AIC 301 FINAL EXAM STUDY GUIDE
2026/2027 | COMPLETE QUESTIONS |
VERIFIED ANSWERS | GRADED A + | PASS
GUARANTEED | RECENT UPDATE
An insurer that finds it economically impractical to establish a claims office in a
given state is likely to use which one of the following to perform the claims
handling function? - ANSWER Independent Adjusters
Tonya is a claims representative tasked with determining whether coverage applies
to a new claim. To ensure that she considers all facets of the claim, she uses the
DICE method, which stands for declarations, insuring agreement, conditions, and -
ANSWER Exclusions.
Which one of the following is correct with respect to the elements of good-faith
claim management? - ANSWER Consistent supervision, thorough training, and
manageable caseloads help ensure that claim representatives are able to handle
claims in good faith.
Which one of the following elements of a policy can include coverage that is
otherwise excluded, exclude coverage that is otherwise included, or add or delete
insureds? - ANSWER An endorsement.
As a claims representative, Joshua frequently requests proofs of loss and affidavits
and conducts examinations under oath and recorded statements. Which one of
,Joshua's sworn statements is administered by the insurer's attorney at the office of
the insurer, attorney, or court reporter? - ANSWER Examination under oath.
The allegations contained in a summons and complaint typically serve four
purposes: To give notice, reveal facts, formulate legal causes of action, and -
ANSWER State the damages sought.
While staff claims representatives may have a variety of titles, the role is typically
defined by two things: having a primary focus on claims and - ANSWER Being
an employee of the insurer.
Millstone Insurance wanted to assign its most complex workers' compensation
claims to experienced claim adjusters as early as possible. The data science team
used the classification tree technique to develop a predictive model. When holdout
data was used to test the model's predictive accuracy, 45% of the complex claims
were assigned to experienced adjusters. When claims were randomly assigned,
only 15% of the complex claims were assigned to experienced adjusters. What is
the lift provided by the predictive model? - ANSWER 3 (45/15=3)
James works for a multi-line insurer. He is responsible for investigating claims
that raise suspicion of fraud. James is in the - ANSWER Special Investigation
Unit.
Luke runs his business out of a storefront in a commercial building. After a fire
destroyed part of the building, Luke made a claim for damages and received a
settlement check from the property insurer. This necessarily means that Luke
ANSWER Is named in the policy declarations or an endorsement.
, Insurers usually send denial letters - ANSWER By certified mail with a return
receipt requested.
Jose is handling a workers' compensation claim. The injured worker claims to
have strained his back when he lifted a box at work. He waited a day to report the
injury because he thought he would be okay. He asked Jose when he would be
referred to a back specialist and when he could expect his first check. Which one of
the injured worker's actions would be the most pertinent fraud indicator to Jose? -
ANSWER Asking for a referral
Which one of the following terms encompasses types of fraud including false
claims and intentional losses? - ANSWER Hard Fraud.
A claims representative should have the ability to persuade or influence -
ANSWER Claimants, insureds, supervisors, and others.
In her investigations into fraudulent claims, Laura uses information about the
driver's history and driving habits to determine factors such as speed, acceleration,
and location. Laura is using - ANSWER Telematics
Attorney Grace is representing an insurer in a case and is preparing a pretrial
motion. Her argument is that the court has no jurisdiction for the cause of action
brought by the claimant. Grace is preparing a - ANSWER Motion to Dismiss.
Among the methods used to pay claims are the issuance of checks and bank drafts.
The main difference between the two is that - ANSWER With a bank draft, the
bank must verify that the insurer has authorized payment.
, The NAIC model act specifies that its provisions regarding bad-faith claims are to
be enforced by the ANSWER State Insurance Department.
Which one of the following can be applied over time to refine a model to better
predict results? - ANSWER Machine Learning
Because a full or partial denial of a claim may result in a bad-faith lawsuit, a
claims representative should - ANSWER Carefully document their reasoning for
denial.
Cristobal is negotiating a settlement with a claimant attorney in a workers'
compensation claim. The attorney has requested 200 weeks of benefits, which was
more than Cristobal was hoping to pay. Cristobal countered with an offer to pay the
200 weeks if the worker would sign an agreement to resign his position and to
never reopen the claim. Cristobal's negotiation strategy is an example of -
ANSWER Making concessions cautiously.
Leila is conducting a claims investigation and is taking a recorded statement from
the claimant. She wants a simple yes-or-no answer to prevent the interviewee from
explaining the answer further. She asks, "You experienced back pain immediately
when you lifted the box, didn't you?" Leila has asked a(n) - ANSWER Leading
question
Ida was named in a bad-faith lawsuit as the claims representative who handled the
file. The court dismissed the suit, however, because the statute of limitations had
expired. This means that - ANSWER Too much time had expired after the claim
concluded.
2026/2027 | COMPLETE QUESTIONS |
VERIFIED ANSWERS | GRADED A + | PASS
GUARANTEED | RECENT UPDATE
An insurer that finds it economically impractical to establish a claims office in a
given state is likely to use which one of the following to perform the claims
handling function? - ANSWER Independent Adjusters
Tonya is a claims representative tasked with determining whether coverage applies
to a new claim. To ensure that she considers all facets of the claim, she uses the
DICE method, which stands for declarations, insuring agreement, conditions, and -
ANSWER Exclusions.
Which one of the following is correct with respect to the elements of good-faith
claim management? - ANSWER Consistent supervision, thorough training, and
manageable caseloads help ensure that claim representatives are able to handle
claims in good faith.
Which one of the following elements of a policy can include coverage that is
otherwise excluded, exclude coverage that is otherwise included, or add or delete
insureds? - ANSWER An endorsement.
As a claims representative, Joshua frequently requests proofs of loss and affidavits
and conducts examinations under oath and recorded statements. Which one of
,Joshua's sworn statements is administered by the insurer's attorney at the office of
the insurer, attorney, or court reporter? - ANSWER Examination under oath.
The allegations contained in a summons and complaint typically serve four
purposes: To give notice, reveal facts, formulate legal causes of action, and -
ANSWER State the damages sought.
While staff claims representatives may have a variety of titles, the role is typically
defined by two things: having a primary focus on claims and - ANSWER Being
an employee of the insurer.
Millstone Insurance wanted to assign its most complex workers' compensation
claims to experienced claim adjusters as early as possible. The data science team
used the classification tree technique to develop a predictive model. When holdout
data was used to test the model's predictive accuracy, 45% of the complex claims
were assigned to experienced adjusters. When claims were randomly assigned,
only 15% of the complex claims were assigned to experienced adjusters. What is
the lift provided by the predictive model? - ANSWER 3 (45/15=3)
James works for a multi-line insurer. He is responsible for investigating claims
that raise suspicion of fraud. James is in the - ANSWER Special Investigation
Unit.
Luke runs his business out of a storefront in a commercial building. After a fire
destroyed part of the building, Luke made a claim for damages and received a
settlement check from the property insurer. This necessarily means that Luke
ANSWER Is named in the policy declarations or an endorsement.
, Insurers usually send denial letters - ANSWER By certified mail with a return
receipt requested.
Jose is handling a workers' compensation claim. The injured worker claims to
have strained his back when he lifted a box at work. He waited a day to report the
injury because he thought he would be okay. He asked Jose when he would be
referred to a back specialist and when he could expect his first check. Which one of
the injured worker's actions would be the most pertinent fraud indicator to Jose? -
ANSWER Asking for a referral
Which one of the following terms encompasses types of fraud including false
claims and intentional losses? - ANSWER Hard Fraud.
A claims representative should have the ability to persuade or influence -
ANSWER Claimants, insureds, supervisors, and others.
In her investigations into fraudulent claims, Laura uses information about the
driver's history and driving habits to determine factors such as speed, acceleration,
and location. Laura is using - ANSWER Telematics
Attorney Grace is representing an insurer in a case and is preparing a pretrial
motion. Her argument is that the court has no jurisdiction for the cause of action
brought by the claimant. Grace is preparing a - ANSWER Motion to Dismiss.
Among the methods used to pay claims are the issuance of checks and bank drafts.
The main difference between the two is that - ANSWER With a bank draft, the
bank must verify that the insurer has authorized payment.
, The NAIC model act specifies that its provisions regarding bad-faith claims are to
be enforced by the ANSWER State Insurance Department.
Which one of the following can be applied over time to refine a model to better
predict results? - ANSWER Machine Learning
Because a full or partial denial of a claim may result in a bad-faith lawsuit, a
claims representative should - ANSWER Carefully document their reasoning for
denial.
Cristobal is negotiating a settlement with a claimant attorney in a workers'
compensation claim. The attorney has requested 200 weeks of benefits, which was
more than Cristobal was hoping to pay. Cristobal countered with an offer to pay the
200 weeks if the worker would sign an agreement to resign his position and to
never reopen the claim. Cristobal's negotiation strategy is an example of -
ANSWER Making concessions cautiously.
Leila is conducting a claims investigation and is taking a recorded statement from
the claimant. She wants a simple yes-or-no answer to prevent the interviewee from
explaining the answer further. She asks, "You experienced back pain immediately
when you lifted the box, didn't you?" Leila has asked a(n) - ANSWER Leading
question
Ida was named in a bad-faith lawsuit as the claims representative who handled the
file. The court dismissed the suit, however, because the statute of limitations had
expired. This means that - ANSWER Too much time had expired after the claim
concluded.
