AIC 300 CLAIMS IN AN EVOLVING WORLD EXAM STUDY GUIDE AND PRACTICE EXAM 2024 2025 ACCURATE REAL EXAM QUESTIONS WITH VERIFIED ANSWERS EXPERT VERIFIED FOR A GUARANTEED PASS LATEST UPDATE Some will also send a copy via regular mail in case the certified letter is not accepted ANSW 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 D Subpoenaed Any written claims communication may be subpoenaed ANSW 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 ANSW 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 ANSW 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 ANSW 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 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 ANSW 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 Listening Claims professionals should first listen carefully to understand what the claimant is saying ANSW 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 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 ANSW 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 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 ANSW 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 A Open ended Open ended questions can be used to clarify an interviewee s statements ANSW When Mehmet interviews witnesses as part of his claims investigation he asks different types of questions based on need such as open ended direct indirect and leading Which type of question should Mehmet ask when he wants to set the interviewee at ease and he is looking for explanation or elaboration of details in the interviewee s own words Select one A Open ended B Direct C Indirect D Leading D Large loss report Most insurers have guidelines outlining when and under what circumstances large loss reports should be prepared ANSW Charlotte is handling a new claim and she has set the initial reserves at 1 000 000 She has been asked to complete an internal report summarizing all the file status information for distribution to management and updated as more information is received The report Charlotte is completing is most likely a Select one A Status report B Summarized report C Preliminary report D Large loss report D A claims rep discovers that their insured s car accident was caused by a road contractor who left equipment lying in the travel lanes of a highway The right of subrogation allows an insurer to recover payment from a negligent third party ANSW In which one of the following scenarios is the right of subrogation most likely to be employed by the insurer Select one A An insured files a homeowners claim for stolen jewelry An investigation reveals that the jewelry is still in the insured s possession B An investigation reveals that an insured set her own business on fire C An insured files a claim for collision damage from a hit and run accident when in fact he backed into a utility pole D A claims rep discovers that their insured s car accident was caused by a road contractor who left equipment lying in the travel lanes of a highway D