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AIC 300 - CLAIMS IN AN EVOLVING WORLD
2025 UPDATED ACTUAL EXAM WITH
CORRECT SOLUTIONS.
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. - correct answer- 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. -
correct answer- 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.
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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. - correct answer- 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. - correct answer- Which one of the
following statements regarding third-party administrators
(TPAs) is most accurate?
Select one:
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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. - correct answer- 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
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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. - correct answer- 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. - correct answer- 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.
AIC 300 - CLAIMS IN AN EVOLVING WORLD
2025 UPDATED ACTUAL EXAM WITH
CORRECT SOLUTIONS.
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. - correct answer- 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. -
correct answer- 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.
,2 | Page
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. - correct answer- 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. - correct answer- Which one of the
following statements regarding third-party administrators
(TPAs) is most accurate?
Select one:
,3 | Page
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. - correct answer- 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
, 4 | Page
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. - correct answer- 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. - correct answer- 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.
