Aic 300 - Claims In An Evolving World
ss ss ss ss ss ss ss ss
Questions With Correct Answers 2025 - 2026
ss ss ss ss ss ss ss
Insurers s s usually s s send s s denial s s letters
Select s s one:
A. s s By s s email s s to s s ensure s s prompt s s receipt s s by s s the s s insured.
B. s s By s s certified s s mail s s with s s a s s return s s receipt s s requested.
C. s s By s s overnight s s courier.
D. s s By s s registered s s mail. s s - s s CORRECT s s ANSWER s s -B. s s By s s certified ss mail ss with ss a ss return
s s receipt s s requested.
Some s s will ss also ss send ss a ss copy ss via ss regular ss mail ss in ss case ss the ss certified ss letter ss is ss not
s s accepted.
As s s methods s s of s s communication s s evolve, s s it's s s important s s for s s claims ss professionals ss to
s s remember s s that s s any s s wri sstten s s claims s s communication s s may s s be
Select s s one:
A. s s Replaced s s with s s verbal s s communication.
B. s s Misinterpreted.
C. s s Edited s s later.
D. s s Subpoenaed. s s - s s CORRECT s s ANSWER s s -D. s s Subpoenaed.
Any ss written ss claims ss communication ss may ss be ss subpoenaed.
In s s which s s one s s of s s the s s following s s scenarios s s is s s a s s public s s adjuster s s most s s likely
s s to s s become s s involved? ssSelect s s one:
A. s s An s s insurer s s finds s s it s s financially s s unfeasible s s to s s hire s s its s s own s s claims s s staff s s in s s a s s given
s s state.
B. s s An s s insured s s is s s unable s s to s s afford s s legal s s representation s s to s s contest s s a s s claim.
C. s s A s s catastrophic s s disaster s s strikes, s s involving s s damage s s to s s many s s properties.
D. s s An s s insured's s s negotiations s s with s s the s s insurer s s on s s a s s complex s s claim s s are
s s not s s going s s well. s s - ssCORRECT s s ANSWER s s -
D. s s An s s insured's s s negotiations s s with s s the s s insurer s s on s s a s s complex s s claim s s are s s not s s going
s s well.
If ssa s s claim s s is s s complex, s s or s s if s s settlement s s negotiations s s are s s not s s progressing s s with
s s the s s insurer, s s the s s insured s s m ssay s s hire s s a s s public s s adjuster s s to s s protect s s his s s or s s her
s s interests.
Which s s one s s of s s the s s following s s statements s s regarding s s third-party s s administrators s s (TPAs) s s is
s s most s s accurate? ssSelect s s one:
A. s s TPAs s s are s s typically s s used s s by s s businesses s s that s s have s s chosen s s not s s to s s self-insure.
B. s s TPAs s s handle s s claims, s s keep s s claims s s records, s s and s s perform s s statistical s s analyses.
C. s s TPAs s s are s s generally s s found s s in s s an s s insurer's s s claims s s department.
D. s s TPAs s s are s s employed s s only s s by s s independent s s adjusting s s firms. s s - s s CORRECT s s ANSWER s s -
B. s s TPAs s s handle s s claims, s s keep s s claims s s records, s s and s s perform s s statistical s s analyses.
Hugo ssis ssconducting ssan ssaudit ssof ssa ssbranch ssoffice ssclaims ssoperation. ssHe ssis ssevaluating sstimeliness ssof
ssreports, ssnumber s s of s s files s s opened, s s proper s s releases s s taken, s s and s s accuracy s s of s s data
s s entry. s s Which s s one s s of s s Hugo's s s metr ssics s s is s s a s s qualitative s s audit s s factor?
,Select s s one:
A. s s Proper s s releases s s taken
B. s s Timeliness s s of s s reports
C. s s Number s s of s s files s s opened
D. s s Accuracy s s of s s data s s entry s s - ss CORRECT ss ANSWER ss -A. ss Proper ss releases ss taken
,Proper ss releases ss taken ss is ss a ss qualitative ss audit ss factor; ss the ss others ss are ss quantitative.
Aaron s s works s s for s s a s s multi-
line s s insurer. s s He s s works s s with s s insurance s s producers s s and s s applicants s s to ss evaluate ss new
s s business s s submissions s s a ssnd s s conduct s s renewal s s underwriting. s s Aaron s s is ss a
Select s s one:
A. s s Staff s s underwriter.
B. s s Public s s underwriter.
C. s s Personal s s lines s s underwriter.
D. s s Line s s underwriter. s s - s s CORRECT s s ANSWER s s -D. s s Line s s underwriter.
Line s s underwriter. s s This s s describes s s the s s duties s s of s s a s s line s s underwriter, s s rather s s than s s a
s s staff s s underwriter. s s There ssis s s not s s enough s s information s s to s s determine s s which s s line s s of
s s business s s is s s being s s written. s s A s s public s s underwriter ssdoes s s not s s exist. s s Line s s underwriters
s s evaluate s s new s s submissions s s and s s perform s s renewal s s underwriting, s s usually ssby s s working
s s directly s s with s s insurance s s producers s s and s s applicants. s s Staff s s underwriters, s s meanwhile,
s s manage s s ris ssk s s selection s s by s s working s s with s s line s s underwriters s s and s s coordinating
s s decisions s s about s s products, s s pricing s s and s s g ssuidelines.
The s s first s s key s s to s s communicating s s empathetically s s as s s a s s claims
s s professional s s is ssSelect s s one:
A. s s A s s comprehensive s s understanding s s of s s relevant s s insurance s s policies.
B. s s Speaking s s calmly s s and s s clearly.
C. s s Being s s prepared s s with s s all s s documentation s s relating s s to s s the s s claim.
D. s s Listening. s s - s s CORRECT s s ANSWER s s -D. s s Listening.
Claims s s professionals ss should ss first ss listen ss carefully ss to ss understand ss what ss the ss claimant ss is
s s saying.
Mia s s tracks s s loss s s adjustment s s expense s s (LAE) s s as s s part s s of s s her s s management ss of ss the ss claims
s s department s s for s s an ssinsurer. s s Mia s s considers s s LAE s s to s s be s s the
Select s s one:
A. s s Total s s amount s s of s s loss s s reserves s s of s s all s s claims.
B. s s Paid s s portion s s of s s claims.
C. s s Cost s s to s s investigate, s s defend, s s and s s settle s s claims.
D. s s Total s s incurred s s amount s s of s s claims. s s - s s CORRECT s s ANSWER s s -
C. s s Cost s s to s s investigate, s s defend, s s and s s settle s s claims.
Cost s s to s s investigate, s s defend, s s and s s settle s s claims. s s LAE s s is s s the s s expense s s that s s an
s s insurer s s incurs s s to s s investigate, ssdefend, s s and s s settle s s claims s s according s s to s s the s s terms
s s specified s s in s s the s s insurance s s policy.
In ssher ssrole sswith ssan ssinsurer, ssKatarina sshas ssopportunity ssto sscollaborate sswith ssnot ssonly ssemployees ssfrom
ssher sscompany, s s but s s also s s external s s experts s s with s s particular s s expertise. s s For s s example, s s as
s s part s s of s s her s s investigation, ssshe s s hired s s an s s engineer s s to s s conduct ssa s s review s s of ssa
s s machine s s that s s was s s involved s s in s s a s s personal s s injury. s s Katari ssna s s is s s a(n)
Select s s one:
A. s s Medical s s provider.
B. s s Expert s s Witness.
C. s s Premium s s auditor.
D. s s Claim s s representative. s s - s s CORRECT s s ANSWER s s -D. s s Claim s s representative.
, Claim s s reps s s collaborate s s with s s more ss than s s other ss insurer s s employees. s s Many ss insurers
s s employ s s a s s panel s s of s s exp sserts s s that ss the s s claims ss rep s s can s s select s s according ss to s s the
s s investigation's s s needs.
ss ss ss ss ss ss ss ss
Questions With Correct Answers 2025 - 2026
ss ss ss ss ss ss ss
Insurers s s usually s s send s s denial s s letters
Select s s one:
A. s s By s s email s s to s s ensure s s prompt s s receipt s s by s s the s s insured.
B. s s By s s certified s s mail s s with s s a s s return s s receipt s s requested.
C. s s By s s overnight s s courier.
D. s s By s s registered s s mail. s s - s s CORRECT s s ANSWER s s -B. s s By s s certified ss mail ss with ss a ss return
s s receipt s s requested.
Some s s will ss also ss send ss a ss copy ss via ss regular ss mail ss in ss case ss the ss certified ss letter ss is ss not
s s accepted.
As s s methods s s of s s communication s s evolve, s s it's s s important s s for s s claims ss professionals ss to
s s remember s s that s s any s s wri sstten s s claims s s communication s s may s s be
Select s s one:
A. s s Replaced s s with s s verbal s s communication.
B. s s Misinterpreted.
C. s s Edited s s later.
D. s s Subpoenaed. s s - s s CORRECT s s ANSWER s s -D. s s Subpoenaed.
Any ss written ss claims ss communication ss may ss be ss subpoenaed.
In s s which s s one s s of s s the s s following s s scenarios s s is s s a s s public s s adjuster s s most s s likely
s s to s s become s s involved? ssSelect s s one:
A. s s An s s insurer s s finds s s it s s financially s s unfeasible s s to s s hire s s its s s own s s claims s s staff s s in s s a s s given
s s state.
B. s s An s s insured s s is s s unable s s to s s afford s s legal s s representation s s to s s contest s s a s s claim.
C. s s A s s catastrophic s s disaster s s strikes, s s involving s s damage s s to s s many s s properties.
D. s s An s s insured's s s negotiations s s with s s the s s insurer s s on s s a s s complex s s claim s s are
s s not s s going s s well. s s - ssCORRECT s s ANSWER s s -
D. s s An s s insured's s s negotiations s s with s s the s s insurer s s on s s a s s complex s s claim s s are s s not s s going
s s well.
If ssa s s claim s s is s s complex, s s or s s if s s settlement s s negotiations s s are s s not s s progressing s s with
s s the s s insurer, s s the s s insured s s m ssay s s hire s s a s s public s s adjuster s s to s s protect s s his s s or s s her
s s interests.
Which s s one s s of s s the s s following s s statements s s regarding s s third-party s s administrators s s (TPAs) s s is
s s most s s accurate? ssSelect s s one:
A. s s TPAs s s are s s typically s s used s s by s s businesses s s that s s have s s chosen s s not s s to s s self-insure.
B. s s TPAs s s handle s s claims, s s keep s s claims s s records, s s and s s perform s s statistical s s analyses.
C. s s TPAs s s are s s generally s s found s s in s s an s s insurer's s s claims s s department.
D. s s TPAs s s are s s employed s s only s s by s s independent s s adjusting s s firms. s s - s s CORRECT s s ANSWER s s -
B. s s TPAs s s handle s s claims, s s keep s s claims s s records, s s and s s perform s s statistical s s analyses.
Hugo ssis ssconducting ssan ssaudit ssof ssa ssbranch ssoffice ssclaims ssoperation. ssHe ssis ssevaluating sstimeliness ssof
ssreports, ssnumber s s of s s files s s opened, s s proper s s releases s s taken, s s and s s accuracy s s of s s data
s s entry. s s Which s s one s s of s s Hugo's s s metr ssics s s is s s a s s qualitative s s audit s s factor?
,Select s s one:
A. s s Proper s s releases s s taken
B. s s Timeliness s s of s s reports
C. s s Number s s of s s files s s opened
D. s s Accuracy s s of s s data s s entry s s - ss CORRECT ss ANSWER ss -A. ss Proper ss releases ss taken
,Proper ss releases ss taken ss is ss a ss qualitative ss audit ss factor; ss the ss others ss are ss quantitative.
Aaron s s works s s for s s a s s multi-
line s s insurer. s s He s s works s s with s s insurance s s producers s s and s s applicants s s to ss evaluate ss new
s s business s s submissions s s a ssnd s s conduct s s renewal s s underwriting. s s Aaron s s is ss a
Select s s one:
A. s s Staff s s underwriter.
B. s s Public s s underwriter.
C. s s Personal s s lines s s underwriter.
D. s s Line s s underwriter. s s - s s CORRECT s s ANSWER s s -D. s s Line s s underwriter.
Line s s underwriter. s s This s s describes s s the s s duties s s of s s a s s line s s underwriter, s s rather s s than s s a
s s staff s s underwriter. s s There ssis s s not s s enough s s information s s to s s determine s s which s s line s s of
s s business s s is s s being s s written. s s A s s public s s underwriter ssdoes s s not s s exist. s s Line s s underwriters
s s evaluate s s new s s submissions s s and s s perform s s renewal s s underwriting, s s usually ssby s s working
s s directly s s with s s insurance s s producers s s and s s applicants. s s Staff s s underwriters, s s meanwhile,
s s manage s s ris ssk s s selection s s by s s working s s with s s line s s underwriters s s and s s coordinating
s s decisions s s about s s products, s s pricing s s and s s g ssuidelines.
The s s first s s key s s to s s communicating s s empathetically s s as s s a s s claims
s s professional s s is ssSelect s s one:
A. s s A s s comprehensive s s understanding s s of s s relevant s s insurance s s policies.
B. s s Speaking s s calmly s s and s s clearly.
C. s s Being s s prepared s s with s s all s s documentation s s relating s s to s s the s s claim.
D. s s Listening. s s - s s CORRECT s s ANSWER s s -D. s s Listening.
Claims s s professionals ss should ss first ss listen ss carefully ss to ss understand ss what ss the ss claimant ss is
s s saying.
Mia s s tracks s s loss s s adjustment s s expense s s (LAE) s s as s s part s s of s s her s s management ss of ss the ss claims
s s department s s for s s an ssinsurer. s s Mia s s considers s s LAE s s to s s be s s the
Select s s one:
A. s s Total s s amount s s of s s loss s s reserves s s of s s all s s claims.
B. s s Paid s s portion s s of s s claims.
C. s s Cost s s to s s investigate, s s defend, s s and s s settle s s claims.
D. s s Total s s incurred s s amount s s of s s claims. s s - s s CORRECT s s ANSWER s s -
C. s s Cost s s to s s investigate, s s defend, s s and s s settle s s claims.
Cost s s to s s investigate, s s defend, s s and s s settle s s claims. s s LAE s s is s s the s s expense s s that s s an
s s insurer s s incurs s s to s s investigate, ssdefend, s s and s s settle s s claims s s according s s to s s the s s terms
s s specified s s in s s the s s insurance s s policy.
In ssher ssrole sswith ssan ssinsurer, ssKatarina sshas ssopportunity ssto sscollaborate sswith ssnot ssonly ssemployees ssfrom
ssher sscompany, s s but s s also s s external s s experts s s with s s particular s s expertise. s s For s s example, s s as
s s part s s of s s her s s investigation, ssshe s s hired s s an s s engineer s s to s s conduct ssa s s review s s of ssa
s s machine s s that s s was s s involved s s in s s a s s personal s s injury. s s Katari ssna s s is s s a(n)
Select s s one:
A. s s Medical s s provider.
B. s s Expert s s Witness.
C. s s Premium s s auditor.
D. s s Claim s s representative. s s - s s CORRECT s s ANSWER s s -D. s s Claim s s representative.
, Claim s s reps s s collaborate s s with s s more ss than s s other ss insurer s s employees. s s Many ss insurers
s s employ s s a s s panel s s of s s exp sserts s s that ss the s s claims ss rep s s can s s select s s according ss to s s the
s s investigation's s s needs.
