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Exam (elaborations)

AIC 300 ALL CLAIMS EXAM 2024

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AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM AND PRACTICE EXAM TEST BANK WITH STUDY GUIDE | ACCURATE FREQUENTLY TESTED QUESTIONS WITH DETAILED ANSWERS AND RATIONALES | GUARANTEED PASS | GRADED A

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Document information

  • July 10, 2024
  • 43
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • aic 300
  • all claims
  • exam 2024
  • actual exam
  • practice exam
  • study guide

Written for

  • AIC 300
All documents for this subject (137)

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By: RegisteredNurse • 1 month ago

Very Informative, detailed and timely, I passed, thank you very much

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AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM AND
PRACTICE EXAM TEST BANK WITH STUDY GUIDE |
ACCURATE FREQUENTLY TESTED QUESTIONS WITH
DETAILED ANSWERS AND RATIONALES | GUARANTEED
PASS | GRADED A
Among the methods used to pay claims are the issuance of checks and bank drafts. The main
difference between the two is that
A. Only bank drafts may be used for claim payments in excess of $10,000.
B. With a bank draft, the bank must verify that the insurer has authorized payment.
C. With a check, the bank must verify that the insurer has authorized payment.
D. Only checks may be used for claim payments in excess of $10,000.
B. With a bank draft, the bank must verify that the insurer has authorized payment.
With a bank draft, the bank must verify that the insurer has authorized payment before disbursing
funds.
Luke runs his business out of a store front in a commercial building. After a fire destroyed part
of the building, Luke made a claim for damages and received a settlement check from the
property insurer. This necessarily means that Luke
A. Has an insurable interest in the damaged property.
B. Has business interruption coverage.
C. Is the owner of the building.
D. Is named in the policy declarations or an endorsement.
D. Is named in the policy declarations or an endorsement.
An individual may have an insurable interest in a building, but not be considered an insured
under the policy because the person's name is not listed in the declarations or on an endorsement.
Sho is a claims representative. With regard to his responsibility for defending his employer
against fraud, Sho understands that
A. Paying fraudulent claims affects insureds.
B. Fraud indicators are proof of fraud.
C. Claims reps are the last defense against fraud.
D. Insurers rely only on SIU to defend against fraud.
A. Paying fraudulent claims affects insureds.
An insurer that pays a high number of fraudulent claims will have to raise its premiums.
Daniel is a claims supervisor. One of his responsibilities is to review claim files to monitor the
performance of the adjusters and to provide guidance. He also realizes that claims department
peers review files as part of roundtable discussions and that state insurance department
representatives might review files as part of market conduct studies. For these reasons, Daniel
makes sure his direct reports
A. Conduct good-faith negotiations.

,B. Maintain complete and accurate documentation.
C. Provide competent legal advice.
D. Make fair evaluations.
B. Maintain complete and accurate documentation.
A claim file must contain a complete and accurate account of the claims rep's activities and
actions.
A claims representative should have the ability to persuade or influence
A. Claimants.
B. Insureds.
C. Supervisors.
D. Claimants, insureds, supervisors and others.
D. Claimants, insureds, supervisors and others.
The impression that claims reps make on claimants, insureds, and others reflects either favorably
or unfavorably on the insurer.
Erik is a claims manager for Taunton Insurance. He is leading a team of property claims
representatives responding to a recent tornado in Kentucky. Before sending the representatives
into the field, Erik has decided to use Internet of Things (IoT) technology to assess the damage
and danger in the area. Which one of the following IoT devices would Erik most likely use in
this situation?
A. Telematics
B. Smartphones
C. Sensors
D. Drones
D. Drones
Erik would most likely use drones to take photos or videos of the difficult-to-reach area and
assess the damage and danger. By using the drones, he can assess the danger without risking the
safety of the claims representatives. Sensors could be used to monitor things such as heat,
moisture, noise, and air quality, but would not provide an overall assessment of the damage to
the area.
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?
A. Producers
B. Third-party administrators
C. Public adjusters
D. Independent adjusters
D. Independent adjusters
Insurers may contract with independent adjusters to handle claims in strategic locations.
Jose is handling a workers compensation claim. The injured worker claims to have strained his
back when he lifted a box at work. He waited a day to report the injury because he thought he

,would be okay. He asked Jose when he would be referred to a back specialist and when he could
expect his first check. Which one of the injured worker's actions would be the most pertinent
fraud indicator to Jose?
A. Asking about check
B. Lifting a box
C. Waiting to report
D. Asking for referral
D. Asking for referral
Asked for referral could indicate that the worker has knowledge of the workers compensation
system because he had been through it before.
James works for a multi-line insurer. He is responsible for investigating claims that raise
suspicion of fraud. James is in the
A. Special Investigation Unit.
B. Legal department.
C. Claims department.
D. Loss control department.
A. Special Investigation Unit.
Insurers have created SIUs to help claims reps detect and report insurance fraud.
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?
A. An endorsement.
B. An exclusion.
C. The declarations.
D. The conditions.
A. An endorsement.
An endorsement can include coverage that is otherwise excluded, exclude coverage that is
otherwise included, or add or delete insureds.
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?
A. Affadivit
B. Recorded statement
C. Proof of loss
D. Examination under oath
D. Examination under oath
Examination under oath is administered by the attorney for the insurer after notice is issued to
appear at the office of the insurer, attorney, or court reporter.
Which one of the following can be applied over time to refine a model to better predict results?
A. Regression

, B. Association rule learning
C. Machine learning
D. Statistics
C. Machine learning
Machine learning can be applied over time to refine a model to better predict results.
Conor is a claims representative whose supervisor is reviewing his claim status notes. The
supervisor took exception with one of Conor's notes, which read, "The claimant is obviously
lying because his account of how the accident happened keeps changing." The supervisor should
advise Conor that this statement is inappropriate because it is not:
A. Objective
B. Concise
C. Accurate
D. Clear
A. Objective
Claim status notes should contain objective comments about the parties, and this statement is
subjective.
Leila is conducting a claims investigation and is taking a recorded statement from the claimant.
She wants a simple yes-or-no answer to prevent the interviewee from explaining the answer
further. She asks, "You experienced back pain immediately when you lifted the box, didn't you?"
Leila has asked a(n)
A. Direct Question
B. Leading Question
C. Open-Ended Question
D. Indirect Question
B. Leading Question
The NAIC model act specifies that its provisions regarding bad-faith claims are to be enforced
by
A. NAIC personnel.
B. Insurer personnel, on the honor system.
C. State insurance departments.
D. The Federal Trade Commission.
C. State insurance departments.
The NAIC model act specifies that its provisions regarding bad-faith claims are to be enforced
by state insurance departments.
Ida was named in a bad-faith lawsuit as the claims representative who handled the file. The court
dismissed the suit, however, because the statute of limitations had expired. This means that
A. She was immune to prosecution as an employee.
B. The limits of the policy had been exceeded.

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