AIC 300 FINALS ANSWERS AND QUESTIONS SET A+
✔✔Precision - ✔✔In model evaluation, correct positive predictions divided by total
positive predictions.
✔✔Actuary - ✔✔A person using mathematical methods to analyze insurance data for
rates or reserves.
✔✔Data science - ✔✔Interdisciplinary field designing techniques to process large
datasets and extract knowledge.
✔✔Domain knowledge - ✔✔Information related to the specific context of the data being
analyzed.
✔✔Insurance fraud - ✔✔Deliberate deception against an insurer or producer for
unwarranted financial gain.
✔✔Special investigation unit (SIU) - ✔✔A division set up to investigate suspicious
claims, premium fraud, or application fraud.
✔✔Predictive model - ✔✔A model used to predict an unknown outcome using a defined
target variable.
✔✔Blockchain - ✔✔A distributed digital ledger facilitating secure transactions without a
third party.
✔✔Material fact - ✔✔A fact that is significant to a decision or matter at hand.
✔✔Hard fraud - ✔✔Actions that are undertaken deliberately to defraud.
✔✔Misrepresentation - ✔✔A false statement of a material fact on which a party relies.
✔✔Concealment - ✔✔An intentional failure to disclose a material fact.
, ✔✔Staged accident - ✔✔An accident deliberately caused to feign injury and collect on a
claim.
✔✔Soft fraud (opportunity fraud) - ✔✔Fraud that occurs when a legitimate claim is
exaggerated.
✔✔Ethics - ✔✔The study of good and bad behavior, dealing with moral duty and
obligation.
✔✔Tort - ✔✔A wrongful act or omission, excluding crime/breach of contract, invading a
protected right.
✔✔Tortfeasor - ✔✔A person or an organization that has committed a tort.
✔✔Contributory negligence - ✔✔Principle preventing recovery if the harmed person's
own negligence contributed to the harm.
✔✔Comparative negligence - ✔✔Principle requiring both parties to share financial loss
according to their degree of fault.
✔✔ Indemnify - ✔✔To restore a party who has sustained a loss to the same financial
position held before the loss.
✔✔Third-party administrator (TPA) - ✔✔An organization providing administrative
services associated with risk financing and insurance.
✔✔Claims representative - ✔✔A person responsible for investigating, evaluating, and
settling claims.
✔✔Producer - ✔✔Several kinds of insurance personnel who place insurance and surety
business with insurers and who represent either insurers or insureds, or both.
✔✔Public adjuster - ✔✔An outside person/organization hired by an insured to represent
them in a claim for a fee.
✔✔Premium audit - ✔✔Methodical examination of policyholder operations, records, &
books to determine actual exposure units and premium for insurance coverages already
provided.
✔✔Loss ratio - ✔✔A ratio measuring losses and loss adjustment expenses against
earned premiums which reflects the percentage of premiums being consumed by
losses.
✔✔Precision - ✔✔In model evaluation, correct positive predictions divided by total
positive predictions.
✔✔Actuary - ✔✔A person using mathematical methods to analyze insurance data for
rates or reserves.
✔✔Data science - ✔✔Interdisciplinary field designing techniques to process large
datasets and extract knowledge.
✔✔Domain knowledge - ✔✔Information related to the specific context of the data being
analyzed.
✔✔Insurance fraud - ✔✔Deliberate deception against an insurer or producer for
unwarranted financial gain.
✔✔Special investigation unit (SIU) - ✔✔A division set up to investigate suspicious
claims, premium fraud, or application fraud.
✔✔Predictive model - ✔✔A model used to predict an unknown outcome using a defined
target variable.
✔✔Blockchain - ✔✔A distributed digital ledger facilitating secure transactions without a
third party.
✔✔Material fact - ✔✔A fact that is significant to a decision or matter at hand.
✔✔Hard fraud - ✔✔Actions that are undertaken deliberately to defraud.
✔✔Misrepresentation - ✔✔A false statement of a material fact on which a party relies.
✔✔Concealment - ✔✔An intentional failure to disclose a material fact.
, ✔✔Staged accident - ✔✔An accident deliberately caused to feign injury and collect on a
claim.
✔✔Soft fraud (opportunity fraud) - ✔✔Fraud that occurs when a legitimate claim is
exaggerated.
✔✔Ethics - ✔✔The study of good and bad behavior, dealing with moral duty and
obligation.
✔✔Tort - ✔✔A wrongful act or omission, excluding crime/breach of contract, invading a
protected right.
✔✔Tortfeasor - ✔✔A person or an organization that has committed a tort.
✔✔Contributory negligence - ✔✔Principle preventing recovery if the harmed person's
own negligence contributed to the harm.
✔✔Comparative negligence - ✔✔Principle requiring both parties to share financial loss
according to their degree of fault.
✔✔ Indemnify - ✔✔To restore a party who has sustained a loss to the same financial
position held before the loss.
✔✔Third-party administrator (TPA) - ✔✔An organization providing administrative
services associated with risk financing and insurance.
✔✔Claims representative - ✔✔A person responsible for investigating, evaluating, and
settling claims.
✔✔Producer - ✔✔Several kinds of insurance personnel who place insurance and surety
business with insurers and who represent either insurers or insureds, or both.
✔✔Public adjuster - ✔✔An outside person/organization hired by an insured to represent
them in a claim for a fee.
✔✔Premium audit - ✔✔Methodical examination of policyholder operations, records, &
books to determine actual exposure units and premium for insurance coverages already
provided.
✔✔Loss ratio - ✔✔A ratio measuring losses and loss adjustment expenses against
earned premiums which reflects the percentage of premiums being consumed by
losses.
