AIC 30 Questions and Answers with complete solution | 2024 update

First Party Focus - Answer-Coverage and Amount of damage Second Party - Answer-Insurance Company First Party - Answer-Insured Third Party - Answer-Claimant Third Party Focus - Answer-Liability, Coverage, and Amount of damage Third Party Administrator (TPA) - Answer-an organization that provides admin services associated with risk financing and insurance. They handle claims and risk management for self-insured organizations Independent Adjuster - Answer-handles claims for the insurer for a fee. Works for the insurer Public Adjuster - Answer-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 - Answer-can have actual numbers assigned, such as number of claims opened and percentage of subrogation recovery Qualitative Measures - Answer-related to intangible measures. nothing concrete, did they do a good job? do they have good negotiation skills? Ethics - Answer-the study of what constitutes good and bad behavior, dealing with the moral duty and obligation Conflict of Interest - Answer-a situation that occurs when a decision makers personal interests interfere to the extent that he/she makes decisions that adversely affect the customer, claimant, or employerEx Parte Contract - Answer-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 - Answer-an intentional misrepresentation resulting in harm to another person or organization Code of Ethics - Answer-professional guidelines of behavior within an organization or profession N.A.I.C - Answer-The National Association of Insurance Commissioners Model Laws - Answer-NAIC develops that they feel is an appropriate law related to insurance/risk management Model Laws - Goal - Answer-to standardize the laws related to insurance, to address issues related to insurance Unfair Claims Settlement Practice Act - Answer-to prevent insurance companies from taking unfair advantage of the insured/claimants