AIC 300 Exam Study Guide with
Complete Solutions
First Party Focus - Answer️️ -Coverage and Amount of damage
Second Party - Answer️️ -Insurance Company
First Party - Answer️️ -Insured
Third Party - Answer️️ -Claimant
Third Party Focus - Answer️️ -Liability, Coverage, and A...
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?
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, 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 employer
Ex 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
Reservations of Rights Letter - Answer✔️✔️-an insurer's letter that specifies coverage
issues and informs the insured that the insurer is handling a claim with the
understanding that the insurer may later deny coverage should the facts warrant it.
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