AIC Adjuster Level 2 Scenario Practice Guide
Use a five-step Level 2 file method to identify authority, classify the claim issue, request decisive evidence, choose a fair next action, and document escalation.
Scenario-practice scope
AIC Adjuster Level 2 scenarios are most useful when they train supervised claims judgment, not answer-pattern recognition. AIC does not publish a separate Level 2 exam; Finance Prep uses scenarios to help candidates practise the authority, evidence, communication, documentation, and escalation decisions associated with the licence route.
The five-step file method
| Step | Question | Output |
|---|---|---|
| 1. Establish authority | Who is acting, for whom, under whose supervision, and with what instruction or limit? | A clear authority boundary |
| 2. Classify the issue | Is this coverage, liability, valuation, damages, evidence, privacy, payment, recovery, service, or conduct? | One primary decision point |
| 3. Find the evidence gap | Which fact, wording, document, statement, inspection, estimate, or expert opinion would change the decision? | A targeted investigation step |
| 4. Choose the next action | What moves the file forward fairly without overpromising or prejudicing the insurer’s position? | A defensible supervised action |
| 5. Record and escalate | What must the note contain, and who must approve, countersign, instruct, or review? | A review-ready file entry |
Read the question stem once for the role and requested decision. Read it a second time for the fact that makes one option safer and more supportable than the others.
Walkthrough 1: coverage uncertainty
Facts: A water-loss file contains a declarations page, photographs, and a contractor estimate. The cause and duration of the leak are disputed, and the endorsement schedule is missing. The insured asks whether the claim will be paid.
Issue: Coverage remains uncertain. The estimate helps with scope and valuation, but it does not establish cause, duration, policy wording, or coverage.
Best Level 2 response: Explain that the coverage review is still in progress, obtain the complete wording and endorsement schedule, investigate cause and duration, document the missing facts, and submit a supportable recommendation for required review.
Weak responses: Promise payment because damage is visible; deny because the cause might be excluded; treat the contractor’s estimate as a coverage opinion; or avoid communicating until every fact is known.
Walkthrough 2: disputed property scope
Facts: An insured’s contractor includes emergency drying, repair of direct damage, replacement of an undamaged adjoining area, and an upgraded finish in one estimate. The insured wants the whole estimate approved immediately.
Issue: Scope, mitigation, matching or related repair, betterment, and valuation are mixed together.
Best Level 2 response: Separate emergency mitigation from permanent repair, identify direct damage and unsupported upgrades, compare the estimate with policy and inspection facts, request clarification where needed, and document a revised recommendation within authority.
Weak responses: Approve the total because one vendor submitted it; reject the total because one line is questionable; or negotiate a number before the covered scope is established.
Walkthrough 3: conflicting automobile evidence
Facts: Two drivers give opposite accounts of an intersection collision. The police report records statements but does not determine fault. Vehicle damage patterns and one independent witness may help.
Issue: Liability facts are incomplete. A report that records allegations is not the same as proof of fault.
Best Level 2 response: Preserve both statements, obtain the witness account and relevant scene or damage evidence, separate policy coverage from fault analysis, avoid admission, and prepare the liability facts for supervised review.
Weak responses: Adopt the insured’s account automatically; treat the police report as a final legal decision; admit liability to speed up repairs; or delay physical-damage handling when it can proceed separately under instruction.
Walkthrough 4: early bodily injury demand
Facts: A claimant requests immediate settlement. Treatment is ongoing, income-loss documents are incomplete, causation is disputed, and the adjuster has no confirmed settlement authority.
Issue: Damages, causation, privacy authorization, liability, and authority are unresolved.
Best Level 2 response: Explain the process without legal advice or a payment promise, identify the missing medical and income evidence, confirm proper consent, document the demand, and escalate the liability and authority questions.
Weak responses: Make a nominal offer merely to close the file; request unrestricted medical information; deny because documents are incomplete; or promise a settlement range without authority.
Walkthrough 5: suspicious invoice
Facts: A vendor invoice is materially higher than the prior estimate, payment instructions changed by email, and the vendor asks for urgent release of funds.
Issue: Invoice support and payment integrity require verification. Suspicious facts are indicators, not proof of fraud.
Best Level 2 response: Pause the unverified payment instruction, authenticate the vendor and change through approved channels, compare scope and supporting records, document objective discrepancies, and escalate under insurer and firm controls.
Weak responses: Accuse the vendor of fraud; pay because the file is urgent; change banking details from the email alone; or delete the invoice and restart without preserving the evidence.
Answer-choice filters
| Choice pattern | Why it is often weak |
|---|---|
| Immediate final decision | A decisive fact, wording, authority, or approval is still missing. |
| Broad true statement | It may describe insurance generally but not answer the file’s next decision. |
| Customer-service shortcut | It creates a promise, admission, privacy breach, or payment-control failure. |
| Total inaction | It ignores mitigation, communication, diary, evidence preservation, or a step that is within authority. |
| Automatic escalation | It passes the file upward without first gathering facts the Level 2 adjuster can properly obtain. |
| Absolute accusation | It converts an indicator or inconsistent fact into an unsupported conclusion. |
Review each answer like a file note
After a practice question, write one sentence for each:
- Issue: What was the real decision point?
- Decisive fact: Which fact made the best option stronger?
- Missing evidence: What remained unknown?
- Authority: What could Level 2 do, and who controlled the final decision?
- Control: Which privacy, payment, recovery, diary, or documentation step mattered?
Move from focused questions to mixed practice only when this five-line review becomes automatic. The goal is not to memorize a preferred phrase; it is to produce a supportable next action from new facts.