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AIC 30 QUESTIONS AND CORRECT ANSWERS | LATEST UPDATE

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First Party Focus -:- Coverage and Amount of damage Second Party -:- Insurance Company First Party -:- Insured Third Party -:- Claimant Third Party Focus -:- Liability, Coverage, and Amount of damage 2 | P a g e | G r a d e A + | 2 0 2 4 / 2 0 2 5 2 0 2 4 /2025 | © copyright | T...

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  • September 17, 2024
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  • Questions & answers
  • AIC
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2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




AIC 30 QUESTIONS AND CORRECT
ANSWERS | LATEST UPDATE
First Party Focus


✓ -:- Coverage and Amount of damage




Second Party


✓ -:- Insurance Company




First Party


✓ -:- Insured




Third Party


✓ -:- Claimant




Third Party Focus


✓ -:- Liability, Coverage, and Amount of damage




1|P a g e | G r a d e A + | 2 0 2 0 2 5

,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




Third Party Administrator (TPA)


✓ -:- an organization that provides admin services associated with risk

financing and insurance. They handle claims and risk management for self -

insured organizations




Independent Adjuster


✓ -:- handles claims for the insurer for a fee. Works for the insurer




Public Adjuster


✓ -:- an outside organization that is hired by the insured to represent the

insured in the claim for a fee. Works for the public




Quantitative Measures


✓ -:- can have actual numbers assigned, such as number of claims opened

and percentage of subrogation recovery




Qualitative Measures




2|P a g e | G r a d e A + | 2 0 2 0 2 5

,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




✓ -:- related to intangible measures. nothing concrete, did they do a good

job? do they have good negotiation skills?




Ethics


✓ -:- the study of what constitutes good and bad behavior, dealing with

the moral duty and obligation




Conflict of Interest


✓ -:- a situation that occurs when a decision makers personal interests

interfere to the extent that he/she makes decisions that adversely affect

the customer, claimant, or employer




Ex Parte Contract


✓ -:- contracts in which only 1 party is heard. discussing the c laim with

the represented person without benefit of their attorney being involved.

this is not illegal, but its not ethical.




Fraud




3|P a g e | G r a d e A + | 2 0 2 0 2 5

, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




✓ -:- an intentional misrepresentation resulting in harm to another person

or organization




Code of Ethics


✓ -:- professional guidelines of behavior within an organization or

profession




N.A.I.C


✓ -:- The National Association of Insurance Commissioners




Model Laws


✓ -:- NAIC develops that they feel is an appropriate law related to

insurance/risk management




Model Laws - Goal


✓ -:- to standardize the laws related to insurance, to address issues

related to insurance




4|P a g e | G r a d e A + | 2 0 2 0 2 5

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