AIC 300 – CLAIMS IN AN EVOLVING WORLD TEST QUESTIONS AND
ACCURATE ANSWERS (LATEST)
A definitive judgement or settlement must have been obtained against the
insured in order to file an excess liability claim, and ANSWER The judgement
must be greater than the insured's policy limit.
Benjamin works at an insurance company's SIU division. His business created
technologies to spot trends in fraudulent claims activity. He is employing a
program to examine claims data in order to find patterns or relationships that
could point to fraud. ANSWER data mining is what Benjamin is using.
Claimants are required by the Office of Foreign Assets Control to compare their
claims against a database of ANSWER Known drug dealers and terrorists
There are three methods to pay claims: cheque, bank transfer or ANSWER By
means of an electronic money transfer
A liability claim is being handled by Carolina, a claim representative. She is on
the phone with the claimant and has warned him that he faces perjury if he
doesn't make truthful remarks. After finishing, she emailed the claimant a
transcription of the exchange to sign in front of a notary. Carolina has taken the
following action: ANSWER Statement that was recorded
Prior to contacting an insured or claimant for the first time, a claims agent
should ANSWER Make a list of enquiries for the policyholder.
In order to allocate vehicle liability claims to qualified adjusters at an early
stage of the process, Greatview Insurance seeks to identify which claims are
most likely to proceed to litigation. Greatview wishes to employ specific
established signs of litigation in the data mining procedure. Which of the
following data mining methods is most likely to be employed by Greatview's
analyst? - Classification of Answers
, The ANSWER A summons and complaint is the first step in the claims
litigation process.
Katarina's position with an insurance gives her the chance to work with both
internal staff members and outside specialists who possess specialised
knowledge. For instance, she engaged an engineer to examine a machine that
was implicated in a personal harm as part of her research. Katarina is a
representative of ANSWER Claims.
As a claims agent, Julio expects to handle claims in good faith. Because
insureds have this expectation and are more likely to file a complaint over bad-
faith claim handling, he keeps them updated on the claim. In addition, he wants
to be involved in the defence and the talks over a potential settlement. Because
of these factors, Julio - ANSWER keeps up timely and consistent
communication
Following the settlement of a claim against her that Ella believed ought to have
been rejected, Ella filed a lawsuit against her insurer, alleging bad-faith claim
management. The settlement resulted in an increase in Ella's premium. Ella
alleged in her lawsuit that the insurance hurried the inquiry and failed to
evaluate all of her defense-related facts. Although the court acknowledged the
validity of Ella's case, it did not give her the whole amount because it concluded
that Ella had failed to promptly supply the insurer with her information.
ANSWER Comparative negligence was the defence employed by the insurance.
In the context of claims professionals, what term best characterises
"professionalism"? ANSWER The actions required to carry out an ethical
judgement
As part of her job managing an insurer's claims department, Mia keeps track of
loss adjustment expense (LAE). According to Mia, LAE is the ANSWER Cost
for looking into, defending, and settling allegations.
Is it true or false?
Typically, third-party administrators (TPAs) manage claims, maintain
documentation, and do statistical analysis. The answer is yes.
ACCURATE ANSWERS (LATEST)
A definitive judgement or settlement must have been obtained against the
insured in order to file an excess liability claim, and ANSWER The judgement
must be greater than the insured's policy limit.
Benjamin works at an insurance company's SIU division. His business created
technologies to spot trends in fraudulent claims activity. He is employing a
program to examine claims data in order to find patterns or relationships that
could point to fraud. ANSWER data mining is what Benjamin is using.
Claimants are required by the Office of Foreign Assets Control to compare their
claims against a database of ANSWER Known drug dealers and terrorists
There are three methods to pay claims: cheque, bank transfer or ANSWER By
means of an electronic money transfer
A liability claim is being handled by Carolina, a claim representative. She is on
the phone with the claimant and has warned him that he faces perjury if he
doesn't make truthful remarks. After finishing, she emailed the claimant a
transcription of the exchange to sign in front of a notary. Carolina has taken the
following action: ANSWER Statement that was recorded
Prior to contacting an insured or claimant for the first time, a claims agent
should ANSWER Make a list of enquiries for the policyholder.
In order to allocate vehicle liability claims to qualified adjusters at an early
stage of the process, Greatview Insurance seeks to identify which claims are
most likely to proceed to litigation. Greatview wishes to employ specific
established signs of litigation in the data mining procedure. Which of the
following data mining methods is most likely to be employed by Greatview's
analyst? - Classification of Answers
, The ANSWER A summons and complaint is the first step in the claims
litigation process.
Katarina's position with an insurance gives her the chance to work with both
internal staff members and outside specialists who possess specialised
knowledge. For instance, she engaged an engineer to examine a machine that
was implicated in a personal harm as part of her research. Katarina is a
representative of ANSWER Claims.
As a claims agent, Julio expects to handle claims in good faith. Because
insureds have this expectation and are more likely to file a complaint over bad-
faith claim handling, he keeps them updated on the claim. In addition, he wants
to be involved in the defence and the talks over a potential settlement. Because
of these factors, Julio - ANSWER keeps up timely and consistent
communication
Following the settlement of a claim against her that Ella believed ought to have
been rejected, Ella filed a lawsuit against her insurer, alleging bad-faith claim
management. The settlement resulted in an increase in Ella's premium. Ella
alleged in her lawsuit that the insurance hurried the inquiry and failed to
evaluate all of her defense-related facts. Although the court acknowledged the
validity of Ella's case, it did not give her the whole amount because it concluded
that Ella had failed to promptly supply the insurer with her information.
ANSWER Comparative negligence was the defence employed by the insurance.
In the context of claims professionals, what term best characterises
"professionalism"? ANSWER The actions required to carry out an ethical
judgement
As part of her job managing an insurer's claims department, Mia keeps track of
loss adjustment expense (LAE). According to Mia, LAE is the ANSWER Cost
for looking into, defending, and settling allegations.
Is it true or false?
Typically, third-party administrators (TPAs) manage claims, maintain
documentation, and do statistical analysis. The answer is yes.
