RESPONSE COLLECTION
◉ B. A legitimate claim is exaggerated.
Soft fraud, also called opportunity fraud, occurs when a legitimate
claim is exaggerated.
Answer: Soft fraud, also called opportunity fraud, occurs when
Select one:
A. An application for insurance contains untrue information.
B. A legitimate claim is exaggerated.
C. A loss is triggered intentionally.
D. A claim is filed for a loss that did not occur.
◉ B. Continue with her investigation.
Continue with her investigation. Indicators of fraud are not proof of
fraud.
Answer: Carla is investigating a claim for a stolen car. The insured
provided a copy of the police report, but she notices that the account
in the police report differs from the insured's version of events. At
this point, Carla should
,Select one:
A. Refer the case to the SIU.
B. Continue with her investigation.
C. Deny the claim.
D. Contact the police.
◉ A. Data mining.
Data mining. This is using computers to analyze vast amounts of
data to detect trends.
Answer: Benjamin is with the SIU department of an insurer. His
company developed technology to identify patterns related to
fraudulent claims activity. He is using a program to analyze claims
data to identify similarities or connections that might indicate fraud.
Benjamin is utilizing
Select one:
A. Data mining.
B. Telematics.
C. Claims audits.
D. Wearables.
◉ C. Opportunity fraud.
,Answer: Soft fraud occurs when a claim is exaggerated and is also
referred to as
Select one:
A. Victimless fraud.
B. Reimbursement fraud.
C. Opportunity fraud.
D. Financial fraud.
◉ B. Telematics.
Telematics are used to collect data on personal autos, commercial
vehicles, products, shipments, machinery, smart devices, and
workers.
Answer: Larissa is an auto claim adjuster. Traditionally, she has
relied on police reports and witness testimony in her decision
making. Recent technological developments give her access to the
driver's driving habits, including acceleration, speed, and braking.
This data available to Larissa is known as
Select one:
A. Artificial Intelligence.
B. Telematics.
C. Wearables.
D. Internet of Things.
, ◉ A. Blockchain.
By having a transparent ledger associated with a car, for example,
insurers can detect fraud that would be difficult to detect otherwise.
Answer: Martin is in SIU and helps his employer, a multi-line insurer,
to detect fraudulent claims. He is using a technology that enables
insurers to share fraud-related information. This distributed digital
ledger that facilitates secure transactions without using a third party
is known as
Select one:
A. Blockchain.
B. A predictive model.
C. The Internet of Things.
D. Telematics.
◉ D. He still needs people because the data need to be analyzed in
context by a human.
Answer: Jack leads the claims department for a large insurer and has
embraced the recent developments in claims data collection and
analysis. Jack knows that
Select one:
A. People make little difference in analyzing data and explaining it to
a customer.