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NEW EN REVISED AIC 300 - CLAIMS IN AN EVOLVING WORLD ACTUAL EXAM QUESTIONS AND ANSWERS SOLVED 100% CORRECT

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NEW EN REVISED AIC 300 - CLAIMS IN AN EVOLVING WORLD ACTUAL EXAM QUESTIONS AND ANSWERS SOLVED 100% CORRECT 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 insuran...

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  • May 30, 2024
  • 24
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • new en revised aic 300
  • new en revised aic 300 claims in an evolving wo
  • new en revised aic 300 claims in an evolving
  • en revised aic 300 claims in an evolving wo

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  • EN REVISED AIC 300 - CLAIMS IN AN EVOLVING
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NEW EN REVISED AIC 300 - CLAIMS IN AN
EVOLVING WORLD ACTUAL EXAM QUESTIONS
AND ANSWERS SOLVED 100% CORRECT

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. - answer -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.

Claim reps collaborate with more than other insurer employees. Many ins urers employ a
panel of experts that the claims rep can select according to the investigation's needs. -
answer -In her role with an insurer, Katarina has opportunity to collaborate with not only
employees from her company, but also external experts with pa rticular 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.

Open -ended questions can be used to clarify an interviewee's statements. - answer -
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

Most insurers have guidelines outlining when and under what circumstances large loss
reports should be prepared. - answer -Charlotte is handling a new claim and she has set
the initial reserves at $1,000,000. S he 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.
1 / 3

B. Su mmarized report.
C. Preliminary report.
D. Large loss report.

Some will also send a copy via regular mail in case the certified letter is not accepted. -
answer -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.

Any written claims communication may be subpoenaed. - answer -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.

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. - answer -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 .

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.

Proper releases taken is a qualitative audit factor; the others are quantitative. - answer -
Hugo is conduct ing 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 t aken
B. Timeliness of reports
C. Number of files opened
2 / 3

D. Accuracy of data entry

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. - answer -Aaron works for a multi -line insurer. He works with
insurance producers and applicants to evaluate new business submissions and con duct
renewal underwriting. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.

Claims professionals should first listen carefully to understand what the claimant is
saying. - answer -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

The right of subrogation allows an insure r to recover payment from a negligent third
party. - answer -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 investigati on 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.

All bodily injury claims, including workers compensation claims, requ ire a medical
investigation. - answer -In claims investigation, all bodily injury claims require
Select one:
A. Statements from all witnesses.
B. Multiple claims payments
C. An attorney.
D. A medical investigation. Powered by TCPDF (www.tcpdf.org)
3 / 3

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