AIC 300 - Simulated Exam Questions And Accurate Answers 2024/25
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Course
AIC 300
Institution
AIC 300
Insurers and claim representatives must keep the promises specified in insurance policies, as well as those created by the law. In insurance transactions, the insured pays a premium for the insurer's promise to - Correct Answer Handle claims in good faith.
Maja handled a large liability claim ...
AIC 300 - Simulated Exam Questions And Accurate Answers
2024/25
Insurers and claim representatives must keep the promises specified in insurance
policies, as well as those created by the law. In insurance transactions, the insured pays
a premium for the insurer's promise to - Correct Answer Handle claims in good faith.
Maja handled a large liability claim that settled above the policy limits. The insured is
now charging the claim was handled in bad faith. During their investigation of the bad-
faith claim, Maja and defense counsel discovered that the claimant had received the
payment from the insurer, but not the amount above the policy limits that was to come
from the insured's assets. Which one of the following defenses would Maja's defense
most likely invoke? - Correct Answer Insured's collusion with the claimant.
Bettina's apartment is burglarized and several items are stolen. In filing her claim, she
tells her insurer that her stolen television was both newer and larger than it actually was.
This constitutes which one of the following types of fraud? - Correct Answer Soft
Fraud.
In liability claims, the claims rep will require an authorization from the injured party to -
Correct Answer Obtain medical records.
Antonia has a general liability policy with a self-insured retention of $50,000. The policy
has an occurrence limit of $250,000 and an aggregate limit of $500,000. She had
submitted one prior claim this policy term for which $100,000 was paid by the insurer.
How much will Antonia's insurer pay on a subsequent claim under the same policy
period that is valued at $400,000? - Correct Answer $250,000
Claims rep Miguel is conducting a settlement with a claimant. He constructs his first
offer so that the claimant will likely find it undesirable. This becomes the basis of
comparison for the second offer that he makes. Miguel understands that people -
Correct Answer Feel empowered when given a choice.
Joy Insurance Company is interested in using data mining to solve a problem it is
having with claims fraud in one of its product lines. The first step it should take is -
Correct Answer To understand what it wants to achieve.
Thomas is an attorney who is defending an insurer in a litigated case. He has located
documents that show the insured was aware of the issue that cause the injury to the
claimant before the accident. Thomas is concerned that this evidence will hurt his case.
He should - Correct Answer Preserve the evidence as part of the record.
As a part of the first contact with an insured on a property damage claim, a claims
representative may provide a blank - Correct Answer Proof of loss form.
Ciara is going to college with the goal of working as a data scientist for an insurer. She
will need a strong foundation in mathematics and statistics, computer programming,
, domain knowledge, and data science. Which one of Ciara's skills will require her to
understand the insurance profession to which the data is being applied? - Correct
Answer Domain knowledge.
Rodrigo manages a claims department for an insurer and uses loss ratio as a measure
of the department's performance. Rodrigo calculates loss ratio as - Correct Answer
Losses and LAE divided by earned premium.
An insurer that finds it economically impractical to establish a claims office in a given
state is likely to use which one of the following to perform the claims handling function?
- Correct Answer Independent Adjusters
Tonya is a claims representative tasked with determining whether coverage applies to a
new claim. To ensure that she considers all facets of the claim, she uses the DICE
method, which stands for declarations, insuring agreement, conditions and - Correct
Answer Exclusions.
Which one of the following is correct with respect to the elements of good-faith claim
management? - Correct Answer Consistent supervision, thorough training, and
manageable caseloads help ensure that claim representatives are able to handle claims
in good faith.
Which one of the following elements of a policy can include coverage that is otherwise
excluded, exclude coverage that is otherwise included, or add or delete insureds? -
Correct Answer An endorsement.
As a claims representative, Joshua frequently requests proofs of loss and affidavits, and
conducts examinations under oath and recorded statements. Which one of Joshua's
sworn statements is administered by the insurer's attorney at the office of the insurer,
attorney, or court reporter? - Correct Answer Examination under oath.
The allegations contained in a summons and complaint typically serve four purposes:
To give notice, reveal facts, formulate legal causes of action and - Correct Answer
State the damages sought.
While staff claims representatives may have a variety of titles, the role is typically
defined by two things: having a primary focus on claims and - Correct Answer Being
an employee of the insurer.
Millstone Insurance wanted to assign its most complex workers compensation claims to
experienced claim adjusters as early as possible. The data science team used the
classification tree technique to develop a predictive model. When holdout data was
used to test the model's predictive accuracy, 45% of the complex claims were assigned
to experienced adjusters. When claims were randomly assigned, only 15% of the
complex claims were assigned to experienced adjusters. What is the lift provided by the
predictive model? - Correct Answer 3 (45/15=3)
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