AIC 300 Practice Questions and Answers 2024
11. offering the settlement payments insureds and claimants demand-
: Claims representatives could quickly reduce LAE in the short term by
rather than spending
resources on in- vestigating claims and calculating and negotiating fair
payments.
12. best practices, claims audits, & customer satisfaction data: 3
frequently used tools provide quality measures of a Claims
Department's performance
13. Best practices: Identified by studying an insurer's own
performance or the performance of successful insurers
14. Claims audits: Used by insurers to ensure compliance with best
practices
and gather statistical information on claims--performed by evaluating
information in open/closed claims.
15. sworn statements: Most policies require the insured, and sometimes
third-par- ty claimants, to provide .
16. coherence, completeness, objectivity: 3 qualities of effective
statements
17. Accident scene details: help the
claims rep- resentative determine whether accounts of the accident are
plausible.
18. prior claim investigations: Claims representatives conduct
on most incoming claims to avoid
paying for property damage or bodily injury that the claimant has already
been compensated for through prior claims.
19. Subrogation: Allows an insurer to recover payment from a negligent
third party when the insurer has paid a claim for a loss caused by the
negligent third party.
20. Subrogation agreement: Clauses in most insurance policies that
require the insured to cooperate with the insurer by assigning the rights of
subrogation to the insurer.
21. give testimony; appear in court: Most subrogation agreements
require the insured to and ,
when necessary, so that the insurer can establish the legal basis to recover
from the negligent third party.
22. Diary system: A suspense system or pending system that combines
work on a claim with documentation by allowing the claims representative
to work on a claim one day and then diary it for review.
23. preliminary, status, summarized: 3 internal reports that a claims
representa- tive may write
24. Stairstepping: When a claims rep sets a modest initial reserve but
then raises it to issue payments, and later again when more bills arrive.
25. ultimate: Reserves should reflect the cost of a claim.