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AIC 30, Chapter 1 Questions And Answers 100% Verified 2024/2025
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AIC 30, Chapter 1 Questions And Answers 100% Verified 2024/2025
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AIC 30, Chapter 1First-Party Claim - ANSDemand by Insured person, or org. seeking recovery from insurer for
loss that insurance policy may cover.
Third-party claim - ANSDemand against an insured by a person or Org. other than the insured
or the insurer, seeking recovery of damages that my be payable by the insured's liability
Insurance.
Claimant - ANSParty that makes a claim and that can be either a first-party claimant, or a
third-party Claimant.
Claim Representative - ANSA person responsible for investigating, evaluating, and settling
claims.
Third-Party administrator (TPA) - ANSAn organization that provides administrative services
associated with risk finance and insurance.
Independent Adjustor - ANSAn independent claim representative who handles claims for
insurers for a fee.
Public Adjustor - ANSAn outside organization or person hired by an insured to represent the
insured in a claim in exchange for a fee.
Ethics - ANSThe study of what constitutes good and bad behavior, dealing with Moral duty and
obligation.
Conflict of Interest - ANSA situation that occurs when a decision maker's personal interests
interfere to the extent that he/she makes decisions that adversely affect customers or
employers.
Ex parte contacts - ANSContacts in which only one party is heard.
Fraud - ANSAn intentional misrepresentation resulting in harm to a person or an organization.
Two primary goals of the claims function - ANS1/compliance with contractual promise 2/support
of the insurer's profit goal
Contractual promise that insured fulfills - ANSPay, Defend, or indemnify insured in event of a
covered loss
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