AIC EXAM PACKAGE 2026 SKILLS AND
APPLICATION WORKBOOK SOLVED
QUESTIONS COMPILATION
◉ Lanny, a claim representative with Babbling Brook Insurance
Company, is ready to settle a serious bodily injury claim with Freda.
He notices that Medicare is listed as payer on her hospital bill of
$75,000. He and Freda have agreed to settle her claim for $255,000.
Since Freda has been enrolled in Medicare for four years, which one
of the following entities must approve the settlement?
Answer: Center for Medicare and Medicaid Services
◉ Which one of the following databases should a claim
representative review prior to issuing a claim payment?
Answer: State databases for delinquent child support payments
◉ Which one of the following alternative dispute resolution methods
enables parties to test the validity of their positions and continue
negotiations?
Answer: mini-trial
◉ George settled a claim with a claimant who is 63 years of age. The
claimant is not receiving Medicare benefits at the time of settlement.
George feels that he is required to advise the Center for Medicare
,and Medicaid Services about the payment. Which one of the
following statements is true in this situation?
Answer: George is correct. There is a reasonable expectation that the
claimant will obtain Medicare benefits within 30 months.
◉ Reserve adequacy and accuracy are important for supporting an
insurer's continued solvency and
Answer: capacity
◉ The average value method of reserving is useful in setting
reserves
Answer: When there are small variations in the loss amounts paid
for specific types of claims.
◉ An insurer may be held liable for damages beyond a policy's limits
in which one of the following?
Answer: Failing to investigate before denying a claim
◉ The claim manager for Reliable Insurance was reviewing a
property claim. The loss records indicated that the claim
representative had made contact with the insured three days after
the loss, but inspected the property within 24 hours. An estimate of
the damages was completed and the claim was paid promptly. Which
one of the following claim adjustment actions addresses a weakness
,in the duty to investigate from the claim representatives handling of
the file?
Answer: Untimely contact with the insured
◉ Many policies allow an insurer to request an injured insured to
submit to an in-person examination. This independent medical
examination (IME) is listed as a
Answer: Policy condition.
◉ Industry databases are investigative tools which contain claim
information from a variety of sources. The oldest and largest of
these industry databases is
Answer: ISO ClaimSearch.
◉ The Internet can facilitate the inspection of a loss thousands of
miles from where the claim representative is located when the claim
representative uses the Internet to
Answer: Contact a local representative who can inspect and report
on the damage.
◉ It is important for the claim representative to verify the property
damaged and the loss location. This verification can be performed by
Answer: A field representative physically viewing the property.
, ◉ If no agency information is provided on the loss notice form, the
claim representative should review the policy to determine
Answer: The producer who submitted the application.
◉ Which one of the following can assist in confirming information
on the automobile loss notice?
Answer: Medical reports
◉ Claim representatives should take special care to eliminate visual
distortions in photos since they are more likely to be challenged in
court. For example, for close-up photos, which one of the following
could be used as a point of reference to accurately depict size or
dimension?
Answer: RULER
◉ A map can be used to show the location of places that are relevant
to the case. Maps should be prepared by professionally trained
Answer: ENGINEERS
◉ Mike reported a claim for property damage to his home. The
damage involved a collapse of part of the structure and appeared to
be related to the grading around the home as well as the land near to
the lot that Mike's home was on. In order to appropriately document
the cause of the damage, which one of the following would be the
best selection?
APPLICATION WORKBOOK SOLVED
QUESTIONS COMPILATION
◉ Lanny, a claim representative with Babbling Brook Insurance
Company, is ready to settle a serious bodily injury claim with Freda.
He notices that Medicare is listed as payer on her hospital bill of
$75,000. He and Freda have agreed to settle her claim for $255,000.
Since Freda has been enrolled in Medicare for four years, which one
of the following entities must approve the settlement?
Answer: Center for Medicare and Medicaid Services
◉ Which one of the following databases should a claim
representative review prior to issuing a claim payment?
Answer: State databases for delinquent child support payments
◉ Which one of the following alternative dispute resolution methods
enables parties to test the validity of their positions and continue
negotiations?
Answer: mini-trial
◉ George settled a claim with a claimant who is 63 years of age. The
claimant is not receiving Medicare benefits at the time of settlement.
George feels that he is required to advise the Center for Medicare
,and Medicaid Services about the payment. Which one of the
following statements is true in this situation?
Answer: George is correct. There is a reasonable expectation that the
claimant will obtain Medicare benefits within 30 months.
◉ Reserve adequacy and accuracy are important for supporting an
insurer's continued solvency and
Answer: capacity
◉ The average value method of reserving is useful in setting
reserves
Answer: When there are small variations in the loss amounts paid
for specific types of claims.
◉ An insurer may be held liable for damages beyond a policy's limits
in which one of the following?
Answer: Failing to investigate before denying a claim
◉ The claim manager for Reliable Insurance was reviewing a
property claim. The loss records indicated that the claim
representative had made contact with the insured three days after
the loss, but inspected the property within 24 hours. An estimate of
the damages was completed and the claim was paid promptly. Which
one of the following claim adjustment actions addresses a weakness
,in the duty to investigate from the claim representatives handling of
the file?
Answer: Untimely contact with the insured
◉ Many policies allow an insurer to request an injured insured to
submit to an in-person examination. This independent medical
examination (IME) is listed as a
Answer: Policy condition.
◉ Industry databases are investigative tools which contain claim
information from a variety of sources. The oldest and largest of
these industry databases is
Answer: ISO ClaimSearch.
◉ The Internet can facilitate the inspection of a loss thousands of
miles from where the claim representative is located when the claim
representative uses the Internet to
Answer: Contact a local representative who can inspect and report
on the damage.
◉ It is important for the claim representative to verify the property
damaged and the loss location. This verification can be performed by
Answer: A field representative physically viewing the property.
, ◉ If no agency information is provided on the loss notice form, the
claim representative should review the policy to determine
Answer: The producer who submitted the application.
◉ Which one of the following can assist in confirming information
on the automobile loss notice?
Answer: Medical reports
◉ Claim representatives should take special care to eliminate visual
distortions in photos since they are more likely to be challenged in
court. For example, for close-up photos, which one of the following
could be used as a point of reference to accurately depict size or
dimension?
Answer: RULER
◉ A map can be used to show the location of places that are relevant
to the case. Maps should be prepared by professionally trained
Answer: ENGINEERS
◉ Mike reported a claim for property damage to his home. The
damage involved a collapse of part of the structure and appeared to
be related to the grading around the home as well as the land near to
the lot that Mike's home was on. In order to appropriately document
the cause of the damage, which one of the following would be the
best selection?
