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| Section | Weight | Objectives |
|---|---|---|
| Other Property and Liability Coverages | - Flood insurance - Ocean marine - Surety and fidelity bonds - Workers compensation - Aviation insurance - Inland marine - Personal automobile - Excess liability - Commercial automobile - Crime insurance | |
| Commercial Package Policy | 38% | - Components of a commercial policy - Common policy conditions - First named insured - Common policy declarations - Monoline versus package policies |
| Dwelling and Homeowners Insurance | - Homeowners liability coverage - New York specific endorsements - Dwelling policies - Homeowners property coverage - Standard Fire Policy - Personal umbrella policies - Personal liability supplement | |
| Commercial Property | - Commercial property coverage - Commercial property forms and endorsements - Businessowners Policy - Commercial General Liability - Commercial Package Policy | |
| Insurance Principles and Concepts | - Insurance contracts - Fraud - Concealment - Representations and misrepresentations - Insurance principles and concepts - Warranties - Morale hazards - Hazards - Moral hazards - Physical hazards - Waiver and estoppel - Insurable interest | |
| Insurance Regulation | - Fingerprinting - Licensing requirements - Qualifications - Temporary adjuster permits - Licensing process - License maintenance and duration - License renewal - Bond requirements | |
| New York Unfair Claim Settlement and Prohibited Practices | - Terrorism Risk Insurance Act - Insurance fraud and false statements - Unfair claim settlement practices - New York cybersecurity regulation - Consumer privacy requirements - New York claim settlement laws and regulations | |
| Claims Adjustment Procedures | - Mediation - Competitive estimates - Claims adjustment procedures - Negotiation - Settlement procedures - Appraisal - Draft authority - Releases - Coverage problems - Arbitration - Alternative dispute resolution - Subrogation procedures - Execution of releases - Reservation of rights letters - Non-waiver agreements - Advance payments |
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NEW QUESTION # 46
In a subrogation process, the role of the adjuster is to
Answer: B
Explanation:
The correct answer is C. Subrogation permits an insurer that has paid a covered loss to step into the insured's rights, to the extent permitted by law and the policy, and pursue the third party legally responsible for causing that loss.
The New York Court of Appeals defines subrogation as the principle by which an insurer, after paying its insured's loss, is placed in the insured's position so that the insurer can recover from the legally responsible third party. The doctrine both prevents double recovery and ultimately places the financial burden on the responsible party.
An adjuster's role includes recognizing subrogation potential, identifying responsible parties, preserving evidence, documenting liability, calculating the insurer's recoverable payment, and referring or pursuing the recovery according to carrier procedures. Thus, determining the amount that may properly be recovered from the third party is directly relevant.
Option B reverses the relationship: the adjuster is not determining damages for the tortfeasor. Option D is nonsensical in the subrogation context because the responsible third party does not owe insurance premium to the insurer. Option A is inconsistent with the need to establish the third party's legal responsibility.
The Series 17-70 outline expressly includes subrogation as a common policy provision and subrogation procedures within claims adjustment.
Therefore, C is correct.
NEW QUESTION # 47
When it comes to liability on a Businessowners Policy, the insurer's duty to defend ends if the
Answer: A
Explanation:
The correct answer is B. Under Businessowners liability coverage, the insurer ordinarily has both a duty to indemnify for covered damages and a duty to defend the insured against qualifying suits. The defense obligation is broad, but it is not unlimited.
Standard BOP wording provides that the insurer's duty to defend terminates when the applicable limit of insurance has been used up through payment of judgments or settlements. Importantly, merely offering or depositing the policy limit is not necessarily sufficient; exhaustion must occur in accordance with the policy's contractual language.
Option A has no relationship to the policy's defense obligation. Tax-payment status is not a BOP liability- defense trigger. Option C can eventually create policy cancellation or lapse issues if premium obligations are not satisfied, but it does not describe the specific provision controlling termination of defense after a covered liability claim has arisen. Option D is entirely unsupported by the contract: an insurer cannot terminate its contractual defense obligation simply because it considers the insured's prior claim history excessive.
The Series 17-70 outline specifically tests Businessowners liability coverage, limits of insurance, liability exclusions, conditions, and claim handling.
Therefore, once the applicable liability limit has been properly exhausted through judgments or settlements, the duty to defend can end.
Thus, B is correct.
NEW QUESTION # 48
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?
Answer: C
Explanation:
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.
NEW QUESTION # 49
A broken bone is the same as a
Answer: A
Explanation:
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.
NEW QUESTION # 50
What is NOT an element of verifying coverage?
Answer: C
Explanation:
The correct answer is D - The value of the claim. Coverage verification is performed to determine whether the insurance contract potentially responds to the reported occurrence. The adjuster first confirms that the policy was in force on the date of loss, because a loss occurring outside the effective policy period normally cannot trigger that contract. The adjuster must also establish that the claimant or affected party qualifies as the named insured or another insured person under the applicable provisions.
For a property claim, the adjuster must verify that the damaged property is property insured by the contract, at an insured location where applicable, and subject to the relevant coverage. These are fundamental coverage questions.
The value of the claim, however, concerns loss measurement rather than initial coverage verification. Once coverage has been established, the adjuster evaluates the extent of damage, repair or replacement costs, actual cash value or replacement cost provisions, depreciation, deductibles, limits, coinsurance, and other valuation considerations.
Coverage and valuation must therefore be distinguished. A loss may be covered even though its final monetary value has not yet been determined.
Series 17-70 reference topics: Insurance Basics - Policy Period, Named Insured, Covered Property, Coverage Analysis, Loss Adjustment, and Claim Valuation.
NEW QUESTION # 51
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