AIC 300 – CLAIMS IN AN EVOLVING WORLD LATEST EXAM
WITH CORRECT QUESTIONS AND ACTUAL ANSWERS
GRADED A+.
B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the
certified letter is not accepted. - ANSWERS-Insurers usually
send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
D. Subpoenaed.
Any written claims communication may be subpoenaed. -
ANSWERS-As methods of communication evolve, it's
important for claims professionals to remember that any
written claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
,D. An insured's negotiations with the insurer on a complex
claim are not going well.
If a claim is complex, or if settlement negotiations are not
progressing with the insurer, the insured may hire a public
adjuster to protect his or her interests. - ANSWERS-In which
one of the following scenarios is a public adjuster most
likely to become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own
claims staff in a given state.
B. An insured is unable to afford legal representation to
contest a claim.
C. A catastrophic disaster strikes, involving damage to many
properties.
D. An insured's negotiations with the insurer on a complex
claim are not going well.
B. TPAs handle claims, keep claims records, and perform
statistical analyses. - ANSWERS-Which one of the following
statements regarding third-party administrators (TPAs) is
most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen
not to self-insure.
B. TPAs handle claims, keep claims records, and perform
statistical analyses.
C. TPAs are generally found in an insurer's claims
department.
D. TPAs are employed only by independent adjusting firms.
A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the
others are quantitative. - 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?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter.
Line underwriter. This describes the duties of a line
underwriter, rather than a staff underwriter. There is not
enough information to determine which line of business is
being written. A public underwriter does not exist. Line
underwriters evaluate new submissions and perform
renewal underwriting, usually by working directly with
insurance producers and applicants. Staff underwriters,
meanwhile, manage risk selection by working with line
underwriters and coordinating decisions about products,
pricing and guidelines. - ANSWERS-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
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
, D. Line underwriter.
D. Listening.
Claims professionals should first listen carefully to
understand what the claimant is saying. - ANSWERS-The first
key to communicating empathetically as a claims
professional is
Select one:
A. A comprehensive understanding of relevant insurance
policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the
claim.
D. Listening.
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the
expense that an insurer incurs to investigate, defend, and
settle claims according to the terms specified in the
insurance policy. - ANSWERS-Mia tracks loss adjustment
expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims.
D. Claim representative.
WITH CORRECT QUESTIONS AND ACTUAL ANSWERS
GRADED A+.
B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the
certified letter is not accepted. - ANSWERS-Insurers usually
send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
D. Subpoenaed.
Any written claims communication may be subpoenaed. -
ANSWERS-As methods of communication evolve, it's
important for claims professionals to remember that any
written claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
,D. An insured's negotiations with the insurer on a complex
claim are not going well.
If a claim is complex, or if settlement negotiations are not
progressing with the insurer, the insured may hire a public
adjuster to protect his or her interests. - ANSWERS-In which
one of the following scenarios is a public adjuster most
likely to become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own
claims staff in a given state.
B. An insured is unable to afford legal representation to
contest a claim.
C. A catastrophic disaster strikes, involving damage to many
properties.
D. An insured's negotiations with the insurer on a complex
claim are not going well.
B. TPAs handle claims, keep claims records, and perform
statistical analyses. - ANSWERS-Which one of the following
statements regarding third-party administrators (TPAs) is
most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen
not to self-insure.
B. TPAs handle claims, keep claims records, and perform
statistical analyses.
C. TPAs are generally found in an insurer's claims
department.
D. TPAs are employed only by independent adjusting firms.
A. Proper releases taken
,Proper releases taken is a qualitative audit factor; the
others are quantitative. - 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?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter.
Line underwriter. This describes the duties of a line
underwriter, rather than a staff underwriter. There is not
enough information to determine which line of business is
being written. A public underwriter does not exist. Line
underwriters evaluate new submissions and perform
renewal underwriting, usually by working directly with
insurance producers and applicants. Staff underwriters,
meanwhile, manage risk selection by working with line
underwriters and coordinating decisions about products,
pricing and guidelines. - ANSWERS-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
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
, D. Line underwriter.
D. Listening.
Claims professionals should first listen carefully to
understand what the claimant is saying. - ANSWERS-The first
key to communicating empathetically as a claims
professional is
Select one:
A. A comprehensive understanding of relevant insurance
policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the
claim.
D. Listening.
C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the
expense that an insurer incurs to investigate, defend, and
settle claims according to the terms specified in the
insurance policy. - ANSWERS-Mia tracks loss adjustment
expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims.
D. Claim representative.
