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| Section | Weight | Objectives |
|---|---|---|
| Adjusting Losses | 11% | - Claim Settlement
|
| Medical Reports and Terminology | 4% | - Medical Terminology
|
| Insurance Basics | 6% | - Insurance Principles
|
| Insurance Regulation | 6% | - Licensing Requirements
|
| Dwelling Policy | 6% | - Coverage Forms and Perils
|
| Homeowners Policy | 10% | - Coverage Forms
|
| Accident and Health Insurance Basics | 6% | - Limited Policies
|
| Personal Inland Marine | 13% | - Personal Effects Floater
|
| Commercial Package Policy | 38% | - Transportation Coverages
|
>> Insurance Licensing NY-Independent-General-Adjuster試験関連赤本 <<
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質問 # 81
Which of the following is NOT an expense that could be covered by the Comprehensive Motor Vehicle Insurance Reparations Act (PIP)?
正解：D
解説：
The correct answer is D - Property damage. New York's Comprehensive Motor Vehicle Insurance Reparations Act establishes the state's No-Fault / Personal Injury Protection system. PIP is designed to reimburse qualifying injured persons for basic economic loss resulting from bodily injury arising out of the use or operation of a motor vehicle, without regard to fault.
New York DFS states that basic No-Fault protection includes medical and health expenses, lost earnings, and certain other reasonable and necessary expenses. Medical expenses expressly include dental services, so both options A and C may qualify. Lost earnings are also expressly included, subject to statutory limitations.
Property damage is fundamentally different. Damage to another person's vehicle or other property is handled under property damage liability coverage, not first-party PIP benefits. PIP follows the injured person and addresses economic losses caused by personal injury; it does not reimburse the insured for physical damage to automobiles or other tangible property.
The Series 17-70 examination outline specifically includes the Comprehensive Motor Vehicle Insurance Reparations Act, mandatory Personal Injury Protection, basic economic loss, and New York auto coverage requirements.
Therefore, D is correct.
質問 # 82
A broken bone is the same as a
正解：B
解説：
The correct answer is A - fracture. A fracture is the medical term for a break in a bone. The break may be complete or partial and can be classified in numerous ways, including open versus closed, displaced versus nondisplaced, transverse, oblique, comminuted, stress, or other fracture patterns. MedlinePlus expressly identifies a fracture as a break in a bone and lists "broken bone" as an alternative description.
A dislocation differs because it involves bones being forced out of their normal relationship at a joint. A sprain involves ligaments, while a strain typically involves muscles or tendons. Although a serious traumatic event can produce more than one of these injuries simultaneously-for example, a fracture-dislocation-they remain medically distinct conditions.
For an independent general adjuster, accurate medical terminology is important when reviewing bodily injury claims. A diagnosis of fracture may affect emergency treatment, immobilization, surgery, rehabilitation, duration of disability, medical expenses, and the eventual evaluation of damages. The adjuster should therefore distinguish structural injury to bone from injuries involving joints, ligaments, muscles, and tendons.
Accordingly, the medical equivalent of a broken bone is a fracture, making A the only correct choice.
質問 # 83
Steve was involved in an automobile accident. He does NOT agree with the settlement offer by the insurer. Which common policy provision allows Steve to dispute the settlement offer?
正解：D
解説：
The correct answer is D - Arbitration. Arbitration is a dispute-resolution mechanism in which a disagreement is submitted to a neutral arbitrator or arbitration panel rather than being resolved solely through continued negotiations between the parties. Depending on the insurance coverage and policy provision involved, arbitration may be used to resolve specified disputes concerning entitlement to recovery, damages, or other issues identified in the contract or applicable law.
The question states that Steve rejects the insurer's settlement offer and asks which common policy provision provides a mechanism for disputing the settlement. Of the available choices, arbitration is the only recognized dispute-resolution provision.
A preferred settlement is not a standard policy dispute mechanism. A competitive bid is an estimating or procurement technique and does not determine contractual disputes between an insured and insurer. A market value clause concerns valuation methodology and does not itself create a formal procedure for resolving a contested settlement.
An adjuster must also distinguish arbitration from appraisal. Appraisal is commonly designed to resolve disputes solely over the amount of property loss, whereas arbitration can address disputes according to the scope established by the applicable contract or statute.
Series 17-70 reference topics: Auto Insurance - Claim Settlement, Arbitration, Appraisal, Loss Valuation, and Dispute Resolution.
質問 # 84
What is the policy limit for personal liability supplement under Coverage L of a dwelling policy?
正解：D
解説：
The correct examination answer is B - $100,000. A standard Dwelling Policy primarily provides property insurance; personal liability protection is added through the Personal Liability Supplement. Under that supplement, Coverage L - Personal Liability responds when an insured becomes legally liable for bodily injury or property damage caused by a covered occurrence. Coverage M separately provides Medical Payments to Others. The Series 17-70 outline expressly identifies the Personal Liability Supplement as a tested Dwelling Policy endorsement.
The traditional standard limit associated with Coverage L in licensing material is $100,000 per occurrence.
Policy analyses of the ISO dwelling liability supplement also illustrate Coverage L using a $100,000 limit.
A technical distinction is important for claims practice: the actual contractual limit is ultimately the amount shown in the policy declarations or Personal Liability Schedule. Therefore, higher limits may be purchased when offered by the insurer. The question is testing the standard/default licensing-exam limit rather than asserting that every dwelling liability supplement is permanently restricted to $100,000.
Coverage L also generally includes the insurer's defense obligation in addition to covered damages, subject to the policy's exclusions and conditions.
Therefore, the required answer is B.
質問 # 85
Charges for transporting a person injured in an aircraft accident by ambulance are covered under
正解：C
解説：
The correct answer is A - medical payments. Aircraft Medical Payments coverage is designed to pay specified reasonable medical expenses resulting from bodily injury sustained in connection with a covered aircraft accident, generally without requiring a determination of legal liability.
Aviation insurance guidance specifically identifies ambulance expenses among the costs payable under Aircraft Medical Payments coverage. AOPA explains that aircraft medical-payments protection can pay expenses including ambulance, surgical, dental, professional nursing, and related medical costs for qualifying injuries involving the insured aircraft. Standard aircraft liability wording likewise describes Medical Payments coverage as including necessary medical, surgical, ambulance, hospital, professional nursing, and funeral services, subject to the stated policy terms and limits.
A deductible, option B, is an amount retained by the insured and therefore is not a coverage category paying transportation charges. Premiums, option C, are the consideration paid for insurance. Fiduciary liability, option D, addresses breaches of fiduciary duties and has no connection with emergency medical transportation following an aircraft accident.
Medical Payments should also be distinguished from Aircraft Bodily Injury Liability. Liability coverage depends upon legal responsibility, whereas medical-payments protection is generally intended to fund relatively immediate medical expenses without first establishing negligence.
Therefore, A is correct.
質問 # 86
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