AIC 30 Questions and Correct Answers/
Latest Update / Already Graded
First Party Focus
Ans: Coverage and Amount of damage
Second Party
Ans: Insurance Company
First Party
Ans: Insured
Third Party
Ans: Claimant
Third Party Focus
Ans: Liability, Coverage, and Amount of damage
Third Party Administrator (TPA)
All rights reserved © 2025/ 2026 |
, Page |2
Ans: an organization that provides admin services associated
with risk financing and insurance. They handle claims and risk
management for self-insured organizations
Independent Adjuster
Ans: handles claims for the insurer for a fee. Works fo r the
insurer
Public Adjuster
Ans: an outside organization that is hired by the insured to
represent the insured in the claim for a fee. Works for the public
Quantitative Measures
Ans: can have actual numbers assigned, such as number of
claims opened and percentage of subrogation recovery
Qualitative Measures
Ans: related to intangible measures. nothing concrete, did they
do a good job? do they have good negotiation skills?
Ethics
All rights reserved © 2025/ 2026 |
, Page |3
Ans: the study of what constitutes good and bad behavior,
dealing with the moral duty and obligation
Conflict of Interest
Ans: a situation that occurs when a decision makers personal
interests interfere to the extent that he/she makes decisio ns
that adversely affect the customer, claimant, or employer
Ex Parte Contract
Ans: contracts in which only 1 party is heard. discussing the
claim with the represented person without benefit of their
attorney being involved. this is not illegal, but its not ethical.
Fraud
Ans: an intentional misrepresentation resulting in harm to
another person or organization
Code of Ethics
Ans: professional guidelines of behavior within an organization
or profession
All rights reserved © 2025/ 2026 |
, Page |4
N.A.I.C
Ans: The National Association of Insurance Commissioners
Model Laws
Ans: NAIC develops that they feel is an appropriate law related
to insurance/risk management
Model Laws - Goal
Ans: to standardize the laws related to insurance, to address
issues related to insurance
Unfair Claims Settlement Practice Act
Ans: to prevent insurance companies from taking unfair
advantage of the insured/claimants
Reservations of Rights Letter
Ans: an insurer's letter that specifies coverage issues and
informs the insured that the insurer is handling a claim with the
understanding that the insurer may later deny coverage should
the facts warrant it.
All rights reserved © 2025/ 2026 |