AIC 300 - CLAIMS IN AN EVOLVING WORLD
QUESTIONS WITH CORRECT ANSWERS 2025
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. - CORRECT ANSWER -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.
As methods of communication evolve, it's important for claims professionals to remember that any wri
tten claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
Any written claims communication may be subpoenaed.
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. -
CORRECT ANSWER -
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 m
ay hire a public adjuster to protect his or her interests.
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. - CORRECT ANSWER -
B. TPAs handle claims, keep claims records, and perform statistical analyses.
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 metr
ics 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 - CORRECT ANSWER -A. Proper releases taken
,Proper L releases L taken L is L a L qualitative L audit L factor; L the L others L are L quantitative.
Aaron L works L for L a L multi-
line L insurer. L He L works L with L insurance L producers L and L applicants L to L evaluate L new L business
L submissions L a Lnd L conduct L renewal L underwriting. L Aaron L is L a
Select L one:
A. L Staff L underwriter.
B. L Public L underwriter.
C. L Personal L lines L underwriter.
D. L Line L underwriter. L - L CORRECT L ANSWER L -D. L Line L underwriter.
Line L underwriter. L This L describes L the L duties L of L a L line L underwriter, L rather L than L a L staff
L underwriter. L There Lis L not L enough L information L to L determine L which L line L of L business L is
L being L written. L A L public L underwriter Ldoes L not L exist. L Line L underwriters L evaluate L new
L submissions L and L perform L renewal L underwriting, L usually Lby L working L directly L with L insurance
L producers L and L applicants. L Staff L underwriters, L meanwhile, L manage L ris Lk L selection L by L working
L with L line L underwriters L and L coordinating L decisions L about L products, L pricing L and L g Luidelines.
The L first L key L to L communicating L empathetically L as L a L claims
L professional L is LSelect L one:
A. L A L comprehensive L understanding L of L relevant L insurance L policies.
B. L Speaking L calmly L and L clearly.
C. L Being L prepared L with L all L documentation L relating L to L the L claim.
D. L Listening. L - L CORRECT L ANSWER L -D. L Listening.
Claims L professionals L should L first L listen L carefully L to L understand L what L the L claimant L is L saying.
Mia L tracks L loss L adjustment L expense L (LAE) L as L part L of L her L management L of L the L claims
L department L for L an Linsurer. L Mia L considers L LAE L to L be L the
Select L one:
A. L Total L amount L of L loss L reserves L of L all L claims.
B. L Paid L portion L of L claims.
C. L Cost L to L investigate, L defend, L and L settle L claims.
D. L Total L incurred L amount L of L claims. L - L CORRECT L ANSWER L -
C. L Cost L to L investigate, L defend, L and L settle L claims.
Cost L to L investigate, L defend, L and L settle L claims. L LAE L is L the L expense L that L an L insurer L incurs
L to L investigate, Ldefend, L and L settle L claims L according L to L the L terms L specified L in L the L insurance
L policy.
In Lher Lrole Lwith Lan Linsurer, LKatarina Lhas Lopportunity Lto Lcollaborate Lwith Lnot Lonly Lemployees Lfrom
Lher Lcompany, L but L also L external L experts L with L particular L expertise. L For L example, L as L part L of
L her L investigation, Lshe L hired L an L engineer L to L conduct L a L review L of L a L machine L that L was
L involved L in L a L personal L injury. L Katari Lna L is L a(n)
Select L one:
A. L Medical L provider.
B. L Expert L Witness.
C. L Premium L auditor.
D. L Claim L representative. L - L CORRECT L ANSWER L -D. L Claim L representative.
Claim L reps L collaborate L with L more L than L other L insurer L employees. L Many L insurers L employ L a
L panel L of L exp Lerts L that L the L claims L rep L can L select L according L to L the L investigation's L needs.
,When L Mehmet L interviews L witnesses L as L part L of L his L claims L investigation, L he L asks L different
L types L of L quest Lions L based L on L need, L such L as L open-
ended, L direct, L indirect, L and L leading. L Which L type L of L question L should L Mehmet L ask L when L he
L wants L to L set Lthe L interviewee L at L ease L and L he L is L looking L for L explanation L or L elaboration
L of L details L in L the L interviewee' Ls L own L words?
Select L one:
A. L Open-ended
B. L Direct
C. L Indirect
D. L Leading L - L CORRECT L ANSWER L -A. L Open-ended
Open-ended L questions L can L be L used L to L clarify L an L interviewee's L statements.
Charlotte L is L handling L a L new L claim L and L she L has L set L the L initial L reserves L at L $1,000,000. L She
L has L been L ask Led L to L complete L an L internal L report L summarizing L all L the L file L status
L information L for L distribution L to L manag Lement L and L updated L as L more L information L is L received.
L The L report L Charlotte L is L completing L is L most L likely La
Select L one:
A. L Status L report.
B. L Summarized L report.
C. L Preliminary L report.
D. L Large L loss L report. L - L CORRECT L ANSWER L -D. L Large L loss L report.
Most L insurers L have L guidelines L outlining L when L and L under L what L circumstances L large L loss
L reports L should Lbe L prepared.
In L which L one L of L the L following L scenarios L is L the L right L of L subrogation L most L likely L to L be
L employed L by L the L i Lnsurer?
Select L one:
A. L An L insured L files L a L homeowners L claim L for L stolen L jewelry. L An L investigation L reveals L that
L the L jewelry L is Lstill L in L the L insured's L possession.
B. L An L investigation L reveals L that L an L insured L set L her L own L business L on L fire.
C. L An L insured L files L a L claim L for L collision L damage L from L a L hit L and L run L accident, L when L in
L fact L he L backed L in Lto L a L utility L pole.
D. L A L claims L rep L discovers L that L their L insured's L car L accident L was L caused L by L a L road L contractor
L who L left L e Lquipment L lying L in L the L travel L lanes L of L a L highway. L - L CORRECT L ANSWER L -
D. L A L claims L rep L discovers L that L their L insured's L car L accident L was L caused L by L a L road L contractor
L who L left L e Lquipment L lying L in L the L travel L lanes L of L a L highway.
The L right L of L subrogation L allows L an L insurer L to L recover L payment L from L a L negligent
L third L party. LIn L claims L investigation, L all L bodily L injury L claims L require
Select L one:
A. L Statements L from L all L witnesses.
B. L Multiple L claims L payments
C. L An L attorney.
D. L A L medical L investigation. L - L CORRECT L ANSWER L -D. L A L medical L investigation.
All L bodily L injury L claims, L including L workers L compensation L claims, L require L a L medical
L investigation. LBefore L making L initial L contact L with L an L insured L or L claimant, L a L claims
, L representative L should
Select L one:
QUESTIONS WITH CORRECT ANSWERS 2025
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. - CORRECT ANSWER -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.
As methods of communication evolve, it's important for claims professionals to remember that any wri
tten claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed. - CORRECT ANSWER -D. Subpoenaed.
Any written claims communication may be subpoenaed.
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. -
CORRECT ANSWER -
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 m
ay hire a public adjuster to protect his or her interests.
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. - CORRECT ANSWER -
B. TPAs handle claims, keep claims records, and perform statistical analyses.
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 metr
ics 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 - CORRECT ANSWER -A. Proper releases taken
,Proper L releases L taken L is L a L qualitative L audit L factor; L the L others L are L quantitative.
Aaron L works L for L a L multi-
line L insurer. L He L works L with L insurance L producers L and L applicants L to L evaluate L new L business
L submissions L a Lnd L conduct L renewal L underwriting. L Aaron L is L a
Select L one:
A. L Staff L underwriter.
B. L Public L underwriter.
C. L Personal L lines L underwriter.
D. L Line L underwriter. L - L CORRECT L ANSWER L -D. L Line L underwriter.
Line L underwriter. L This L describes L the L duties L of L a L line L underwriter, L rather L than L a L staff
L underwriter. L There Lis L not L enough L information L to L determine L which L line L of L business L is
L being L written. L A L public L underwriter Ldoes L not L exist. L Line L underwriters L evaluate L new
L submissions L and L perform L renewal L underwriting, L usually Lby L working L directly L with L insurance
L producers L and L applicants. L Staff L underwriters, L meanwhile, L manage L ris Lk L selection L by L working
L with L line L underwriters L and L coordinating L decisions L about L products, L pricing L and L g Luidelines.
The L first L key L to L communicating L empathetically L as L a L claims
L professional L is LSelect L one:
A. L A L comprehensive L understanding L of L relevant L insurance L policies.
B. L Speaking L calmly L and L clearly.
C. L Being L prepared L with L all L documentation L relating L to L the L claim.
D. L Listening. L - L CORRECT L ANSWER L -D. L Listening.
Claims L professionals L should L first L listen L carefully L to L understand L what L the L claimant L is L saying.
Mia L tracks L loss L adjustment L expense L (LAE) L as L part L of L her L management L of L the L claims
L department L for L an Linsurer. L Mia L considers L LAE L to L be L the
Select L one:
A. L Total L amount L of L loss L reserves L of L all L claims.
B. L Paid L portion L of L claims.
C. L Cost L to L investigate, L defend, L and L settle L claims.
D. L Total L incurred L amount L of L claims. L - L CORRECT L ANSWER L -
C. L Cost L to L investigate, L defend, L and L settle L claims.
Cost L to L investigate, L defend, L and L settle L claims. L LAE L is L the L expense L that L an L insurer L incurs
L to L investigate, Ldefend, L and L settle L claims L according L to L the L terms L specified L in L the L insurance
L policy.
In Lher Lrole Lwith Lan Linsurer, LKatarina Lhas Lopportunity Lto Lcollaborate Lwith Lnot Lonly Lemployees Lfrom
Lher Lcompany, L but L also L external L experts L with L particular L expertise. L For L example, L as L part L of
L her L investigation, Lshe L hired L an L engineer L to L conduct L a L review L of L a L machine L that L was
L involved L in L a L personal L injury. L Katari Lna L is L a(n)
Select L one:
A. L Medical L provider.
B. L Expert L Witness.
C. L Premium L auditor.
D. L Claim L representative. L - L CORRECT L ANSWER L -D. L Claim L representative.
Claim L reps L collaborate L with L more L than L other L insurer L employees. L Many L insurers L employ L a
L panel L of L exp Lerts L that L the L claims L rep L can L select L according L to L the L investigation's L needs.
,When L Mehmet L interviews L witnesses L as L part L of L his L claims L investigation, L he L asks L different
L types L of L quest Lions L based L on L need, L such L as L open-
ended, L direct, L indirect, L and L leading. L Which L type L of L question L should L Mehmet L ask L when L he
L wants L to L set Lthe L interviewee L at L ease L and L he L is L looking L for L explanation L or L elaboration
L of L details L in L the L interviewee' Ls L own L words?
Select L one:
A. L Open-ended
B. L Direct
C. L Indirect
D. L Leading L - L CORRECT L ANSWER L -A. L Open-ended
Open-ended L questions L can L be L used L to L clarify L an L interviewee's L statements.
Charlotte L is L handling L a L new L claim L and L she L has L set L the L initial L reserves L at L $1,000,000. L She
L has L been L ask Led L to L complete L an L internal L report L summarizing L all L the L file L status
L information L for L distribution L to L manag Lement L and L updated L as L more L information L is L received.
L The L report L Charlotte L is L completing L is L most L likely La
Select L one:
A. L Status L report.
B. L Summarized L report.
C. L Preliminary L report.
D. L Large L loss L report. L - L CORRECT L ANSWER L -D. L Large L loss L report.
Most L insurers L have L guidelines L outlining L when L and L under L what L circumstances L large L loss
L reports L should Lbe L prepared.
In L which L one L of L the L following L scenarios L is L the L right L of L subrogation L most L likely L to L be
L employed L by L the L i Lnsurer?
Select L one:
A. L An L insured L files L a L homeowners L claim L for L stolen L jewelry. L An L investigation L reveals L that
L the L jewelry L is Lstill L in L the L insured's L possession.
B. L An L investigation L reveals L that L an L insured L set L her L own L business L on L fire.
C. L An L insured L files L a L claim L for L collision L damage L from L a L hit L and L run L accident, L when L in
L fact L he L backed L in Lto L a L utility L pole.
D. L A L claims L rep L discovers L that L their L insured's L car L accident L was L caused L by L a L road L contractor
L who L left L e Lquipment L lying L in L the L travel L lanes L of L a L highway. L - L CORRECT L ANSWER L -
D. L A L claims L rep L discovers L that L their L insured's L car L accident L was L caused L by L a L road L contractor
L who L left L e Lquipment L lying L in L the L travel L lanes L of L a L highway.
The L right L of L subrogation L allows L an L insurer L to L recover L payment L from L a L negligent
L third L party. LIn L claims L investigation, L all L bodily L injury L claims L require
Select L one:
A. L Statements L from L all L witnesses.
B. L Multiple L claims L payments
C. L An L attorney.
D. L A L medical L investigation. L - L CORRECT L ANSWER L -D. L A L medical L investigation.
All L bodily L injury L claims, L including L workers L compensation L claims, L require L a L medical
L investigation. LBefore L making L initial L contact L with L an L insured L or L claimant, L a L claims
, L representative L should
Select L one:
