Identified by studying an insurer's own performance or the performance of successful insurers -
Best practices
A representative often hired by the insured to protect their interests if a claim is complex or if settlement
negotiations are not progressing with the insurer. - Public adjuster
_____...
AIC 300 Part 1
Identified by studying an insurer's own performance or the performance of successful insurers -
Best practices
A representative often hired by the insured to protect their interests if a claim is complex or if settlement
negotiations are not progressing with the insurer. - Public adjuster
________________________ are used to increase the accuracy of fraud detection. - Predictive
models
1st step in the data mining process - Understanding what you want to achieve by applying data
mining
2 techniques for negotiating - Principle of yes & Choicing
2nd step in the data mining process - Understanding the types of data being used and its source
3 frequently used tools provide quality measures of a Claims Department's performance - best
practices, claims audits, & customer satisfaction data
3 internal reports that a claims representative may write - preliminary, status, summarized
3 qualities of effective statements - coherence, completeness, objectivity
3 ways good faith is established - 1) By satisfying contractual duties and other promises
2) By maintaining insurers' credibility
3) By complying with legal duty
, 4 data mining techniques - 1) Classification
2) Regression analysis
3) Association rule learning
4) Cluster analysis
4 techniques for negotiating directly with claimants - 1) Collect and use extraneous information
2) Use traditional sales techniques
3) Perform a needs analysis
4) Set appropriate expectations with the first offer
5 techniques for negotiating with claimant's representatives - 1) Lean on the evaluation
2) Establish strengths and weaknesses
3) Time settlements effectively
4) Entice a reasonable demand
5) Make concessions cautiously
A data mining technique categorizing members of a dataset based on known characteristics. -
Classification
A data mining technique of statistical nature that predicts a numerical value given characteristics of each
member of a dataset. - Regression analysis
A data mining technique that examines data to discover new and interesting relationships based on
algorithms. - Association rule learning
A data mining technique using statistical methods and a computer program to explore data to find
groups with common and previously unknown characteristics. - Cluster analysis
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