ACE Fraud Detection & Prevention 2

Question 1

Which ACORD form field is most commonly manipulated in staged auto accident fraud schemes?

Accepted Answer

Vehicle identification number (VIN)

Answer

VIN manipulation allows fraudsters to misrepresent vehicle identity, value, or ownership in staged auto accident claims.

Question 2

In the context of ACORD data standards, what is a 'soft fraud' indicator in property claims?

Accepted Answer

Slightly inflating the value of legitimately damaged items

Answer

Soft fraud (opportunistic fraud) involves exaggerating legitimate claims, such as inflating damaged item values, rather than fabricating the entire loss.

Question 3

Which data element in ACORD's AL3 standard is critical for detecting policy stacking fraud in auto insurance?

Accepted Answer

Vehicle use code

Answer

Vehicle use codes help identify whether a personal-use vehicle is actually being used commercially, a common discrepancy in policy stacking schemes.

Question 4

What is the primary purpose of the NAIC's Special Investigations Unit (SIU) data call?

Accepted Answer

Collecting standardized fraud referral data across insurers

Answer

The NAIC SIU data call collects standardized information about insurer fraud referral activities to benchmark anti-fraud efforts industry-wide.

Question 5

Under the ISO ClaimSearch system, what triggers an automatic cross-match alert for a claimant?

Accepted Answer

Matching name, SSN, or vehicle data against prior claims in the database

Answer

ISO ClaimSearch cross-matches claimant identifiers such as name, SSN, and vehicle data against its national claims database to surface prior loss patterns.

(ACE) ACORD Certified Expert Practice Test

(ACE) ACORD Certified Expert Practice Test

ACE Fraud Detection & Prevention 2