AIC 300: Claims in an Evolving World Latest 2024/2025 Updated Questions and Answers Guaranteed 100% Success.
8 views 0 purchase
Course
AIC 300: Claims in an Evolving World
Institution
AIC 300: Claims In An Evolving World
Although most policies are occurrence forms, covering claims that occur during the policy period, some
are claims-made forms. Which one of the following types of loss is most likely to involve a claims-made
form?
Select one:
A. An automotive collision claim.
B. A homeowners liability claim due...
Although most policies are occurrence forms, covering claims that occur during the policy period, some
are claims-made forms. Which one of the following types of loss is most likely to involve a claims-made
form?
Select one:
A. An automotive collision claim.
B. A homeowners liability claim due to a slip and fall.
C. A homeowners claim due to storm damage.
D. A medical malpractice claim. - D. A medical malpractice claim.
Claims-made forms are most often used for environmental, medical malpractice and directors and
officers' policies.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department for an
insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid portion of claims.
C. Cost to investigate, defend, and settle claims.
D. Total incurred amount of claims. - C. Cost to investigate, defend, and settle claims.
Cost to investigate, defend, and settle claims. LAE is the expense that an insurer incurs to investigate,
defend, and settle claims according to the terms specified in the insurance policy.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees from her
company, but also external experts with particular expertise. For example, as part of her investigation,
she hired an engineer to conduct a review of a machine that was involved in a personal injury. Katarina is
a(n)
Select one:
,A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representative. - D. Claim representative.
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel of
experts that the claims rep can select according to the investigation's needs.
Thomas is an attorney who is defending an insurer in a litigated case. He has located documents that
show the insured was aware of the issue that cause the injury to the claimant before the accident.
Thomas is concerned that this evidence will hurt his case. He should
Select one:
A. Preserve the evidence as part of the record.
B. File a motion to suppress the evidence.
C. File a motion in limine to exclude the evidence.
D. Destroy the evidence to make the defense stronger. - A. Preserve the evidence as part of the
record.
An insurer defending a first-party coverage lawsuit could be found liable if evidence is intentionally or
negligently lost or destroyed.
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. Subpoenaed.
Any written claims communication may be subpoenaed.
,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. - 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.
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. - ✔️✔️B. TPAs handle claims, keep claims
records, and perform statistical analyses.
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 - ✔️✔️A. Proper releases taken
Proper releases taken is a qualitative audit factor; the others are quantitative.
, Aaron works for a multi-line insurer. He works with insurance producers and applicants to evaluate new
business submissions and conduct renewal underwriting. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter. - D. Line underwriter.
Line underwriter. This describes the duties of a line underwriter, rather than a staff underwriter. There is
not enough information to determine which line of business is being written. A public underwriter does
not exist. Line underwriters evaluate new submissions and perform renewal underwriting, usually by
working directly with insurance producers and applicants. Staff underwriters, meanwhile, manage risk
selection by working with line underwriters and coordinating decisions about products, pricing and
guidelines.
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. - 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.
The first key to communicating empathetically as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documentation relating to the claim.
D. Listening. - D. Listening.
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 PatrickKaylian. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.59. You're not tied to anything after your purchase.
