Social Science Business Insurance
Claims in an Evolving World - AIC 300
ACTUAL EXAM QUESTIONS WITH COMPLETE
SOLUTION GUIDE) (MULTIPLE CHOICES) (A+
GRADED 100% VERIFIED) LATEST VERSION
2025
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B. By certified mail with a return Insurers usually send denial letters
receipt requested. Select one:
A. By email to ensure prompt receipt by the insured.
Some will also send a copy via B. By certified mail with a return receipt requested.
regular mail in case the certified C. By overnight courier.
letter is not accepted. D. By registered mail.
As methods of communication evolve, it's important for claims
professionals to remember that any written claims
D. Subpoenaed.
communication may be
Select one:
Any written claims
A. Replaced with verbal communication.
communication may be
B. Misinterpreted.
subpoenaed.
C. Edited later.
D. Subpoenaed.
In which one of the following scenarios is a public adjuster most
D. An insured's negotiations with
likely to become involved?
the insurer on a complex claim
Select one:
are not going well.
A. An insurer finds it financially unfeasible to hire its own claims
staff in a given state.
If a claim is complex, or if
B. An insured is unable to afford legal representation to contest a
settlement negotiations are not
claim.
progressing with the insurer, the
C. A catastrophic disaster strikes, involving damage to many
insured may hire a public
properties.
adjuster to protect his or her
D. An insured's negotiations with the insurer on a complex claim
interests.
are not going well.
, Which one of the following statements regarding third-party
administrators (TPAs) is most accurate?
Select one:
B. TPAs handle claims, keep A. TPAs are typically used by businesses that have chosen not to
claims records, and perform self-insure.
statistical analyses. B. TPAs handle claims, keep claims records, and perform
statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms.
Hugo is conducting an audit of a branch office claims operation.
He is evaluating timeliness of reports, number of files opened,
A. Proper releases taken proper releases taken, and accuracy of data entry. Which one of
Hugo's metrics is a qualitative audit factor?
Proper releases taken is a Select one:
qualitative audit factor; the A. Proper releases taken
others are quantitative. B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter. Aaron works for a multi-line insurer. He works with insurance
producers and applicants to evaluate new business submissions
Line underwriter. This describes and conduct renewal underwriting. Aaron is a
the duties of a line underwriter, Select one:
rather than a staff underwriter. A. Staff underwriter.
There is not enough information B. Public underwriter.
to determine which line of C. Personal lines underwriter.
business is being written. A D. Line underwriter.
public underwriter does not
exist. Line underwriters evaluate
new submissions and perform
renewal underwriting, usually by
working directly with insurance
producers and applicants. Staff
underwriters, meanwhile,
manage risk selection by
working with line underwriters
and coordinating decisions
about products, pricing and
guidelines.
The first key to communicating empathetically as a claims
professional is
D. Listening.
Select one:
A. A comprehensive understanding of relevant insurance
Claims professionals should first
policies.
listen carefully to understand
B. Speaking calmly and clearly.
what the claimant is saying.
C. Being prepared with all documentation relating to the claim.
D. Listening.
, C. Cost to investigate, defend, Mia tracks loss adjustment expense (LAE) as part of her
and settle claims. management of the claims department for an insurer. Mia
considers LAE to be the
Cost to investigate, defend, and Select one:
settle claims. LAE is the expense A. Total amount of loss reserves of all claims.
that an insurer incurs to B. Paid portion of claims.
investigate, defend, and settle C. Cost to investigate, defend, and settle claims.
claims according to the terms D. Total incurred amount of claims.
specified in the insurance policy.
In her role with an insurer, Katarina has opportunity to
D. Claim representative.
collaborate with not only employees from her company, but also
external experts with particular expertise. For example, as part of
Claim reps collaborate with
her investigation, she hired an engineer to conduct a review of a
more than other insurer
machine that was involved in a personal injury. Katarina is a(n)
employees. Many insurers
Select one:
employ a panel of experts that
A. Medical provider.
the claims rep can select
B. Expert Witness.
according to the investigation's
C. Premium auditor.
needs.
D. Claim representative.
When Mehmet interviews witnesses as part of his claims
investigation, he asks different types of questions based on need,
such as open-ended, direct, indirect, and leading. Which type of
A. Open-ended question should Mehmet ask when he wants to set the
interviewee at ease and he is looking for explanation or
Open-ended questions can be elaboration of details in the interviewee's own words?
used to clarify an interviewee's Select one:
statements. A. Open-ended
B. Direct
C. Indirect
D. Leading
Charlotte is handling a new claim and she has set the initial
reserves at $1,000,000. She has been asked to complete an
D. Large loss report. internal report summarizing all the file status information for
distribution to management and updated as more information is
Most insurers have guidelines received. The report Charlotte is completing is most likely a
outlining when and under what Select one:
circumstances large loss reports A. Status report.
should be prepared. B. Summarized report.
C. Preliminary report.
D. Large loss report.
In which one of the following scenarios is the right of
subrogation most likely to be employed by the insurer?
D. A claims rep discovers that Select one:
their insured's car accident was A. An insured files a homeowners claim for stolen jewelry. An
caused by a road contractor investigation reveals that the jewelry is still in the insured's
who left equipment lying in the possession.
travel lanes of a highway. B. An investigation reveals that an insured set her own business
on fire.
The right of subrogation allows C. An insured files a claim for collision damage from a hit and run
an insurer to recover payment accident, when in fact he backed into a utility pole.
from a negligent third party. D. A claims rep discovers that their insured's car accident was
caused by a road contractor who left equipment lying in the
travel lanes of a highway.
Claims in an Evolving World - AIC 300
ACTUAL EXAM QUESTIONS WITH COMPLETE
SOLUTION GUIDE) (MULTIPLE CHOICES) (A+
GRADED 100% VERIFIED) LATEST VERSION
2025
Save
Students also studied
Flashcard sets Study guides
EPIC Training Xcel Solutions Property & Casualty Nevada Life and Hea
50 terms Teacher 123 terms Teacher 314 terms
muemamutunga01 Preview christine_kimathi Preview rockykithaka
B. By certified mail with a return Insurers usually send denial letters
receipt requested. Select one:
A. By email to ensure prompt receipt by the insured.
Some will also send a copy via B. By certified mail with a return receipt requested.
regular mail in case the certified C. By overnight courier.
letter is not accepted. D. By registered mail.
As methods of communication evolve, it's important for claims
professionals to remember that any written claims
D. Subpoenaed.
communication may be
Select one:
Any written claims
A. Replaced with verbal communication.
communication may be
B. Misinterpreted.
subpoenaed.
C. Edited later.
D. Subpoenaed.
In which one of the following scenarios is a public adjuster most
D. An insured's negotiations with
likely to become involved?
the insurer on a complex claim
Select one:
are not going well.
A. An insurer finds it financially unfeasible to hire its own claims
staff in a given state.
If a claim is complex, or if
B. An insured is unable to afford legal representation to contest a
settlement negotiations are not
claim.
progressing with the insurer, the
C. A catastrophic disaster strikes, involving damage to many
insured may hire a public
properties.
adjuster to protect his or her
D. An insured's negotiations with the insurer on a complex claim
interests.
are not going well.
, Which one of the following statements regarding third-party
administrators (TPAs) is most accurate?
Select one:
B. TPAs handle claims, keep A. TPAs are typically used by businesses that have chosen not to
claims records, and perform self-insure.
statistical analyses. B. TPAs handle claims, keep claims records, and perform
statistical analyses.
C. TPAs are generally found in an insurer's claims department.
D. TPAs are employed only by independent adjusting firms.
Hugo is conducting an audit of a branch office claims operation.
He is evaluating timeliness of reports, number of files opened,
A. Proper releases taken proper releases taken, and accuracy of data entry. Which one of
Hugo's metrics is a qualitative audit factor?
Proper releases taken is a Select one:
qualitative audit factor; the A. Proper releases taken
others are quantitative. B. Timeliness of reports
C. Number of files opened
D. Accuracy of data entry
D. Line underwriter. Aaron works for a multi-line insurer. He works with insurance
producers and applicants to evaluate new business submissions
Line underwriter. This describes and conduct renewal underwriting. Aaron is a
the duties of a line underwriter, Select one:
rather than a staff underwriter. A. Staff underwriter.
There is not enough information B. Public underwriter.
to determine which line of C. Personal lines underwriter.
business is being written. A D. Line underwriter.
public underwriter does not
exist. Line underwriters evaluate
new submissions and perform
renewal underwriting, usually by
working directly with insurance
producers and applicants. Staff
underwriters, meanwhile,
manage risk selection by
working with line underwriters
and coordinating decisions
about products, pricing and
guidelines.
The first key to communicating empathetically as a claims
professional is
D. Listening.
Select one:
A. A comprehensive understanding of relevant insurance
Claims professionals should first
policies.
listen carefully to understand
B. Speaking calmly and clearly.
what the claimant is saying.
C. Being prepared with all documentation relating to the claim.
D. Listening.
, C. Cost to investigate, defend, Mia tracks loss adjustment expense (LAE) as part of her
and settle claims. management of the claims department for an insurer. Mia
considers LAE to be the
Cost to investigate, defend, and Select one:
settle claims. LAE is the expense A. Total amount of loss reserves of all claims.
that an insurer incurs to B. Paid portion of claims.
investigate, defend, and settle C. Cost to investigate, defend, and settle claims.
claims according to the terms D. Total incurred amount of claims.
specified in the insurance policy.
In her role with an insurer, Katarina has opportunity to
D. Claim representative.
collaborate with not only employees from her company, but also
external experts with particular expertise. For example, as part of
Claim reps collaborate with
her investigation, she hired an engineer to conduct a review of a
more than other insurer
machine that was involved in a personal injury. Katarina is a(n)
employees. Many insurers
Select one:
employ a panel of experts that
A. Medical provider.
the claims rep can select
B. Expert Witness.
according to the investigation's
C. Premium auditor.
needs.
D. Claim representative.
When Mehmet interviews witnesses as part of his claims
investigation, he asks different types of questions based on need,
such as open-ended, direct, indirect, and leading. Which type of
A. Open-ended question should Mehmet ask when he wants to set the
interviewee at ease and he is looking for explanation or
Open-ended questions can be elaboration of details in the interviewee's own words?
used to clarify an interviewee's Select one:
statements. A. Open-ended
B. Direct
C. Indirect
D. Leading
Charlotte is handling a new claim and she has set the initial
reserves at $1,000,000. She has been asked to complete an
D. Large loss report. internal report summarizing all the file status information for
distribution to management and updated as more information is
Most insurers have guidelines received. The report Charlotte is completing is most likely a
outlining when and under what Select one:
circumstances large loss reports A. Status report.
should be prepared. B. Summarized report.
C. Preliminary report.
D. Large loss report.
In which one of the following scenarios is the right of
subrogation most likely to be employed by the insurer?
D. A claims rep discovers that Select one:
their insured's car accident was A. An insured files a homeowners claim for stolen jewelry. An
caused by a road contractor investigation reveals that the jewelry is still in the insured's
who left equipment lying in the possession.
travel lanes of a highway. B. An investigation reveals that an insured set her own business
on fire.
The right of subrogation allows C. An insured files a claim for collision damage from a hit and run
an insurer to recover payment accident, when in fact he backed into a utility pole.
from a negligent third party. D. A claims rep discovers that their insured's car accident was
caused by a road contractor who left equipment lying in the
travel lanes of a highway.
