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| Section | Weight | Objectives |
|---|---|---|
| New York Unfair Claim Settlement and Prohibited Practices | - Consumer privacy requirements - Terrorism Risk Insurance Act - Unfair claim settlement practices - New York cybersecurity regulation - New York claim settlement laws and regulations - Insurance fraud and false statements | |
| Claims Adjustment Procedures | - Mediation - Subrogation procedures - Alternative dispute resolution - Non-waiver agreements - Claims adjustment procedures - Appraisal - Negotiation - Reservation of rights letters - Advance payments - Arbitration - Execution of releases - Releases - Settlement procedures - Coverage problems - Competitive estimates - Draft authority | |
| Dwelling and Homeowners Insurance | - Homeowners liability coverage - Dwelling policies - Personal liability supplement - Standard Fire Policy - Homeowners property coverage - Personal umbrella policies - New York specific endorsements | |
| Other Property and Liability Coverages | - Flood insurance - Workers compensation - Inland marine - Commercial automobile - Ocean marine - Surety and fidelity bonds - Crime insurance - Aviation insurance - Excess liability - Personal automobile | |
| Commercial Property | - Commercial property coverage - Commercial Package Policy - Commercial General Liability - Commercial property forms and endorsements - Businessowners Policy | |
| Insurance Regulation | - Licensing process - Temporary adjuster permits - License maintenance and duration - Qualifications - Licensing requirements - License renewal - Bond requirements - Fingerprinting | |
| Commercial Package Policy | 38% | - First named insured - Components of a commercial policy - Common policy declarations - Monoline versus package policies - Common policy conditions |
| Insurance Principles and Concepts | - Physical hazards - Concealment - Moral hazards - Warranties - Insurance contracts - Waiver and estoppel - Representations and misrepresentations - Hazards - Morale hazards - Insurance principles and concepts - Fraud - Insurable interest |
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NEW QUESTION # 50
When investigating a liability claim against your insured, the insured calls you and requests that you deny the claim because the insured believes the claim lacks merit. As the adjuster you CANNOT
Answer: D
Explanation:
The correct answer is B. An independent adjuster's claim decision must be based on the policy, facts, evidence, applicable law, and authority received from the insurer, not merely on the insured's preference that a third-party claim be rejected. An insured's assertion that a claim is meritless is relevant information, but it does not substitute for an objective investigation.
New York Regulation 64 establishes prompt and fair claims-handling standards. DFS states that insurers should assist in claim processing, obtain verification where reasonably necessary, clearly communicate positions on disputed matters, and respond promptly to interested parties. DFS also identifies unfair claims settlement practices as prohibited conduct.
Accordingly, the adjuster may inform the insurer of the insured's position, making A permissible. The adjuster can also decline to follow an unsupported instruction to deny the claim, so C is permissible. Contacting the claimant to investigate the circumstances is an appropriate fact-development step, making D permissible.
What the adjuster cannot properly do is deny liability simply because the insured wants a denial. Such action would bypass the required investigation and professional evaluation.
The Series 17-70 outline specifically tests the adjuster's role, duties and responsibilities, claim investigation, liability-loss investigation procedures, verification, and settlement procedures.
NEW QUESTION # 51
After a loss occurs to an insured automobile, according to the conditions of a personal automobile insurance policy, what MUST the insured party do?
Answer: B
Explanation:
The correct answer is D - Permit the insurer to inspect the vehicle before it is repaired. Under the Personal Auto Policy's duties following an accident or loss, a person seeking physical-damage coverage must give the insurer a reasonable opportunity to inspect and appraise damaged property before repair or disposal. This allows the carrier to document the damage, determine whether it resulted from a covered cause of loss, evaluate repairability, estimate repair costs, establish actual cash value where necessary, and determine whether the automobile constitutes a total loss. Standard personal-auto policy language expressly imposes this duty.
Option A is not universally required for every collision. Police notification is specifically required by the standard policy for situations such as theft, while state law may independently impose accident-reporting obligations in particular circumstances. Option B concerns maintaining coverage before the loss, not a post- loss claim duty. Option C does not express the relevant physical-damage requirement.
The insured must also take reasonable steps to protect the covered auto against further loss and comply with other cooperation and documentation requirements.
The official Series 17-70 outline expressly includes Personal Auto Policy-Coverage for Damage to Your Auto and Duties After an Accident or Loss.
Therefore, the required answer is D.
NEW QUESTION # 52
Which of the following benefits are NOT paid under workers' compensation laws?
Answer: B
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 # 53
A limit of insurance that determines the maximum amount that can be paid out annually is
Answer: B
Explanation:
The correct answer is C - an aggregate limit. An aggregate limit establishes the maximum amount an insurer will pay for all covered claims subject to that aggregate during the applicable policy period, ordinarily one year. The Hartford describes an aggregate limit as the maximum amount an insurer pays for all claims during the policy period.
This must be distinguished from an occurrence limit, which caps the amount payable for one occurrence. For example, a liability policy might provide a $1 million each-occurrence limit and a $2 million general aggregate. Multiple individually covered occurrences can therefore consume the aggregate until the total available limit has been exhausted.
A single limit generally refers to one combined limit rather than separate limits for different components, such as bodily injury and property damage. "Face amount" is terminology more commonly associated with life insurance or other contracts stating a specified benefit amount and does not describe an annual liability ceiling.
The official Series 17-70 outline specifically tests policy limits, per-occurrence limits, per-person limits, general and products/completed-operations aggregate limits, single/split limits, and combined single limits.
Thus, when the question asks for the limit controlling the maximum cumulative payout during the annual policy period, aggregate limit is the precise insurance term.
Therefore, C is correct.
NEW QUESTION # 54
An example of the insured's consideration is
Answer: C
Explanation:
The correct answer is B. Consideration is one of the elements required for an enforceable insurance contract.
Consideration means something of legal value exchanged between the contracting parties. From the insured's side of an insurance transaction, the principal consideration consists of the premium, together with the representations and promises made in the application. From the insurer's side, consideration is the contractual promise to provide the insurance protection and pay covered claims according to the policy terms.
Of the available choices, a paid premium is therefore the clearest and most direct example of the insured's consideration. An application, option A, is primarily the mechanism through which the prospective insured requests coverage and provides underwriting information; the application itself is not the best answer to what constitutes consideration. A contract-signing requirement is procedural rather than the exchanged value supporting the contract. A notice of beneficiary is associated with identifying or changing the person entitled to receive certain policy benefits and is unrelated to contractual consideration.
The official Series 17-70 examination outline specifically places Contract Basics, Elements of a Legal Contract, Offer and Acceptance, and Consideration under Insurance Basics.
Accordingly, the premium supplied by the insured in exchange for the insurer's promise of coverage makes B correct.
NEW QUESTION # 55
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