Insurancece.com is as easy as 1, 2, 3

Transcription

1 All Wisconsin Agents may take online and self study continuing education. The Wisconsin Insurance Commissioners Office state on their website Self-study, correspondence and online courses can be approved if they meet the criteria under s. Ins (6), Wis. Adm. Code, and include completion of a certified proctored examination. Insurancece.com is as easy as 1, 2, 3 1 Complete the online course. Most agents find the information to be interesting and practical. 2 Find a proctor and take the exam provided at the end of the course. The exam is a multiple-choice proctored quiz. Passing is 70%. A back-up exam is available, if needed, at no charge. A proctor should be: An impartial, disinterested third party, or A currently licensed agent with no family or financial relationship to the student. The proctor should Verify the agent s identity, Observe the agent while taking the exam, and Complete the affidavit supplied. 3 Fax the answer key and affidavit to We will grade your exam and fax your certificate within 48 hours. (If you have not already paid for your credits, that should also be done at this time.) Then, relax and tell a friend about Online. Spreading the word will allow us to offer more quality courses. The Van Wyhe Group P O Box 159 Shell Lake, WI Voice: Fax:

2 The Van Wyhe Group Wisconsin CE Affidavit Wisconsin law no longer requires a major industry designation for Online and Self Study CE. A proctored exam is required. An approved proctor is: An impartial, disconnected third party or a currently licensed agent with no family or financial relationship to the student. Proctor s responsibilities are to verify the agent s identity and complete the affidavit supplied, testifying that the agent received no outside assistance. Please call Angela at (877) with any questions. Name of Student: WI Insurance License #: I declare that I personally completed this exam without any outside assistance including course material, other source material or assistance from any person(s). Signature: Name of Course(s): Address where exam was taken: Date of Exam: Beginning time: Ending time: Print Name of Proctor: Type of Proctor: (check one) Licensed Producer License # Other (Please specify relationship to licensee) Proctor s Job title: Company Name: Mailing Address: Phone: Proctor s Signature: Date:

3 ANSWER KEY: Name of Course: Name of Agent: Phone: Agency Name: Fax: Please circle the correct answer: 1. a b c d 18. a b c d 35. a b c d 2. a b c d 19. a b c d 36. a b c d 3. a b c d 20. a b c d 37. a b c d 4. a b c d 21. a b c d 38. a b c d 5. a b c d 22. a b c d 39. a b c d 6. a b c d 23. a b c d 40. a b c d 7. a b c d 24. a b c d 41. a b c d 8. a b c d 25. a b c d 42. a b c d 9. a b c d 26. a b c d 43. a b c d 10. a b c d 27. a b c d 44. a b c d 11. a b c d 28. a b c d 45. a b c d 12. a b c d 29. a b c d 46. a b c d 13. a b c d 30. a b c d 47. a b c d 14. a b c d 31. a b c d 48. a b c d 15. a b c d 32. a b c d 49. a b c d 16. a b c d 33. a b c d 50. a b c d 17. a b c d 34. a b c d When you have completed this answer key fax it along with your signed affidavit to us at We will fax back a copy of your certificate if you have correctly completed at least 70%. Call with questions. The Van Wyhe Group P O Box 159 Shell Lake, WI 54871

4 EXAMINATION: Fraud And The Agent 1. There are two basic types of fraud databases in the insurance industry: a. Claims databases and Clue b. Clue and ADD c. Underwriting databases and Motor Vehicle Records d. Claims fraud databases and underwriting databases 2. State Insurance Fraud Bureaus: a. Are against the law in 37 states. b. Have not been very effective in fighting insurance fraud. c. Are only used to combat workers compensation fraud. d. Thirty-seven states have now created them. 3. All of the following were given by focus groups as reasons for committing insurance fraud except: a. To save money or reduce costs b. To help bring down the establishment c. To get done expensive work they would not otherwise be able to afford d. To get back at insurance companies 4. All of the following organizations are involved in anti-fraud reporting except: a. Chambers of Commerce b. Employers c. Non-industry organizations d. Insurance companies 5. All of the following are anti-fraud activities of the government except: a. State anti-fraud bureaus b. State insurance fraud statutes c. Immunity statutes d. Mandatory jail time for those convicted of insurance fraud 6. All of the following are true about Special Investigative Units (SIUs) except: a. Most insurance companies now have SIUs. b. They are designed to investigate claims and train claims professionals c. They have been around for over 100 years, but have received limited use. d. Some states require insurance companies to have SIUs. 7. The Insurance Fraud Bureau of Massachusetts: a. Is funded by the legislature in Massachusetts. b. Is totally funded by the insurance industry in Massachusetts. c. Is funded by the federal government. d. Is funded by contributions from local businesses.

5 8. All of the following groups can be expected to combine to form coalitions to fight insurance fraud except: a. Focus groups b. Government and law enforcement professionals c. Insurance industry professionals d. Consumer advocate groups 9. According to the research done on the public attitude, the Critic s attitude is: a. There is simply no excuse for this type of behavior. b. It s their own fault. c. It is a societal problem. d. Everybody is doing it. 10. Federal statutes used in insurance fraud prosecution include all of the following except: a. Wire Fraud Statute b. Racketeer Influenced and Corrupt Organizations Act (RICO) c. The American With Disabilities Act (ADA) d. Mail Fraud Statute 11. Datamining is: a. Illegal in most states. b. Too expensive to be used in the insurance industry. c. Used only by five companies at this time. d. A new type of software tool that is used on large fraud databases. 12. State Insurance Fraud Bureaus: a. Are prohibitively expensive to operate. b. Have not been very effective in fighting insurance fraud. c. Have not been around long enough to see any real results. d. Differ greatly in structure and operations from state to state. 13. All of the following are justifications Americans make for insurance fraud except: a. To make up for premiums paid in the past b. To improve the insurance coverage provided by the standard contracts the industry uses c. To make up for the deductible they have to pay d. To get back money they have paid in 14. All of the following organizations are involved in anti-fraud reporting except: a. Local insurance agencies b. Employers c. National organizations such as the National Insurance Crime Bureau d. Insurance companies 15. All of the following are anti-fraud activities of the government except: a. Arson reporting statutes b. State insurance fraud statutes c. FBI forming liaisons with insurance industry organizations d. Massive federal funds to fight insurance fraud

6 16. All of the following are true about Special Investigative Units (SIUs) except: a. One of their jobs is to train claims professionals. b. One of their jobs is to investigate claims. c. Law enforcement does not approve of the activities of SIUs. d. Some states require insurance companies to have SIUs. 17. The mission of the Insurance Fraud Bureau of Massachusetts includes all of the following except: a. Fraud Prevention b. Fraud Research c. Fraud Investigation d. Fraud Prosecution 18. A coalition can be defined as a. A temporary alliance of distinct parties, persons or states for joint action b. A small group of individuals with similar backgrounds c. A small group of individuals with dissimilar backgrounds d. A permanent alliance of distinct parties, persons or states for joint action 19. According to the research done on the public attitude, the Conformist attitude is: a. There is simply no excuse for this type of behavior. b. Everybody is doing it. c. It is a societal problem. d. It s their own fault. 20. State statutes used in insurance fraud prosecution include all of the following except: a. Anti-Arson Laws b. Premium Fraud Laws c. Wrongful Death Statutes d. Vehicle Chop Shop, Stolen and Altered Property Acts 21. All of the following are examples of Contract or Application fraud except: a. Underreporting the number of miles driven on an auto application b. Failure to report an accurate medical history when applying for health insurance c. Misstating lost history in order to obtain a policy d. Concealing an underwriting characteristic, such as a wood burning stove. 22. The cost of Workers Compensation fraud is borne by: a. The consumer b. Businesses, employees, and consumers c. The employer d. The employee 23. All of the flowing are true of internal insurance fraud except: a. It is committed by people inside the insurance industry. b. It is also referred to as insider insurance fraud. c. It is committed by people outside the insurance industry. d. It is the opposite of external insurance fraud.

7 24. With health insurance fraud, the perpetrator is usually: a. The consumer b. Medical laboratories and other suppliers c. Medical facilities, such as hospitals d. The health care professional 25. All of the following are true of soft fraud except: a. It is a deliberate attempt, either to state or invent a loss that would be covered. b. It occurs when a policyholder or claimant exaggerates a legitimate claim. c. It is also known as opportunistic fraud. d. It is usually committed by a policyholder. 26. All of the following are true of Special Investigative Units (SIUs) except: a. Law enforcement does not approve of the activities of SIUs. b. One of their jobs is to train claims professionals. c. One of their jobs is to investigate claims. d. Some states require insurance companies to have SIUs. 27. All of the following are examples of Claims Fraud except: a. Malingering on Workers Compensation b. Adding additional items to the list of things stolen in a theft loss c. Working with a provider to inflate a claim d. D. The insured completing some repairs to defray the deductible 28. All of the following are part of the definition of insurance fraud except: a. It is a deliberate and premeditated act. b. It can only be committed by someone outside the insurance industry. c. It is perpetrated for the purpose of unwarranted gain. d. It can be committed either by or against an insurance company or agent. 29. All of the following are types of auto insurance fraud except: a. Forward Posting b. Past Posting c. Auto Theft d. Auto Arson 30. All of the following are true of premium fraud except: a. It involves misrepresentations b. The goal is to induce an insurance company to charge a lower premium. c. It is often referred to as rate evasion. d. In overall size, it is insignificant. 31. Each of the following is an identified cause of insurance fraud except: a. Anti-trust laws b. Conflicts of interest c. The threat of Bad Faith awards d. Apathy of the insurance industry

8 32. Which of the following best describes the attitude of the Realist s attitude toward insurance fraud? a. The Realists have the least tolerance for insurance fraud. b. The Realists have a low tolerance for insurance fraud but realize it occurs c. The Realists believe perpetrators should be locked up permanently. d. The Realists believe insurance fraud is not an important issue in modern society. 33. According to the research done by the Coalition Against Insurance Fraud, all of the following should be done to combat insurance fraud except: a. mm b. Inform people of how fraud increases costs. c. Lower premiums for people with few or no claims. d. Investigate claims more thoroughly. 34. According to the Insurance Research Council, tolerance of insurance fraud is greatest in: a. Those between the ages of 75 and 85 b. Those between the ages of 18 and 24 c. Everyone over 65 d. Everyone under Three of the following are examples of what agency management can do to prevent insurance fraud. Which one is not a recommended action to accomplish this goal? a. Check out all employees through the state s insurance department b. Run criminal checks on all new employees because reference checks are often inadequate c. Turn the agency computer system off when there is no one in the office d. Establish a system of checks and balances, such as having documents signed by two people. 36. All of the following are true about the insurance agent and insurance fraud except: a. Regulators are taking a much closer look at sales practices across the industry. b. Courts are beginning to hold agents to higher standards about what they should have known and when. c. Agency executives also can be found liable for selling policies underwritten by insurers that turn out to be bogus. d. The insurance agent is not really impacted by insurance fraud at this time. 37. Many agents are angered when they read of internal insurance fraud because: a. They feel they are being ripped off. b. They feel the problem of insurance fraud committed by the consumer is much greater. c. They feel internal insurance fraud is an industry problem and should be handled by the industry without any publicity or outside interference. d. They feel such actions can only worsen the public perception of the industry. 38. In property and casualty insurance, approximately what percentage of a claims dollar can be attributed to insurance fraud? a. 1% b. 10% c. 50% d. 75%

9 39. Hard fraud is defined as: a. A deliberate attempt to state or invent an accident, injury, theft, or arson that would be covered under an insurance policy. b. A deliberate attempt to state or invent an accident, injury, theft, or arson that would not be covered under an insurance policy. c. An accidental accident or injury. d. An uncovered claim that is presented to an insurance company. 40. The following are indicators of a fraudulent auto loss except: a. A large valuable automobile rear-ends a poorly maintained, old, dented vehicle. b. More than one claimant involved in the same accident and they all treat with the same physician or chiropractor or are represented by the same attorney. c. The claimant has a medical history of soft tissue injuries. d. The accident was at lower speeds but the damages are over $ , The workers compensation system is being defrauded by three types of insurance fraud perpetrators: a. Dishonest claims professionals, dishonest underwriters, and dishonest agents b. Malingers, claims exaggerators, and the unemployed c. Dishonest claimants, dishonest professionals, and dishonest employers d. Insureds, insurance companies, and the workers compensation bureaus 42. All of the following are health insurance fraud most frequently reported by insurance companies except: a. Billing for services not rendered b. Billing done over 6 months after providing the service c. Billing under false procedure codes to raise the level of payment d. Billings coming from two or more providers for the same service to the same patient on the same day. 43. There are several reasons why insurance fraud received little public attention until the 1980 s. All of the following are included except: a. Insurance fraud before 1980 was practically non existent. b. Many insurers are afraid that a concerted effort to eradicate fraud might be perceived as an anti-consumer move. c. Law enforcement agencies had other priorities. d. The insurance industry has been able to pass the cost of insurance fraud on to consumers as a cost of doing business. 44. All of the following are common indicators of Workers Compensation fraud except: a. Injured worker is in seasonal work that is about to end b. Injured worker is a long-term employee c. Accident occurs late Friday afternoon or when the worker comes back on Monday d. Accident is not witnessed 45. All of the following are true of the attitude of the Moralist except: a. They have the least tolerance of insurance fraud. b. They are most willing to punish perpetrators severely. c. They are the smallest group of people. d. They are the largest group of people, comprising over 30% of those surveyed.

10 46. Three of the following are examples of what agency management can do to prevent insurance fraud. Which one is not a recommended action to accomplish this goal? a. Have every employee sign an anti-fraud pledge b. Audit all computer activities c. Adopt a culture in which fraud is not tolerated d. Let everyone know the agency will report suspected fraud 47. All of the following are indicators of insurance fraud except: a. A loss shortly after the issuance of the policy. b. The insured is not a U.S. citizen. c. Losses include a large amount of cash. d. The insured is unusually knowledgeable with regard to insurance terminology and the claims settlement process. 48. All of the following are common ways employers commit Workers Compensation fraud except: a. Understating payroll b. Mis-classification of employee job codes c. Failing to train new employees d. Experience Mod avoidance 49. The success of the battle against insurance fraud depends on all of the following except: a. The resources the insurance industry has devoted to detecting fraud b. The level of priority assigned by legislators, regulators, law enforcement agencies c. The attitudes of society as a whole to eradicating it. d. Insurance agents becoming the primary factor in the battle. 50. The areas in which insurance companies have become active in fighting insurance fraud include the following except: a. Establish SIUs b. Use databases c. Train employees and agents d. Train policyholders to spot and report fraud.