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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: New York Unfair Claim Settlement and Prohibited Practices | - New York cybersecurity regulation - Insurance fraud and false statements - Consumer privacy requirements - Unfair claim settlement practices - New York claim settlement laws and regulations - Terrorism Risk Insurance Act | |
| Topic 2: Claims Adjustment Procedures | - Claims adjustment procedures - Competitive estimates - Subrogation procedures - Reservation of rights letters - Execution of releases - Arbitration - Alternative dispute resolution - Releases - Appraisal - Advance payments - Mediation - Coverage problems - Settlement procedures - Draft authority - Negotiation - Non-waiver agreements | |
| Topic 3: Commercial Property | - Commercial property forms and endorsements - Businessowners Policy - Commercial property coverage - Commercial General Liability - Commercial Package Policy | |
| Topic 4: Insurance Regulation | - Licensing requirements - Qualifications - Fingerprinting - License maintenance and duration - Temporary adjuster permits - License renewal - Licensing process - Bond requirements | |
| Topic 5: Insurance Principles and Concepts | - Fraud - Insurance contracts - Moral hazards - Morale hazards - Hazards - Insurance principles and concepts - Insurable interest - Waiver and estoppel - Warranties - Physical hazards - Representations and misrepresentations - Concealment | |
| Topic 6: Other Property and Liability Coverages | - Personal automobile - Inland marine - Aviation insurance - Excess liability - Commercial automobile - Crime insurance - Workers compensation - Flood insurance - Surety and fidelity bonds - Ocean marine | |
| Topic 7: Commercial Package Policy | 38% | - Common policy conditions - Common policy declarations - Components of a commercial policy - Monoline versus package policies - First named insured |
| Topic 8: Dwelling and Homeowners Insurance | - Homeowners liability coverage - Homeowners property coverage - New York specific endorsements - Personal umbrella policies - Standard Fire Policy - Dwelling policies - Personal liability supplement |
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NEW QUESTION # 54
Which of the following benefits are NOT paid under workers' compensation laws?
Answer: A
Explanation:
The correct answer is C - Pain and suffering. Workers compensation is a statutory no-fault system designed to provide defined benefits for employees who suffer qualifying occupational injuries or illnesses. New York Workers' Compensation Board guidance identifies benefits including medical care, lost-wage benefits, disability-related awards, survivor benefits, and vocational rehabilitation services.
Workers compensation does not function like a negligence tort action. An injured employee generally does not receive damages for noneconomic elements such as pain, suffering, emotional distress, inconvenience, or loss of enjoyment of life merely because those consequences accompany the occupational injury. Statutory benefits replace the ordinary tort remedy against the employer for covered injuries, subject to limited exceptions under New York law.
Option A is therefore incorrect because vocational rehabilitation services are available to assist qualifying injured workers in returning to employment. Option D is incorrect because cash benefits for disability or lost earning capacity are fundamental workers compensation benefits. Independent medical examinations can also be required within the administration of workers compensation claims; they are not equivalent to tort damages for pain and suffering.
The Series 17-70 outline specifically tests New York Workers Compensation Law, exclusive remedy, covered injuries, benefits provided, disability, medical benefits, and claim procedures.
NEW QUESTION # 55
If a businessowner has a loss, which of the following will the insurer REQUIRE from the insured to assist in the business interruption portion of the claim?
Answer: C
Explanation:
The correct answer is A. A business interruption or Business Income claim requires documentary evidence sufficient to establish what the business would probably have earned had the covered loss not occurred.
Financial records are therefore indispensable. Relevant documentation commonly includes profit-and-loss statements, sales records, payroll information, general ledgers, prior financial statements, income-tax returns, and associated tax schedules.
The standard Business Income coverage conditions authorize the insurer, as often as reasonably required, to examine the insured's books and records and make copies. This enables the adjuster to reconstruct historical income, determine continuing and noncontinuing expenses, identify trends, evaluate the period of restoration, and calculate the actual Business Income loss.
An examination under oath can also be required during a claim investigation, but it is not the best answer to what specifically assists with the business interruption calculation. Furniture and fixture inventories principally support physical property claims. An onsite inspection likewise assists investigation but does not provide the financial evidence needed to quantify lost earnings.
The official Series 17-70 outline specifically tests Business Income/Extra Expense, Business Interruption/time element, and the insured's duty to produce books and records after loss.
NEW QUESTION # 56
The self-insured portion of an insurance claim is called a
Answer: C
Explanation:
The correct answer is D - deductible. A deductible is the amount of an otherwise covered loss that the insured agrees to retain before or as part of the insurer's claim payment. In practical terms, it represents a form of self-insurance or risk retention within the policy.
New York Department of Financial Services defines an automobile physical-damage deductible as an amount the insured agrees to be responsible for in the event of a covered collision or comprehensive loss. DFS also explains that increasing the deductible generally shifts a larger portion of potential loss to the insured and can reduce the insurance premium.
For example, if a covered property loss is $8,000 and the policy contains a $1,000 deductible, the insurer ordinarily pays $7,000, assuming no other limitation applies. The insured absorbs the first $1,000.
Coinsurance is different. It is an insurance-to-value mechanism that can reduce recovery when the insured fails to maintain the required amount of insurance. A principal is a party or amount concept used in other financial or surety contexts. Liability describes legal responsibility and is not the portion of a loss retained by the insured.
The Series 17-70 outline specifically tests deductibles, loss valuation, policy limits, coinsurance, and claim settlement calculations.
Therefore, D is correct.
NEW QUESTION # 57
A commercial umbrella policy provides coverage in which of the following situations?
Answer: C
Explanation:
The correct answer is D. A commercial umbrella policy provides an additional layer of liability insurance above specified underlying policies, such as Commercial General Liability, Business Auto Liability, or Employers Liability. For a loss covered by both the underlying policy and umbrella, the umbrella generally begins responding after the applicable underlying limits have been exhausted by covered loss, subject to the umbrella's terms, limits, exclusions, and attachment requirements.
Travelers describes umbrella coverage as providing additional limits for types of losses covered by primary policies, while excess liability functions as another layer over primary protection. The Series 17-70 outline specifically tests commercial umbrella coverage, underlying limits, excess coverage, stand-alone coverage, and follow-form concepts.
Option A is incorrect because an umbrella ordinarily does not automatically drop down merely because an underlying insurer becomes insolvent; insolvency treatment depends on the umbrella's exact wording. Option B refers to a personal-auto exposure rather than the commercial liability structure asked about. Option C is incorrect because a loss still within the retained underlying limit is principally the responsibility of the underlying insurer or insured retention.
Thus, once the required underlying policy limits have been exhausted by covered claims, the umbrella layer can attach.
Therefore, D is correct.
NEW QUESTION # 58
Which of the following is the medical abbreviation for getting something done immediately?
Answer: C
Explanation:
The correct answer is B - Stat. The medical abbreviation "stat" derives from the Latin statim, meaning immediately. In medical documentation and treatment instructions, a stat order indicates that the specified procedure, medication, diagnostic test, or other clinical action should be performed without ordinary scheduling delay because prompt action is required.
Option A, A and P, does not mean immediately. Depending on context, similar abbreviations may refer to anatomy and physiology or another clinical designation. Option C, Rx, commonly refers to a prescription, prescribed treatment, or therapy and does not establish urgency. Option D, DNR, means Do Not Resuscitate and identifies an instruction concerning cardiopulmonary resuscitation rather than the timing of treatment.
Medical terminology is relevant to accident and health claim adjustment because adjusters must accurately interpret medical records, physician reports, treatment documentation, hospital bills, diagnostic information, and indications of emergency care. A misunderstanding of basic medical terminology can materially affect evaluation of causation, necessity of treatment, disability periods, and damages.
Accordingly, where a medical record directs that an action be performed immediately, "stat" is the recognized term.
Series 17-70 reference topics: Other Coverages - Accident and Health Claims, Medical Terminology, Medical Documentation, and Evaluation of Treatment Records.
NEW QUESTION # 59
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