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AIC 300 - CLAIMS IN AN EVOLVING
WORLD 2025 QUESTIONS AND ANSWERS.
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. 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. 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.
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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. 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. 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.
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A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are
quantitative. 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. 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.
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D. Line underwriter.
D. Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying. 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. 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.
AIC 300 - CLAIMS IN AN EVOLVING
WORLD 2025 QUESTIONS AND ANSWERS.
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. 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. 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.
, Page |2
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. 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. 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.
, Page |3
A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are
quantitative. 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. 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.
, Page |4
D. Line underwriter.
D. Listening.
Claims professionals should first listen carefully to understand what the
claimant is saying. 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. 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.
