AIC 300 - CLAIMS IN AN EVOLVING
WORLD EXAM 100% SOLVED 2025
Soft fraud, also called opportunity fraud, occurs when... - ANSWERA legitimate claim is
exaggerated.
The first key to communicating empathetically as a claims professional is... -
ANSWERListening.
Claims professionals should first listen carefully to understand what the claimant is
saying.
The Office of Foreign Assets Control requires claims payors to check payees against a
database of... - ANSWERKnown terrorists & drug traffickers
Mia tracks loss adjustment expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the... - ANSWERCost to investigate,
defend & settle claims
In which one of the following scenarios is a public adjuster most likely to become
involved? - ANSWERAn 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.
When Mehmet interviews witnesses as part of his claim 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? - ANSWEROpen-Ended.
Open-Ended questions can be used to clarify an interviewee's statements.
Tobias is a claims representative who understands the importance of good-faith claims
handling, including fair evaluation, good-faith negotiation, complete and accurate
documentation, and timely contact with all parties to a claim. Which one of Tobias'
good-faith claims handling practices helps his employer because the parties will be
more likely to remember details of the loss accurately? - ANSWERTimely contact with
all parties to a claim.
, Timely contact with all parties to a claim helps ensure that parties will be more likely to
remember details of the loss accurately.
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 best
describes the level of predictive power of each attribute? - ANSWERInformation Gain.
Information gain is a measure of the predictive power of one or more attributes.
Not long after Valteri issued a denial and closed the claim, the insured sued for
coverage and alleged bad-faith claim handling against the insurer. Valteri was able to
demonstrate for his superiors that he had made a good-faith investigation and
determined that the claim was not covered by the policy. The insurer maintains that
Valteri had reasonable justification in fact for denying the claim. The insurer is
employing the... - ANSWERDebatable reasonable basis defense.
Debatable reasonable basis defense. The insurer may establish that defense that it has
a reasonable basis for questioning whether a claim was covered.
Which one of the following best described the term 'professionalism' as it relates to
claims professionals? - ANSWERThe behaviors necessary to implement an ethical
decision.
Professionalism involves the behaviors and qualities necessary to implement an ethical
deecision.
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? -
ANSWERUsing traditional sales techniques.
A common technique is mirroring the behavior of the customer.
In which one of the following scenarios is the right of subrogation most likely to be
employed by the insurer? - ANSWERA claims rep discovers that their insured's car
accident was caused by a road contractor who left equipment lying in the travel lanes of
the highway.
The right of subrogation allows an insurer to recover payment from a negligent third
party.
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... - ANSWERBlockchain.
WORLD EXAM 100% SOLVED 2025
Soft fraud, also called opportunity fraud, occurs when... - ANSWERA legitimate claim is
exaggerated.
The first key to communicating empathetically as a claims professional is... -
ANSWERListening.
Claims professionals should first listen carefully to understand what the claimant is
saying.
The Office of Foreign Assets Control requires claims payors to check payees against a
database of... - ANSWERKnown terrorists & drug traffickers
Mia tracks loss adjustment expense (LAE) as part of her management of the claims
department for an insurer. Mia considers LAE to be the... - ANSWERCost to investigate,
defend & settle claims
In which one of the following scenarios is a public adjuster most likely to become
involved? - ANSWERAn 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.
When Mehmet interviews witnesses as part of his claim 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? - ANSWEROpen-Ended.
Open-Ended questions can be used to clarify an interviewee's statements.
Tobias is a claims representative who understands the importance of good-faith claims
handling, including fair evaluation, good-faith negotiation, complete and accurate
documentation, and timely contact with all parties to a claim. Which one of Tobias'
good-faith claims handling practices helps his employer because the parties will be
more likely to remember details of the loss accurately? - ANSWERTimely contact with
all parties to a claim.
, Timely contact with all parties to a claim helps ensure that parties will be more likely to
remember details of the loss accurately.
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 best
describes the level of predictive power of each attribute? - ANSWERInformation Gain.
Information gain is a measure of the predictive power of one or more attributes.
Not long after Valteri issued a denial and closed the claim, the insured sued for
coverage and alleged bad-faith claim handling against the insurer. Valteri was able to
demonstrate for his superiors that he had made a good-faith investigation and
determined that the claim was not covered by the policy. The insurer maintains that
Valteri had reasonable justification in fact for denying the claim. The insurer is
employing the... - ANSWERDebatable reasonable basis defense.
Debatable reasonable basis defense. The insurer may establish that defense that it has
a reasonable basis for questioning whether a claim was covered.
Which one of the following best described the term 'professionalism' as it relates to
claims professionals? - ANSWERThe behaviors necessary to implement an ethical
decision.
Professionalism involves the behaviors and qualities necessary to implement an ethical
deecision.
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? -
ANSWERUsing traditional sales techniques.
A common technique is mirroring the behavior of the customer.
In which one of the following scenarios is the right of subrogation most likely to be
employed by the insurer? - ANSWERA claims rep discovers that their insured's car
accident was caused by a road contractor who left equipment lying in the travel lanes of
the highway.
The right of subrogation allows an insurer to recover payment from a negligent third
party.
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... - ANSWERBlockchain.
