AIC 300 FINAL TEST PREPARATION QUESTIONS AND ANSWERS!!!
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Module
AIC 300
Institution
AIC 300
AIC 300 FINAL TEST PREPARATION QUESTIONS AND ANSWERS!!!
Types of Questions - Answer-1. Direct (get confirmation, clarify statement)
2. Open ended (give details, relaxes interviewee)
3. Leading (yes/no)
representational documentation - Answer-photos by claim rep
Diff types of claims invest...
AIC 300 FINAL TEST PREPARATION
QUESTIONS AND ANSWERS!!!
Types of Questions - Answer-1. Direct (get confirmation, clarify statement)
2. Open ended (give details, relaxes interviewee)
3. Leading (yes/no)
representational documentation - Answer-photos by claim rep
Diff types of claims investigations - Answer-- accident scene investigation
- property damage investigation
- medical investigation
- prior claim investigation
- subrogation investigation and recovery
right of subrogation - Answer-the right of an insurer, who has paid an insured's claim, to
request reimbursement from either the person who caused the loss or that person's
insurer (if proven that the loss was not insured's fault)
Claims diary system - Answer-suspense/pending system combines work on a claim with
documentation
Claims file status notes - Answer-- activity log, accurately reflects and documents
investigations, evaluations of claims, decisions to decline coverage, and decisions to
settle claims
- chronological account of claim rep's actions
- open as long as claim is open
Claims file reports - Answer-- made for various parties (internal reports, large loss
reports)
- preliminary, status, and summarized reports may have attachments
- some external reports for producers, advisory org, etc
5 Methods of Case Reserving - Answer-1. Individual case method - based on claims
circumstances and claim reps experience/opinion
2. Roundtable method - consensus of 2+ claims personnel
3. Avg value method - establishes a predetermined amount of reserve for each claim
4. Formula method - using a mathematical formula
5. Expert system method - software application estimates losses and LAEs
Stairstepping - Answer-when reserves keep getting raised due to improper initial
reserve/poor claims handling (NOT factual changes)
, Occurrence vs Claims Made Forms - Answer-occurrence: when it happens
claims made: cover claims made during policy period for losses prior
Direct vs indirect loss - Answer-direct loss: reduction in the value of property that results
directly and often immediately from damage to that property
indirect loss: loss that arises as a *result* of damage to property
pro rata contribution - Answer-insurers contribute to the loss payment in the proportion
to which they contribute to the total amount of coverage purchased (limits of liability)
^ when there is overlapping coverage
insurable interest - Answer-an interest in the subject of an insurance policy that is not
unduly remote and would cause the interested party to suffer financial loss if an insured
event occurred
punitive damages - Answer-punish a wrongdoer for a reckless, malicious, or deceitful
act to deter similar conduct. not related to party's actual damages
*usually excluded in policies
types of compensatory damages - Answer-special: specific, identifiable expenses like
medical expense/lost wages
general damages: compensate a victim for losses that are not measurable
(pain/suffering)
coinsurance clauses - Answer-require the insured to carry insurance equal to at least a
specified percentage of the insured property's value
occurrence vs aggregate limits - Answer-occurrence: per occurrence that fits within the
policy
aggregate: total policy limit $
self-insured retention - Answer-some insureds pay losses up to SIR level, then once
limit is exceeded the insurer is responsible
Claims denial - Answer-- denial letters are sent out, sometimes drafted by lawyers to
ensure they comply with requirements
- sent by certified mail, sometimes requested to be signed by addressee or marked
confidential
3 types of legal approaches - Answer-mediation: neutral mediator to reach settlement
appraisal: professional appraiser evaluates dollar portions
litigation: court, creates a binding decision
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