to
smooth the process. She is matching her demeanor, tone, and mannerisms to those of the
claimant. Lily is using which one of the following negotiation techniques? - Using
traditional sales techniques
Linnea is an attorney who is preparing to defend an insurer in a workers compensation case.
Discovery produced several documents that are being presented as witnesses statements, but
the witnesses admit in the statements to not actually seeing the accident. Linnea would like to
omit these statements from the proceedings, so she is filing a - Motion in limine.
The claims litigation process begins with the receipt of - A summons and complaint.
Riko is an experienced settlement negotiator. When negotiating with claimant representatives,
she uses techniques such as timing settlements effectively, enticing a reasonable demand,
making concessions cautiously, and leaning on the evaluation. She understands that her current
claimant is eager to receive money, so she is delaying the negotiations as long as possible.
Which negotiation technique is Riko using? - Timing settlements effectively
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 - Lower courts must follow
precedents set by higher courts.
Kira, a claims representative, receives a summons and complaint from an insured. In reviewing
the facts, she has doubts that the insured's applicable policy will provide coverage. She should
work with counsel and request a managerial review in order to issue - A reservation of
rights letter.
Rin works for an insurer designing and using techniques to process large amounts of data from
various sources and providing knowledge based on the analysis of that data. Rin is a(n) -
Data scientist.
Part of the continuous cycle of data mining is preparing the data to eliminate missing or
inaccurate information. This process is called - Cleaning
Greatview Insurance wants to predict which auto liability claims will most likely go to litigation,
so it can assign them to experienced adjusters early in the process. There are certain known
indicators of litigation that Greatview wants to use in the data mining process. Which one of the
following data mining techniques would Greatview's analyst most likely use? -
Classification
, Which one of the following is a data mining technique an insurer applies when it knows what
information it wants to predict? - Classification
Hanna is in IT and works on data analytics projects for an insurer. These projects involve
analyzing large amounts of data to help underwriting to select risks and price policies. Hanna
knows that collaboration between data science, IT, underwriting, and actuary is critical to the
success of these projects. In Hanna's experience, as soon as the need for a data project arises,
the key to collaborating effectively is to engage which one of the following teams as soon as
possible? - Data science
The first step in the data mining process is to - Understand what a business wants to
achieve.
Which one of the following types of workers compensation claims are the most difficult for
insurers to identify at the time of first report? - Potentially complex claims
Generally speaking, the most common application of predictive modeling in insurance occurs in
- Risk selection
In seeking to identify claims that will potentially develop into complex and more costly claims,
the data science team at Great Midsouthwest Insurance ranks a series of attributes by their
importance to the data model. Which one of the following terms describes the level of
predictive power of each attribute? - Information gain
Martin is in SIU and helps his employer, a multi-line insurer, to detect fraudulent claims. He is
using a technology that enables insurers to share fraud-related information. This distributed
digital ledger that facilitates secure transactions without using a third party is known as -
Blockchain
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 - Continue with her investigation.
Soft fraud, also called opportunity fraud, occurs when - A legitimate claim is exaggerated.
Larissa is an auto claim adjuster. Traditionally, she has relied on police reports and witness
testimony in her decision making. Recent technological developments give her access to the
driver's driving habits, including acceleration, speed, and braking. This data available to Larissa
is known as - Telematics
Soft fraud occurs when a claim is exaggerated and is also referred to as - Opportunity
fraud.
Benjamin is with the SIU department of an insurer. His company developed technology to
identify patterns related to fraudulent claims activity. He is using a program to analyze claims
VERIFIED ANSWERS
Hugo is conducting an audit of a branch office claims operation. He is evaluating timeliness of
reports, number of files opened, proper releases taken, and accuracy of data entry. Which one
of Hugo's metrics is a qualitative audit factor? - Proper releases taken
The first key to communicating empathetically as a claims professional is - Listening.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department
for an insurer. Mia considers LAE to be the - Cost to investigate, defend, and settle claims.
As methods of communication evolve, it's important for claims professionals to remember that
any written claims communication may be - Subpoenaed.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees
from her company, but also external experts with particular expertise. For example, as part of
her investigation, she hired an engineer to conduct a review of a machine that was involved in a
personal injury. Katarina is a(n) - Claim representative.
In which one of the following scenarios is a public adjuster most likely to become involved? -
An insured's negotiations with the insurer on a complex claim are not going well.
Aaron works for a multi-line insurer. He works with insurance producers and applicants to
evaluate new business submissions and conduct renewal underwriting. Aaron is a - Line
underwriter.
Which one of the following statements regarding third-party administrators (TPAs) is most
accurate? - TPAs handle claims, keep claims records, and perform statistical analyses.
In claims investigation, all bodily injury claims require - A medical investigation.
Before making initial contact with an insured or claimant, a claims representative should -
Prepare a list of questions for the insured.
Carolina is a claim representative handling a liability claim. She is speaking to the claimant over
the phone and has informed him that his statements must be true under penalty of perjury.
When completed, she sent a transcription of the conversation to the claimant for him to sign
before a notary. Carolina has taken a(n) - Recorded statement.
Charlotte is handling a new claim and she has set the initial reserves at $1,000,000. She has
been asked to complete an internal report summarizing all the file status information for
distribution to management and updated as more information is received. The report Charlotte
is completing is most likely a - Large loss report.
,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? - Average value
method
When Mehmet interviews witnesses as part of his claims investigation, he asks different types
of questions based on need, such as open-ended, direct, indirect, and leading. Which type of
question should Mehmet ask when he wants to set the interviewee at ease and he is looking for
explanation or elaboration of details in the interviewee's own words? - Open-ended
In which one of the following scenarios is the right of subrogation most likely to be employed by
the insurer? - 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.
To determine whether an insurer typically underreserves or overreserves claims, actuaries
compare the insurer's paid losses to - The insurer's case reserves.
In the process of assigning a claim, an internal claims handler will often transfer information to
the insurer's standard form, called the - First notice of loss (FNOL) form.
One of Juan's responsibilities as a claims representative is to prepare internal reports, such as
preliminary, interim, large loss, and captioned. Which one of the reports Juan prepares is
required for claims with reserves that exceed a specified threshold? - Large loss
Mitsuki was severely injured when the safety latch on an amusement park ride failed and she
was thrown from the ride. In her lawsuit with the amusement park, Mitsuki was awarded
payment for pain and suffering, emotional distress, disfigurement, and loss of earnings. Which
one of Mitsuki's awards is considered special damages? - Loss of earnings
Andrew is a claims representative investigating whether coverage applies to a new claim. To
help ensure that he considers every facet of the policy before determining coverage, he might
use - The DICE method.
Although most policies are occurrence forms, covering claims that occur during the policy
period, some are claims-made forms. Which one of the following types of loss is most likely to
involve a claims-made form? - A medical malpractice claim.
Claims may be paid in any of three ways: by check, by bank transfer or - By electronic
funds transfer.
The Office of Foreign Assets Control requires claims payors to check payees against a database
of - Known terrorists and drug traffickers.
Samuel was seriously injured in a car accident caused by a drunk driver. His settlement included
payments for repairs to his vehicle, medical bills, pain and suffering, and lost wages. Which one
,of the payments in Samuel's settlement is considered general damages? - Pain and
suffering
Claims rep Lily is negotiating a claim settlement with an unrepresented claimant and wishes to
smooth the process. She is matching her demeanor, tone, and mannerisms to those of the
claimant. Lily is using which one of the following negotiation techniques? - Using
traditional sales techniques
Linnea is an attorney who is preparing to defend an insurer in a workers compensation case.
Discovery produced several documents that are being presented as witnesses statements, but
the witnesses admit in the statements to not actually seeing the accident. Linnea would like to
omit these statements from the proceedings, so she is filing a - Motion in limine.
The claims litigation process begins with the receipt of - A summons and complaint.
Riko is an experienced settlement negotiator. When negotiating with claimant representatives,
she uses techniques such as timing settlements effectively, enticing a reasonable demand,
making concessions cautiously, and leaning on the evaluation. She understands that her current
claimant is eager to receive money, so she is delaying the negotiations as long as possible.
Which negotiation technique is Riko using? - Timing settlements effectively
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 - Lower courts must follow
precedents set by higher courts.
Kira, a claims representative, receives a summons and complaint from an insured. In reviewing
the facts, she has doubts that the insured's applicable policy will provide coverage. She should
work with counsel and request a managerial review in order to issue - A reservation of
rights letter.
Rin works for an insurer designing and using techniques to process large amounts of data from
various sources and providing knowledge based on the analysis of that data. Rin is a(n) -
Data scientist.
Part of the continuous cycle of data mining is preparing the data to eliminate missing or
inaccurate information. This process is called - Cleaning
Greatview Insurance wants to predict which auto liability claims will most likely go to litigation,
so it can assign them to experienced adjusters early in the process. There are certain known
indicators of litigation that Greatview wants to use in the data mining process. Which one of the
following data mining techniques would Greatview's analyst most likely use? -
Classification
, Which one of the following is a data mining technique an insurer applies when it knows what
information it wants to predict? - Classification
Hanna is in IT and works on data analytics projects for an insurer. These projects involve
analyzing large amounts of data to help underwriting to select risks and price policies. Hanna
knows that collaboration between data science, IT, underwriting, and actuary is critical to the
success of these projects. In Hanna's experience, as soon as the need for a data project arises,
the key to collaborating effectively is to engage which one of the following teams as soon as
possible? - Data science
The first step in the data mining process is to - Understand what a business wants to
achieve.
Which one of the following types of workers compensation claims are the most difficult for
insurers to identify at the time of first report? - Potentially complex claims
Generally speaking, the most common application of predictive modeling in insurance occurs in
- Risk selection
In seeking to identify claims that will potentially develop into complex and more costly claims,
the data science team at Great Midsouthwest Insurance ranks a series of attributes by their
importance to the data model. Which one of the following terms describes the level of
predictive power of each attribute? - Information gain
Martin is in SIU and helps his employer, a multi-line insurer, to detect fraudulent claims. He is
using a technology that enables insurers to share fraud-related information. This distributed
digital ledger that facilitates secure transactions without using a third party is known as -
Blockchain
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 - Continue with her investigation.
Soft fraud, also called opportunity fraud, occurs when - A legitimate claim is exaggerated.
Larissa is an auto claim adjuster. Traditionally, she has relied on police reports and witness
testimony in her decision making. Recent technological developments give her access to the
driver's driving habits, including acceleration, speed, and braking. This data available to Larissa
is known as - Telematics
Soft fraud occurs when a claim is exaggerated and is also referred to as - Opportunity
fraud.
Benjamin is with the SIU department of an insurer. His company developed technology to
identify patterns related to fraudulent claims activity. He is using a program to analyze claims
