AIC 300 WITH 100% CORRECT
QUESTIONS AND ANSWERS
first party insurance - CORRECT ANSWER-insurer makes
payment for covered losses directly to the policyholder (first
party)
third-party insurance - CORRECT ANSWER-insurer makes
payments on behalf of the policyholder to a claimant (third
par...
first party insurance - CORRECT ANSWER-insurer makes
payment for covered losses directly to the policyholder (first
party)
third-party insurance - CORRECT ANSWER-insurer makes
payments on behalf of the policyholder to a claimant (third
party)
third party administrators (TPAs) - CORRECT ANSWER-- an
organization that provides administrative services associated
with risk financing and insurance (claims, records, analysis, etc)
- self insured businesses can handle their own claims or hire a
TPA
- P&C insurers have subsidiaries that serve as a TPA
staff claims representatives - CORRECT ANSWER-a person
responsible for investigating, evaluating, and settling claims
(ex: adjusters)
independent adjusters - CORRECT ANSWER-- specialized
claims + field work
- if insurer cant afford claims offices in every state
, - some are self employed, some work for adjusting firms
producers - CORRECT ANSWER-- any kinds of insurance
personnel who place insurance and surety business with
insurers and who represent either insurers, insureds, or both
- ex: agents, brokers, sales reps
public adjusters - CORRECT ANSWER-- outside organization
or person hired by an insured to represent the insured in a
claim in exchange for a fee
- if insured is not happy with settlement or it is a complex claim
types of staff claims representatives - CORRECT ANSWER-
inside: exclusively from insurer's office
field: outside, both in and out of office, handle claims with tasks
like investigating scene of loss, meeting with insureds, etc
line underwriters - CORRECT ANSWER-work directly with
insurance producers and applicants to evaluate new
submissions & renewals
staff underwriters - CORRECT ANSWER-work with line
underwriters to coordinate decisions about products, pricing,
and guidelines
premium audit - CORRECT ANSWER-methodical examinations
of a policyholder's operations, records, and books of account to
determine the actual exposure units and premium for insurance
coverages already provided
why should claim reps be careful with what they say on claims
communication? - CORRECT ANSWER-claims investigation
activities can later be used as evidence in legal proceedings,
any written claims communication can be subpoenaed
loss ratio - CORRECT ANSWER-losses & los adjustment
expenses / earned premium
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