Practice Test Geeks(ACE) ACORD Certified Expert Practice Test
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Claims Processing & Investigation Flashcards

7 cards from real ACE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Claims Processing & Investigation flashcards as text

  1. Under ACORD standards, which field in the ACORD 3 (Loss Notice) form captures the reported date of loss distinct from the discovery date?

    Answer: Loss Date

    The Loss Date field captures when the actual loss event occurred, which may differ from when it was discovered or reported.

  2. A subrogation right in property insurance means the insurer, after paying a claim, can:

    Answer: Pursue recovery from the responsible third party

    Subrogation allows the insurer to step into the insured's shoes and seek reimbursement from the negligent third party who caused the loss.

  3. Which investigation technique is MOST appropriate when a claimant alleges permanent disability but surveillance footage shows physical activity inconsistent with the claim?

    Answer: Independent Medical Examination (IME)

    An IME uses an independent physician to objectively assess the claimant's actual physical condition against the alleged disability.

  4. In workers' compensation claims, the term 'compensable injury' means:

    Answer: An injury arising out of and in the course of employment

    A compensable injury must meet the dual test of arising out of employment and occurring in the course of employment.

  5. The ACORD AL3 (Auto Loss Notice) form's 'Point of Impact' field primarily assists in:

    Answer: Reconstructing the accident sequence and assigning fault

    The point of impact information helps adjusters and accident reconstructionists determine how the collision occurred and who bears liability.

  6. A reservation of rights letter is sent by an insurer to:

    Answer: Notify the insured that coverage may be denied while the investigation continues

    A reservation of rights letter allows the insurer to defend or investigate a claim without waiving any coverage defenses.

  7. Under the principle of indemnity, an insured who suffers a $50,000 loss with a $10,000 deductible and $500,000 policy limit should receive:

    Answer: $40,000

    Indemnity restores the insured to pre-loss condition; the deductible is subtracted from the covered loss amount ($50,000 - $10,000 = $40,000).