Associate in Claims (AIC) Exam — Questions and Answers
Question 1: In liability claims, what is the difference between 'negligence' and 'strict liability'?
- Negligence only applies in automobile accidents
- Negligence applies only to product claims; strict liability applies to workplace injuries
- Strict liability requires proof of intentional misconduct
- Negligence requires proof of fault, while strict liability holds a party responsible regardless of fault or intent (Correct answer)
Correct answer: Negligence requires proof of fault, while strict liability holds a party responsible regardless of fault or intent
Under strict liability, a defendant is held responsible for damages caused by their product or activity without the need to prove they acted negligently.
Question 2: Why is risk assessment important in compliance?
- It prioritizes risks and resource allocation (Correct answer)
- It eliminates the need for controls.
- It delays regulatory reporting.
- It increases regulatory violations.
Correct answer: It prioritizes risks and resource allocation
Risk assessment in compliance involves identifying potential compliance failures and evaluating their likelihood and impact. This process allows organizations to prioritize which risks are most critical and allocate resources effectively to mitigate them. By understanding the severity of various compliance risks, companies can develop targeted controls and strategies, ensuring efficient use of resources and stronger overall compliance.
Question 3: In the context of claims litigation, what does 'subrogation' allow an insurer to do?
- Assign the claim to another insurer
- Increase the insured's deductible
- Pursue recovery from a negligent third party after paying a claim (Correct answer)
- Deny a claim based on fraud
Correct answer: Pursue recovery from a negligent third party after paying a claim
Subrogation gives the insurer the legal right to step into the insured's shoes and seek reimbursement from the party responsible for the loss.
Question 4: How can positive language improve customer interactions?
- By ignoring customer complaints.
- By focusing on what can’t be done.
- By emphasizing solutions and opportunities (Correct answer)
- By using technical jargon.
Correct answer: By emphasizing solutions and opportunities
Using positive language in customer interactions helps to create a more constructive and reassuring environment. Instead of focusing on limitations or problems, positive language emphasizes what *can* be done, offering solutions and highlighting opportunities for resolution. This approach can de-escalate tension, build rapport, and leave customers feeling more satisfied and confident in the service received, improving overall interaction quality.
Question 5: What is the importance of record keeping in claims processing?
- To increase paperwork unnecessarily.
- To maintain accurate and compliant records (Correct answer)
- To confuse clients.
- To delay claim processing.
Correct answer: To maintain accurate and compliant records
Meticulous record keeping is paramount in claims processing to ensure accuracy, transparency, and compliance with legal and regulatory requirements. Comprehensive records document every step of the claim, from initial report to final settlement, providing an audit trail. This helps in resolving disputes, preventing fraud, and demonstrating adherence to industry standards and laws.
Question 6: What documentation is essential for claims processing?
- Only verbal agreements.
- No documentation needed.
- Complete and accurate claim forms (Correct answer)
- Only emails.
Correct answer: Complete and accurate claim forms
Complete and accurate claim forms are essential for claims processing because they provide the initial, structured information about the loss or incident. This documentation allows the insurer to understand the nature of the claim, the parties involved, and the extent of the damage or injury. Without precise and thorough forms, verifying the claim and initiating the settlement process would be significantly hindered, leading to delays or denials.
Question 7: How do 'policy limits' impact the coverage of an insurance policy?
- They have no effect on claims.
- They set the maximum payout the insurer will provide for claims (Correct answer)
- They are the same as deductibles.
- They represent the minimum payment required from the insured.
Correct answer: They set the maximum payout the insurer will provide for claims
Policy limits are crucial because they define the maximum amount of money an insurance company will pay out for a covered loss or over a specific policy period. These limits can apply per occurrence, per person, or as an aggregate total. Understanding policy limits is essential for policyholders to know the extent of their financial protection and potential out-of-pocket exposure beyond these maximums.
Question 8: How does the concept of 'coinsurance' typically affect an insured policyholder?
- The insurer pays the full amount of the claim.
- The insured pays no deductible.
- Coinsurance is a type of deductible.
- The insured shares a percentage of the loss costs with the insurer (Correct answer)
Correct answer: The insured shares a percentage of the loss costs with the insurer
Coinsurance is a provision in an insurance policy that requires the insured to pay a certain percentage of the costs of a covered loss after the deductible has been met. For example, with 80/20 coinsurance, the insurer pays 80% and the insured pays 20%. This mechanism encourages policyholders to adequately insure their property and shares the financial burden of a loss.
Question 9: How should documentation & reporting retention policies be determined in Associate in Claims?
- Based on legal requirements, operational needs, and industry best practices (Correct answer)
- Based on available storage space
- Keeping everything indefinitely
- Destroying records as soon as they are no longer immediately needed
Correct answer: Based on legal requirements, operational needs, and industry best practices
Retention policies should balance legal requirements, operational needs, and best practices to ensure appropriate preservation and disposal.
Question 10: A 'Coblentz agreement' (also called a settlement demand letter) is most relevant in which situation?
- When an insured breaches a condition of the policy and the insurer denies coverage, and the insured then settles directly with the plaintiff and assigns rights against the insurer (Correct answer)
- When the insurer exercises subrogation rights against a third party
- When multiple insurers share coverage for the same loss
- When a claimant requests a structured settlement in a workers compensation case
Correct answer: When an insured breaches a condition of the policy and the insurer denies coverage, and the insured then settles directly with the plaintiff and assigns rights against the insurer
A Coblentz agreement arises when the insurer wrongfully denies coverage, the insured settles with the plaintiff and assigns bad-faith claims to the plaintiff, who can then sue the insurer.
Question 11: What is the role of a compliance officer?
- To manage compliance activities and regulatory requirements (Correct answer)
- To sell insurance policies.
- To avoid customer complaints.
- To underwrite policies.
Correct answer: To manage compliance activities and regulatory requirements
A compliance officer is responsible for overseeing and managing an organization's adherence to internal policies, external laws, and regulatory standards. Their role involves developing and implementing compliance programs, conducting risk assessments, training staff, and monitoring activities to ensure the company operates ethically and legally. This helps prevent violations, fines, and reputational damage.
Question 12: What is 'general liability' insurance designed to cover?
- Workers injured on the job
- Third-party bodily injury and property damage claims arising from the insured's business operations (Correct answer)
- The insured's professional errors and omissions
- Property damage to the insured's own building
Correct answer: Third-party bodily injury and property damage claims arising from the insured's business operations
Commercial general liability (CGL) insurance protects businesses against third-party claims of bodily injury, property damage, personal injury, and advertising injury.
Question 13: Which section of an insurance policy defines coverage limitations and exceptions?
- The declarations page.
- The exclusions and conditions section (Correct answer)
- The endorsements.
- The premium schedule.
Correct answer: The exclusions and conditions section
The exclusions and conditions section of an insurance policy explicitly defines what is not covered and the circumstances under which coverage may be limited or voided. This section is vital for policyholders to understand the boundaries of their protection, as it details specific perils, property, or situations that are excluded from coverage. It clarifies the insurer's obligations and the policyholder's responsibilities.
Question 14: What is an endorsement in an insurance policy?
- A rider that modifies or adds to the original policy coverage (Correct answer)
- A claim form.
- A premium payment schedule.
- A separate insurance policy.
Correct answer: A rider that modifies or adds to the original policy coverage
An endorsement, also known as a rider, is a written amendment added to an insurance policy that modifies its original terms. It can be used to add, delete, or modify coverage, clarify policy language, or update information. Endorsements allow policies to be customized to specific needs without rewriting the entire document, ensuring the policy accurately reflects the desired coverage.
Question 15: In liability claims, what is the purpose of a 'structured settlement'?
- To structure the insurer's legal defense team
- To resolve coverage disputes between insurers
- To apportion liability among multiple defendants
- To pay a large claim as a series of periodic payments over time rather than a single lump sum (Correct answer)
Correct answer: To pay a large claim as a series of periodic payments over time rather than a single lump sum
A structured settlement converts a lump-sum award into periodic payments, often funded by an annuity, providing the claimant with long-term financial security while potentially reducing the insurer's total payout.
Question 16: How often should quality assurance & improvement metrics be reviewed in Associate in Claims?
- When problems are reported
- Regularly at defined intervals with additional reviews triggered by significant events (Correct answer)
- When external audits are scheduled
- Only during annual performance reviews
Correct answer: Regularly at defined intervals with additional reviews triggered by significant events
Regular scheduled reviews ensure ongoing monitoring while event-triggered reviews capture the impact of significant changes.
Question 17: What is 'products liability' in the context of general liability claims?
- Liability for a service performed incorrectly
- Liability for damage to products during shipping
- Coverage for product recalls
- Legal liability arising from injuries or damages caused by a defective product the insured manufactured, distributed, or sold (Correct answer)
Correct answer: Legal liability arising from injuries or damages caused by a defective product the insured manufactured, distributed, or sold
Products liability claims arise when a defective or unreasonably dangerous product causes bodily injury or property damage to a consumer or third party.
Question 18: What is a 'compensable injury' under workers' compensation?
- An injury requiring surgery costing more than $5,000
- An occupational disease not covered by health insurance
- Any injury that occurs at home while working remotely
- A work-related injury or illness arising out of and in the course of employment that qualifies for workers' compensation benefits (Correct answer)
Correct answer: A work-related injury or illness arising out of and in the course of employment that qualifies for workers' compensation benefits
For an injury to be compensable under workers' compensation, it must arise out of employment (causation) and occur in the course of employment (time and place).
Question 19: What is the PRIMARY benefit of continuous improvement in leadership & management for Associate in Claims?
- Reduced need for employee input
- Higher operational costs in the short term
- Enhanced efficiency, quality, and competitive advantage over time (Correct answer)
- Increased complexity in operations
Correct answer: Enhanced efficiency, quality, and competitive advantage over time
Continuous improvement systematically enhances efficiency and quality, leading to sustained competitive advantage.
Question 20: What does a policy’s deductible represent?
- The total policy coverage limit.
- The amount the insurer pays before claims are processed.
- The out-of-pocket amount the insured must pay before coverage applies (Correct answer)
- The monthly premium amount.
Correct answer: The out-of-pocket amount the insured must pay before coverage applies
A policy's deductible represents the specific amount of money that the insured policyholder must pay out-of-pocket towards a covered loss before their insurance company begins to pay. It acts as a form of cost-sharing, reducing the insurer's payout for smaller claims and encouraging policyholders to be more careful. Once the deductible is met, the insurer covers the remaining eligible costs up to the policy limits.
Question 21: What is the primary purpose of a reservation of rights letter in claims litigation?
- To deny the claim outright
- To request additional medical records
- To settle the claim quickly
- To notify the insured that coverage may not apply while the insurer continues to investigate (Correct answer)
Correct answer: To notify the insured that coverage may not apply while the insurer continues to investigate
A reservation of rights letter allows the insurer to investigate or defend a claim while preserving the right to deny coverage later if a policy exclusion applies.
Question 22: Which characteristic BEST describes a successful quality assurance & improvement culture in Associate in Claims?
- Continuous learning where all team members actively seek improvement (Correct answer)
- Periodic campaigns without sustained effort
- Top-down directives without employee input
- Focus on compliance over genuine improvement
Correct answer: Continuous learning where all team members actively seek improvement
A culture where all team members actively seek improvement opportunities creates sustainable quality enhancement across the organization.
Question 23: What is the difference between named perils and open perils coverage?
- Open perils cover only the perils listed in the policy.
- Named perils cover all risks except exclusions.
- Named perils cover specific listed risks; open perils cover all risks except exclusions (Correct answer)
- There is no difference between them.
Correct answer: Named perils cover specific listed risks; open perils cover all risks except exclusions
Named perils coverage only provides protection against the specific risks or events explicitly listed in the policy, such as fire or theft. In contrast, open perils (or 'all-risk') coverage is broader, covering all causes of loss unless they are specifically excluded in the policy language. This distinction is crucial for understanding the scope of protection an insurance policy offers.
Question 24: Which action BEST demonstrates a commitment to professional standards & ethics in Associate in Claims?
- Maintaining current knowledge of all applicable regulations and standards (Correct answer)
- Relying on colleagues to interpret regulatory requirements
- Following only the regulations that are convenient
- Addressing compliance issues only when audited
Correct answer: Maintaining current knowledge of all applicable regulations and standards
Actively maintaining current knowledge of applicable regulations demonstrates genuine commitment to compliance and helps prevent violations.
Question 25: What is the PRIMARY objective of professional standards & ethics in the Associate in Claims field?
- To create additional paperwork for professionals
- To increase operational costs for organizations
- To ensure adherence to established standards and protect stakeholders (Correct answer)
- To limit the scope of professional practice
Correct answer: To ensure adherence to established standards and protect stakeholders
The primary objective of compliance and regulatory frameworks is to ensure adherence to standards that protect stakeholders.
Question 26: What is the FOUNDATION of effective quality assurance & improvement in Associate in Claims?
- Personal opinion of experienced practitioners
- Clearly defined standards and measurable criteria (Correct answer)
- Customer complaints as the sole quality indicator
- Industry averages without internal benchmarks
Correct answer: Clearly defined standards and measurable criteria
Clearly defined standards and measurable criteria provide an objective foundation for assessing and improving quality.
Question 27: What does 'bad faith' mean in the context of insurance claims handling?
- An insured's failure to cooperate
- A claimant's exaggeration of damages
- Filing a fraudulent claim
- An insurer's unreasonable denial or delay of a valid claim without a legitimate basis (Correct answer)
Correct answer: An insurer's unreasonable denial or delay of a valid claim without a legitimate basis
Bad faith occurs when an insurer unreasonably refuses to pay, delays payment, or fails to properly investigate a valid claim, exposing the insurer to extra-contractual damages.
Question 28: What is the 'made whole doctrine' in subrogation?
- The requirement for insurers to file subrogation within one year
- The principle that an insured must be fully compensated for all losses before the insurer can recover subrogation proceeds (Correct answer)
- The rule requiring the insurer to fully pay the claim before filing subrogation
- The doctrine requiring joint settlement of all parties
Correct answer: The principle that an insured must be fully compensated for all losses before the insurer can recover subrogation proceeds
The made whole doctrine prevents the insurer from pursuing subrogation until the insured has been fully compensated for all damages, including uninsured losses.
Question 29: What is the primary purpose of an insurance policy declaration page?
- To provide premium payment history.
- To provide a detailed list of policy exclusions.
- To describe claim procedures in detail.
- To summarize key policy information like coverage limits and insured details (Correct answer)
Correct answer: To summarize key policy information like coverage limits and insured details
The declaration page is the front page of an insurance policy and serves as a concise summary of its most critical information. It typically includes the policyholder's name and address, the policy period, types of coverage, coverage limits, deductibles, and the premium amount. This page provides an at-a-glance overview of the policy's key details, making it easy for the insured to understand their coverage.
Question 30: What is 'loss development' in workers' compensation reserve management?
- The calculation of premium based on payroll
- The process of training new claims adjusters
- The development of new loss prevention programs
- The growth or change in the estimated ultimate cost of a claim over time as new information becomes available (Correct answer)
Correct answer: The growth or change in the estimated ultimate cost of a claim over time as new information becomes available
Loss development tracks how initial reserves change as claims mature and more information about medical costs, disability duration, and legal exposure becomes known.
Question 31: Which element is ESSENTIAL for an effective professional standards & ethics program in Associate in Claims?
- Documentation stored without regular updates
- Compliance responsibility assigned to one individual only
- Regular audits and continuous monitoring processes (Correct answer)
- Annual review without interim checks
Correct answer: Regular audits and continuous monitoring processes
Regular audits and continuous monitoring enable early detection of compliance gaps and ensure ongoing adherence to standards.
Question 32: How can cultural awareness improve customer communication?
- By ignoring cultural differences.
- By recognizing and respecting cultural differences (Correct answer)
- By speaking loudly to show authority.
- By using slang and idioms freely.
Correct answer: By recognizing and respecting cultural differences
Cultural awareness in customer communication involves understanding and appreciating that customers from different backgrounds may have varying communication styles, expectations, and cultural norms. By recognizing and respecting these differences, representatives can tailor their approach, avoid misunderstandings, and communicate more effectively. This fosters a more inclusive and positive customer experience.
Question 33: What is the function of a claims adjuster?
- To deny all claims.
- To assess claim validity and recommend settlements (Correct answer)
- To market insurance policies.
- To process payments only.
Correct answer: To assess claim validity and recommend settlements
A claims adjuster is a professional who investigates insurance claims to determine the extent of the insurer's liability. Their function involves gathering facts, interviewing witnesses, inspecting damages, and reviewing policy terms to assess the validity of the claim. Based on their findings, they recommend an appropriate settlement amount to the insurance company, ensuring fair and accurate resolution.
Question 34: Why is the concept of 'actual cash value' important in insurance claims?
- It is replacement cost minus depreciation, impacting claim payments (Correct answer)
- It only applies to liability claims.
- It is the original purchase price of the insured item.
- It is the amount paid to replace an item without depreciation.
Correct answer: It is replacement cost minus depreciation, impacting claim payments
Actual Cash Value (ACV) is important in insurance claims because it determines the amount an insurer will pay for damaged or lost property. ACV is calculated as the replacement cost of an item at the time of loss, minus depreciation due to age, wear, and tear. This valuation method means the policyholder receives the depreciated value, not the cost to buy a brand-new replacement, unless their policy specifies replacement cost coverage.
Question 35: What is the role of empathy in customer service?
- To judge customer complaints critically.
- To avoid responsibility.
- To rush the customer interaction.
- To show understanding and care for customer feelings (Correct answer)
Correct answer: To show understanding and care for customer feelings
Empathy in customer service involves actively listening and understanding the customer's perspective and emotions. This helps representatives connect with customers on a human level, validating their feelings and building trust. By demonstrating care, empathy can de-escalate tense situations and lead to more satisfactory resolutions.
Question 36: What is an 'excess judgment' in insurance litigation?
- The amount the insured must pay before coverage applies
- A court verdict that exceeds the insured's policy limits (Correct answer)
- A judgment awarded only for punitive damages
- A judgment against a third-party claimant
Correct answer: A court verdict that exceeds the insured's policy limits
An excess judgment is a court award that surpasses the insured's policy limits, potentially exposing both the insured and insurer to personal liability claims.
Question 37: How should a customer service representative handle a complaint?
- Argue with the customer.
- Listen, acknowledge, and provide solutions (Correct answer)
- Ignore the complaint if it seems minor.
- Interrupt the customer to fix it immediately.
Correct answer: Listen, acknowledge, and provide solutions
Effectively handling a customer complaint begins with actively listening to understand the full scope of the issue without interruption. Acknowledging the customer's feelings and validating their experience helps de-escalate tension and shows empathy. Finally, the representative should focus on providing clear, actionable solutions to resolve the problem, ensuring customer satisfaction.
Question 38: When a claimant demands $50,000 and the adjuster offers $20,000, and both parties agree to split the difference at $35,000, this is an example of:
- Bracketing
- Compromising via midpoint settlement (Correct answer)
- Integrative bargaining
- Principled negotiation
Correct answer: Compromising via midpoint settlement
Splitting the difference is a compromising strategy where both parties agree to settle at the mathematical midpoint between their stated positions.
Question 39: How does ongoing professional development support professional standards & ethics in Associate in Claims?
- It keeps professionals informed of evolving standards and best practices (Correct answer)
- It is irrelevant to compliance outcomes
- It replaces the need for formal compliance audits
- It only benefits entry-level professionals
Correct answer: It keeps professionals informed of evolving standards and best practices
Ongoing professional development ensures that practitioners stay current with evolving regulations, standards, and best practices in their field.
Question 40: What steps can improve claims accuracy?
- Skipping audits.
- Implementing consistent procedures and training (Correct answer)
- Ignoring claim policies.
- Delaying claims.
Correct answer: Implementing consistent procedures and training
Improving claims accuracy relies heavily on establishing and consistently following standardized procedures for processing claims. Coupled with comprehensive and ongoing training for claims personnel, this ensures that claims are handled uniformly, correctly, and according to policy terms and regulations. This approach minimizes errors, reduces inconsistencies, and enhances the overall quality of claims handling, leading to better outcomes for both the insurer and the insured.
Question 41: What is the 'duty to defend' as it applies to liability insurance claims?
- The insurer's obligation to provide a legal defense for covered claims even if the claim may be groundless (Correct answer)
- The insurer's right to settle without insured consent
- The duty to report all claims within 24 hours
- The insured's obligation to cooperate with the insurer
Correct answer: The insurer's obligation to provide a legal defense for covered claims even if the claim may be groundless
The duty to defend requires the insurer to defend the insured against lawsuits alleging covered losses, regardless of whether the suit ultimately has merit.
Question 42: How can risk management help an insurance company?
- By identifying and controlling risks (Correct answer)
- By ignoring potential risks.
- By increasing claim payouts.
- By avoiding customer service.
Correct answer: By identifying and controlling risks
Risk management is crucial for insurance companies as it involves systematically identifying, assessing, and prioritizing potential risks that could impact their operations or financial stability. By understanding these risks, companies can implement strategies to mitigate them, such as setting appropriate premiums, diversifying portfolios, or establishing robust claims processes. This proactive approach helps maintain solvency and profitability.
Question 43: What is the BEST approach to documentation & reporting standardization in Associate in Claims?
- Using whatever format is most convenient at the time
- Implementing consistent formats, terminology, and processes across the organization (Correct answer)
- Standardizing only external-facing documents
- Allowing each department to create its own standards
Correct answer: Implementing consistent formats, terminology, and processes across the organization
Organization-wide consistency in formats, terminology, and processes ensures data can be shared, compared, and analyzed effectively.
Question 44: Which quality assurance & improvement tool is MOST valuable for identifying root causes in Associate in Claims?
- Blame assignment without investigation
- Historical trend analysis alone
- Root cause analysis with systematic investigation methods (Correct answer)
- Quick fixes based on symptoms
Correct answer: Root cause analysis with systematic investigation methods
Root cause analysis with systematic methods identifies underlying causes rather than symptoms, leading to lasting solutions.
Question 45: In Associate in Claims, how should quality assurance & improvement initiatives be prioritized?
- Based on impact on outcomes, feasibility, and alignment with strategic goals (Correct answer)
- In order of ease of implementation only
- Based on the most recent complaints
- By the department requesting the improvement
Correct answer: Based on impact on outcomes, feasibility, and alignment with strategic goals
Prioritizing by impact, feasibility, and strategic alignment ensures resources are directed where they will produce the greatest benefit.
Question 46: Which of the following best describes 'integrative bargaining' in a claims context?
- Parties work together to find creative solutions that expand value for both sides (Correct answer)
- Each party gives up something to reach agreement
- The adjuster integrates all claim data before making an offer
- A mediator integrates both parties' positions into a final award
Correct answer: Parties work together to find creative solutions that expand value for both sides
Integrative bargaining (win-win negotiation) seeks to expand the pie by addressing underlying interests rather than rigid positions, creating solutions beneficial to both parties.
Question 47: During litigation, what is the purpose of an Examination Under Oath (EUO)?
- To conduct a physical inspection of damaged property
- To finalize settlement terms
- To assign liability to a third party
- To allow the insurer to formally question the insured about the claim under oath (Correct answer)
Correct answer: To allow the insurer to formally question the insured about the claim under oath
An EUO is a formal, sworn proceeding where the insurer questions the claimant or insured to gather facts and assess the validity of the claim.
Question 48: What is the primary role of a coverage counsel in complex insurance litigation?
- To provide legal opinions on whether a policy covers a particular claim or loss (Correct answer)
- To manage subcontractor relationships
- To negotiate salvage values
- To handle day-to-day claims adjusting
Correct answer: To provide legal opinions on whether a policy covers a particular claim or loss
Coverage counsel analyzes policy language, endorsements, and applicable law to advise the insurer on whether coverage exists for a disputed claim.
Question 49: What role does documentation play in communication & collaboration within Associate in Claims?
- It ensures continuity, accountability, and serves as a reference for all parties (Correct answer)
- It replaces the need for verbal communication
- It is only needed for legal protection
- It is optional and rarely reviewed
Correct answer: It ensures continuity, accountability, and serves as a reference for all parties
Proper documentation ensures continuity of care or service, establishes accountability, and provides a reliable reference for all involved parties.
Question 50: What role does the 'insuring agreement' play in an insurance policy?
- It lists the premium payment schedule.
- It contains the policyholder's personal information.
- It explains how claims are processed.
- It describes the insurer’s coverage obligations (Correct answer)
Correct answer: It describes the insurer’s coverage obligations
The insuring agreement is a core part of an insurance policy that outlines the insurer's promise to pay for losses or damages under specified conditions. It defines the scope of coverage, detailing what perils are covered, what property is insured, and the types of losses the policy is designed to protect against. This section establishes the fundamental contractual relationship between the insurer and the insured.
Question 51: What is 'comparative bad faith' in insurance litigation?
- Bad faith claims against the reinsurer
- A defense where the insurer argues the insured also acted in bad faith, reducing the insurer's liability (Correct answer)
- A statutory penalty for late payments
- The comparison of two insurers' claims handling practices
Correct answer: A defense where the insurer argues the insured also acted in bad faith, reducing the insurer's liability
Comparative bad faith is raised as a defense when the insured's own conduct, such as concealing material facts, contributed to the claims dispute and may offset the insurer's bad faith exposure.
Associate in Claims (AIC) Exam
The Associate in Claims (AIC) designation demonstrates a professional's fundamental knowledge of property and casualty claims handling, including investigation, evaluation, negotiation, and settlement.
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