AIC 300 - Claims in an Evolving World|Ques ons and
answers | Updated RATED A+ 2026 | NEW
B. By cer fied mail with a return receipt requested.
Some will also send a copy via regular mail in case the cer fied le er is not accepted.
Insurers usually send denial le ers
Select one:
A. By email to ensure prompt receipt by the insured.
B. By cer fied mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
D. Subpoenaed.
Any wri en claims communica on may be subpoenaed.
As methods of communica on evolve, it's important for claims professionals to remember that
any wri en claims communica on may be
Select one:
A. Replaced with verbal communica on.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
D. An insured's nego a ons with the insurer on a complex claim are not going well.
If a claim is complex, or if se lement nego a ons are not progressing with the insurer, the
insured may hire a public adjuster to protect his or her interests.
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 representa on to contest a claim.
C. A catastrophic disaster strikes, involving damage to many proper es.
D. An insured's nego a ons with the insurer on a complex claim are not going well.
B. TPAs handle claims, keep claims records, and perform sta s cal analyses.
,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 sta s cal analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjus ng firms.
A. Proper releases taken
Proper releases taken is a qualita ve audit factor; the others are quan ta ve.
Hugo is conduc ng an audit of a branch office claims opera on. He is evalua ng meliness of
reports, number of files opened, proper releases taken, and accuracy of data entry. Which one
of Hugo's metrics is a qualita ve audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter.
Line underwriter. This describes the du es of a line underwriter, rather than a staff underwriter.
There is not enough informa on to determine which line of business is being wri en. A public
underwriter does not exist. Line underwriters evaluate new submissions and perform renewal
underwri ng, usually by working directly with insurance producers and applicants. Staff
underwriters, meanwhile, manage risk selec on by working with line underwriters and
coordina ng decisions about products, pricing and guidelines.
Aaron works for a mul -line insurer. He works with insurance producers and applicants to
evaluate new business submissions and conduct renewal underwri ng. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
,D. Listening.
Claims professionals should first listen carefully to understand what the claimant is saying.
The first key to communica ng empathe cally as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documenta on rela ng to the claim.
D. Listening.
C. Cost to inves gate, defend, and se le claims.
Cost to inves gate, defend, and se le claims. LAE is the expense that an insurer incurs to
inves gate, defend, and se le claims according to the terms specified in the insurance policy.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department
for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid por on of claims.
C. Cost to inves gate, defend, and se le claims.
D. Total incurred amount of claims.
D. Claim representa ve.
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel
of experts that the claims rep can select according to the inves ga on's needs.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees
from her company, but also external experts with par cular exper se. For example, as part of
her inves ga on, she hired an engineer to conduct a review of a machine that was involved in a
personal injury. Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representa ve.
, A. Open-ended
Open-ended ques ons can be used to clarify an interviewee's statements.
When Mehmet interviews witnesses as part of his claims inves ga on, he asks different types
of ques ons based on need, such as open-ended, direct, indirect, and leading. Which type of
ques on should Mehmet ask when he wants to set the interviewee at ease and he is looking for
explana on or elabora on of details in the interviewee's own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances large loss reports
should be prepared.
Charlo e is handling a new claim and she has set the ini al reserves at $1,000,000. She has
been asked to complete an internal report summarizing all the file status informa on for
distribu on to management and updated as more informa on is received. The report Charlo e
is comple ng is most likely a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report.
D. A claims rep discovers that their insured's car accident was caused by a road contractor who
le? equipment lying in the travel lanes of a highway.
The right of subroga on allows an insurer to recover payment from a negligent third party.
In which one of the following scenarios is the right of subroga on most likely to be employed by
the insurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An inves ga on reveals that the
jewelry is s ll in the insured's possession.
B. An inves ga on reveals that an insured set her own business on fire.
answers | Updated RATED A+ 2026 | NEW
B. By cer fied mail with a return receipt requested.
Some will also send a copy via regular mail in case the cer fied le er is not accepted.
Insurers usually send denial le ers
Select one:
A. By email to ensure prompt receipt by the insured.
B. By cer fied mail with a return receipt requested.
C. By overnight courier.
D. By registered mail.
D. Subpoenaed.
Any wri en claims communica on may be subpoenaed.
As methods of communica on evolve, it's important for claims professionals to remember that
any wri en claims communica on may be
Select one:
A. Replaced with verbal communica on.
B. Misinterpreted.
C. Edited later.
D. Subpoenaed.
D. An insured's nego a ons with the insurer on a complex claim are not going well.
If a claim is complex, or if se lement nego a ons are not progressing with the insurer, the
insured may hire a public adjuster to protect his or her interests.
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 representa on to contest a claim.
C. A catastrophic disaster strikes, involving damage to many proper es.
D. An insured's nego a ons with the insurer on a complex claim are not going well.
B. TPAs handle claims, keep claims records, and perform sta s cal analyses.
,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 sta s cal analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjus ng firms.
A. Proper releases taken
Proper releases taken is a qualita ve audit factor; the others are quan ta ve.
Hugo is conduc ng an audit of a branch office claims opera on. He is evalua ng meliness of
reports, number of files opened, proper releases taken, and accuracy of data entry. Which one
of Hugo's metrics is a qualita ve audit factor?
Select one:
A. Proper releases taken
B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter.
Line underwriter. This describes the du es of a line underwriter, rather than a staff underwriter.
There is not enough informa on to determine which line of business is being wri en. A public
underwriter does not exist. Line underwriters evaluate new submissions and perform renewal
underwri ng, usually by working directly with insurance producers and applicants. Staff
underwriters, meanwhile, manage risk selec on by working with line underwriters and
coordina ng decisions about products, pricing and guidelines.
Aaron works for a mul -line insurer. He works with insurance producers and applicants to
evaluate new business submissions and conduct renewal underwri ng. Aaron is a
Select one:
A. Staff underwriter.
B. Public underwriter.
C. Personal lines underwriter.
D. Line underwriter.
,D. Listening.
Claims professionals should first listen carefully to understand what the claimant is saying.
The first key to communica ng empathe cally as a claims professional is
Select one:
A. A comprehensive understanding of relevant insurance policies.
B. Speaking calmly and clearly.
C. Being prepared with all documenta on rela ng to the claim.
D. Listening.
C. Cost to inves gate, defend, and se le claims.
Cost to inves gate, defend, and se le claims. LAE is the expense that an insurer incurs to
inves gate, defend, and se le claims according to the terms specified in the insurance policy.
Mia tracks loss adjustment expense (LAE) as part of her management of the claims department
for an insurer. Mia considers LAE to be the
Select one:
A. Total amount of loss reserves of all claims.
B. Paid por on of claims.
C. Cost to inves gate, defend, and se le claims.
D. Total incurred amount of claims.
D. Claim representa ve.
Claim reps collaborate with more than other insurer employees. Many insurers employ a panel
of experts that the claims rep can select according to the inves ga on's needs.
In her role with an insurer, Katarina has opportunity to collaborate with not only employees
from her company, but also external experts with par cular exper se. For example, as part of
her inves ga on, she hired an engineer to conduct a review of a machine that was involved in a
personal injury. Katarina is a(n)
Select one:
A. Medical provider.
B. Expert Witness.
C. Premium auditor.
D. Claim representa ve.
, A. Open-ended
Open-ended ques ons can be used to clarify an interviewee's statements.
When Mehmet interviews witnesses as part of his claims inves ga on, he asks different types
of ques ons based on need, such as open-ended, direct, indirect, and leading. Which type of
ques on should Mehmet ask when he wants to set the interviewee at ease and he is looking for
explana on or elabora on of details in the interviewee's own words?
Select one:
A. Open-ended
B. Direct
C. Indirect
D. Leading
D. Large loss report.
Most insurers have guidelines outlining when and under what circumstances large loss reports
should be prepared.
Charlo e is handling a new claim and she has set the ini al reserves at $1,000,000. She has
been asked to complete an internal report summarizing all the file status informa on for
distribu on to management and updated as more informa on is received. The report Charlo e
is comple ng is most likely a
Select one:
A. Status report.
B. Summarized report.
C. Preliminary report.
D. Large loss report.
D. A claims rep discovers that their insured's car accident was caused by a road contractor who
le? equipment lying in the travel lanes of a highway.
The right of subroga on allows an insurer to recover payment from a negligent third party.
In which one of the following scenarios is the right of subroga on most likely to be employed by
the insurer?
Select one:
A. An insured files a homeowners claim for stolen jewelry. An inves ga on reveals that the
jewelry is s ll in the insured's possession.
B. An inves ga on reveals that an insured set her own business on fire.
