AIC 300 ALL CLAIMS EXAM |TESTED & CONFIRMED A+ ANSWERS.
1 view 0 purchase
Course
AIC 300 ALL CLAIMS EXA
Institution
AIC 300 ALL CLAIMS EXA
AIC 300 ALL CLAIMS EXAM |TESTED & CONFIRMED A+
ANSWERS.
In soft fraud, a legitimate loss occurs but the value of that loss is exaggerated. -
CORRECT ANSWERS -Bettina's apartment is burglarized and several items are stolen.
In filing her claim, she tells her insurer that her stolen television wa...
AIC 300 ALL CLAIMS EXAM |TESTED & CONFIRMED A+
ANSWERS.
In soft fraud, a legitimate loss occurs but the value of that loss is exaggerated. -
CORRECT ANSWERS -Bettina's apartment is burglarized and several items are stolen.
In filing her claim, she tells her insurer that her stolen television was both newer and
larger than it actually was. This constitutes which one of the following types of fraud?
Select one:
A. Concealment
B. Misrepresentation
C. False claim
D. Soft fraud
B. Best practices
Best practices generally refers to a system of identified internal practices that are
shared with claims reps and produce superior performance. - CORRECT ANSWERS -
Adam manages a claims department for an insurer. He measures the department's
performance by best practices, claims audits, customer satisfaction data, and loss ratio.
Which one of Adam's measures refers to a system of identified internal practices that
claims representatives perform to produce superior performance?
Select one:
A. Customer satisfaction data
B. Loss ratio
C. Best practices
D. Claims audits
C. An endorsement.
An endorsement can include coverage that is otherwise excluded, exclude coverage
that is otherwise included, or add or delete insureds. - CORRECT ANSWERS -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?
Select one:
A. The declarations.
B. The conditions.
C. An exclusion.
D. An endorsement.
D. Examination under oath
Examination under oath is administered by the attorney for the insurer after notice is
issued to appear at the office of the insurer, attorney, or court reporter. - CORRECT
ANSWERS -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?
Select one:
A. Affidavit
B. Examination under oath
C. Recorded statement
D. Proof of loss
E. Carefully document their reasoning for denial. - CORRECT ANSWERS -Because a
full or partial denial of a claim may result in a bad-faith lawsuit, a claims representative
should
Select one:
A. Seek a supervisor's approval before denying a claim.
B. Make every effort to approve each claim.
C. Carefully document their reasoning for denial.
D. Check with the reinsurer before denying a claim.
F. Are not always sequential, and may overlap. - CORRECT ANSWERS -The activities
that make up the claims handling process
Select one:
A. Are always sequential but may overlap.
B. Are always sequential and do not overlap.
C. Are not always sequential, and may overlap.
D. Are not always sequential, but do not overlap.
A. State insurance departments.
The NAIC model act specifies that its provisions regarding bad-faith claims are to be
enforced by state insurance departments. - CORRECT ANSWERS -The NAIC model
act specifies that its provisions regarding bad-faith claims are to be enforced by
Select one:
A. State insurance departments.
B. The Federal Trade Commission.
C. NAIC personnel.
D. Insurer personnel, on the honor system.
B. By certified mail with a return receipt requested.
Some will also send a copy via regular mail in case the certified letter is not accepted. -
CORRECT ANSWERS -Insurers usually send denial letters
Select one:
A. By email to ensure prompt receipt by the insured.
B. By certified mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
, C. Subpoenaed.
Any written claims communication may be subpoenaed. - CORRECT ANSWERS -As
methods of communication evolve, it's important for claims professionals to remember
that any written claims communication may be
Select one:
A. Replaced with verbal communication.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
D. An insured's negotiations with the insurer on a complex claim are not going well.
If a claim is complex, or if settlement negotiations are not progressing with the insurer,
the insured may hire a public adjuster to protect his or her interests. - CORRECT
ANSWERS -In which one of the following scenarios is a public adjuster most likely to
become involved?
Select one:
A. An insurer finds it financially unfeasible to hire its own claims staff in a given state.
B. An insured is unable to afford legal representation to contest a claim.
C. A catastrophic disaster strikes, involving damage to many properties.
D. An insured's negotiations with the insurer on a complex claim are not going well.
B. TPAs handle claims, keep claims records, and perform statistical analyses. -
CORRECT ANSWERS -Which one of the following statements regarding third-party
administrators (TPAs) is most accurate?
Select one:
A. TPAs are typically used by businesses that have chosen not to self-insure.
B. TPAs handle claims, keep claims records, and perform statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms.
A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are quantitative. -
CORRECT ANSWERS -Hugo is conducting an audit of a branch office claims
operation. He is evaluating timeliness of reports, number of files opened, proper
releases taken, and accuracy of data entry. Which one of Hugo's metrics is a qualitative
audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
B. Line underwriter.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller gideonngari. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.49. You're not tied to anything after your purchase.
