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| Section | Weight | Objectives |
|---|---|---|
| Claims Investigation & Adjusting Procedures | 20% | - Loss valuation, damage assessment, and estimating - Settlement negotiation, reservation of rights, and denial procedures - Evidence gathering, coverage analysis, and policy interpretation - Claim intake, notice of loss, and initial investigation |
| Property & Casualty Coverages | 25% | - Commercial Property and Businessowners policies - General Liability and Commercial General Liability - Specialty lines — Inland Marine, Flood, Workers' Compensation, Crime - Dwelling and Homeowners policies - Automobile coverages — Personal and Commercial |
| New York Insurance Law & Regulations | 25% | - State-specific policy provisions and mandatory endorsements - Licensing requirements, eligibility, and examination rules - NY Insurance Law Articles and DFS regulations - Unfair Claims Settlement Practices Act / Regulation 64 |
| Insurance Fundamentals & General Principles | 15% | - Indemnity, subrogation, utmost good faith - Insurance contract elements and legal structure - Risk management and insurable interest |
| Ethics & Professional Responsibility | 15% | - Fraud detection and reporting obligations - Fair claims handling standards and professional conduct - Fiduciary duty, conflict of interest, and confidentiality |
>> NY-Independent-General-Adjuster認定資格 <<
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質問 # 23
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 # 24
Leah provides transportation for her client to their business lunch. Leah's client closes the car door on her own hand. What type of coverage applies?
正解：A
解説：
The correct answer is C - Medical payments. Automobile Medical Payments coverage is designed to pay qualifying medical and funeral expenses for the insured and passengers injured in an accident involving the covered automobile, without regard to fault, up to the stated policy limit. New York DFS expressly describes Medical Payments Coverage in these terms.
The client closes the vehicle door on her own hand. No fact establishes negligence by Leah, so liability coverage is not the best answer. Liability coverage ordinarily responds when an insured becomes legally responsible for bodily injury or property damage to another person. Here, the passenger's own action caused the injury.
Physical Damage coverage is also incorrect because it protects against damage to the automobile itself, not bodily injury sustained by a passenger. Health insurance may ultimately address certain medical expenses depending on coordination-of-benefits rules, but it is not the automobile coverage specifically designed for this scenario.
In New York, mandatory No-Fault/PIP may also be relevant to injuries arising from the use or operation of a motor vehicle and is generally primary to health insurance. However, PIP is not one of the options. Among the listed answers, Medical Payments is the intended coverage classification.
Therefore, C is correct.
質問 # 25
Accident-only policies commonly include benefits due to losses related to
正解：C
解説：
The correct answer is C. Accident-only insurance is a limited form of accident and health coverage in which benefits are triggered by an accident or specified category of accidental event, rather than by sickness generally. The NAIC defines an accident as an unexpected event or circumstance without deliberate intent and describes accident-only insurance as coverage for death, dismemberment, disability, hospital treatment, or medical care caused or necessitated by an accident or specified kinds of accidents.
Option A is incorrect because illness is not converted into an accident simply because its onset is unexpected.
Coverage for sickness belongs to health or medical insurance provisions unless specifically included by another policy form. Option B, congenital diseases, similarly concerns medical conditions rather than accidental occurrences. Option D is too broad because the mere absence of intentional conduct does not automatically satisfy the policy's definition of an accidental injury or covered accident. There must be the required causal connection to an insured accidental event.
The Series 17-70 content outline expressly tests Accidental Injury, classes of accident and health coverage, limited policies, and specifically Accident-Only coverage.
Accordingly, a fortuitous, unexpected accidental event is the operative trigger, making C the correct answer.
質問 # 26
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：C
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 # 27
The liability section of a businessowners policy (BOP) covers which of the following?
正解：A
解説：
The correct answer is D - Customer injured on the business premises. The Businessowners Policy liability section protects an eligible business against covered legal liability for bodily injury, property damage, and personal and advertising injury arising from covered business operations. A customer who is injured on the insured premises represents a classic premises-liability exposure.
Option A concerns first-party property damage to the insured building. A roof damaged by a covered windstorm would therefore be analyzed under the BOP property section, not business liability coverage.
Option B is incorrect because bodily injury to an employee arising out of and in the course of employment is generally excluded from ordinary BOP business liability coverage and is instead addressed by Workers Compensation and Employers Liability insurance.
Option C is also incorrect in the ordinary BOP liability form because bodily injury arising from ownership, maintenance, or use of autos is subject to the policy's auto exclusion. Commercial auto exposures typically require separate Business Auto coverage or an applicable BOP endorsement for limited hired/nonowned auto liability.
The official Series 17-70 blueprint expressly tests the Businessowners liability coverage form, coverages, exclusions, who is an insured, limits, general conditions, and hired/nonowned auto endorsements.
Therefore, D is correct.
質問 # 28
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