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AIC 300 - Claims in an Evolving World Exam Study Guide Solutions

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AIC 300 - Claims in an Evolving World Exam Study Guide Solutions 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. - ANSWER-B. By certifie...

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  • October 29, 2024
  • 68
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • AIC 300
  • AIC 300
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Emillect
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FIRST PUBLISH OCTOBER 2024




AIC 300 - Claims in an Evolving World

Exam Study Guide Solutions


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. - ANSWER✔✔-B. By certified mail with a return receipt requested.




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


As methods of communication evolve, it's important for claims professionals to remember that any

written claims communication may be


Select one:



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A. Replaced with verbal communication.


B. Misinterpreted.


C. Edited later.


D. Subpoenaed. - ANSWER✔✔-D. Subpoenaed.




Any written claims communication may be subpoenaed.


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. - ANSWER✔✔-D. An

insured's negotiations with the insurer on a complex claim are not going well.




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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.


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. - ANSWER✔✔-B. TPAs handle claims, keep

claims records, and perform statistical analyses.


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


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D. Accuracy of data entry - ANSWER✔✔-A. Proper releases taken




Proper releases taken is a qualitative audit factor; the others are quantitative.


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. - ANSWER✔✔-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




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