AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | 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.
,AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
,AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
, AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | 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.
,AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
,AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
, AIC 300 ALL CLAIMS EXAM 2024 | ACTUAL EXAM TEST BANK
WITH STUDY GUIDE QUESTIONS WITH DETAILED ANSWERS
AND RATIONALES | GRADED A
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
