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| Section | Weight | Objectives |
|---|---|---|
| New York Insurance Law & Regulations | 25% | - NY Insurance Law Articles and DFS regulations - Licensing requirements, eligibility, and examination rules - Unfair Claims Settlement Practices Act / Regulation 64 - State-specific policy provisions and mandatory endorsements |
| Ethics & Professional Responsibility | 15% | - Fair claims handling standards and professional conduct - Fiduciary duty, conflict of interest, and confidentiality - Fraud detection and reporting obligations |
| Insurance Fundamentals & General Principles | 15% | - Insurance contract elements and legal structure - Indemnity, subrogation, utmost good faith - Risk management and insurable interest |
| Claims Investigation & Adjusting Procedures | 20% | - Evidence gathering, coverage analysis, and policy interpretation - Settlement negotiation, reservation of rights, and denial procedures - Loss valuation, damage assessment, and estimating - Claim intake, notice of loss, and initial investigation |
| Property & Casualty Coverages | 25% | - Automobile coverages — Personal and Commercial - Commercial Property and Businessowners policies - General Liability and Commercial General Liability - Dwelling and Homeowners policies - Specialty lines — Inland Marine, Flood, Workers' Compensation, Crime |
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NEW QUESTION # 95
Which of the following is an example of an unfair claim settlement practice?
Answer: D
Explanation:
The correct answer is A. New York Insurance Law §2601 identifies specified conduct as unfair claim settlement practices when performed without just cause with sufficient frequency to constitute a general business practice. One expressly identified practice is failing to attempt in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear. Deliberately or unjustifiably delaying such a settlement therefore falls directly within the regulatory concept tested by this question.
Option C describes the opposite behavior. Insurers are expected to adopt and implement reasonable standards for prompt claim investigation and settlement. Failure to establish reasonable standards may itself support an unfair-practices finding.
Option D is likewise inconsistent with an unfair-practice answer because accurate disclosure of relevant coverage or settlement provisions promotes informed claim handling. Misrepresentation or improper withholding of material policy information, rather than appropriate disclosure, raises regulatory concerns.
Option B does not describe an unfair claim settlement practice on the facts given.
The official New York Series 17-70 blueprint specifically includes Claim Settlement Laws and Regulations- Regulation 64, Part 216, and Unfair Claim Practices-Insurance Law §2601 under Insurance Regulation.
Accordingly, the conduct in A is the regulatory violation contemplated by the question.
NEW QUESTION # 96
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 # 97
One of the MAIN purposes of the automobile mandatory inspection requirement is to
Answer: C
Explanation:
The correct answer is D. New York's mandatory automobile physical-damage inspection requirements are fundamentally an anti-fraud and loss-verification mechanism. By inspecting and documenting the automobile when collision or comprehensive coverage is written, the insurer establishes the vehicle's pre-insurance physical condition. If a later claim is submitted, the insurer can compare claimed damage with the condition documented before or at the inception of physical-damage coverage.
New York DFS explains that when physical-damage coverage applies, the insurer inspects and photographs the automobile for comparison purposes if future damages are claimed. That directly supports D: the process helps prevent payment for pre-existing damage incorrectly presented as having occurred during the policy period.
The inspection is not primarily intended to surcharge vehicles because they are cosmetically imperfect, making A incorrect. It is not a consumer notification program concerning scratches or dents, eliminating B.
Nor does it guarantee that covered vehicles are in "top condition," so C is incorrect.
The Series 17-70 examination outline expressly identifies mandatory inspection requirements for private passenger automobiles under Regulation 79, Parts 67.0-67.11 as an Auto Insurance examination subject.
NEW QUESTION # 98
Which of the following is covered by the Causes of Loss - Special Form under commercial property?
Answer: D
Explanation:
The correct answer is D - Windstorm. The Commercial Property Causes of Loss - Special Form is written on an open-perils basis. Instead of providing coverage only for specifically named perils, it defines covered causes of loss broadly as risks of direct physical loss unless the cause is expressly excluded or limited.
Windstorm is not generally excluded by the standard Special Form and is therefore ordinarily covered. By contrast, the form expressly excludes smog and includes broad water exclusions encompassing flood, surface water, waves, tides, and mudslide or mudflow. The actual ISO-derived Special Form wording identifies those exclusions directly. New York case law applying the Special Form likewise recognizes flood and mudslide
/mudflow within the standard water exclusion.
This illustrates the key distinction between Basic, Broad, and Special Causes of Loss forms. With a named- peril form, the insured generally begins by demonstrating that a listed peril caused the damage. With Special Form coverage, direct physical loss is presumptively within the broad coverage grant unless an exclusion or limitation applies.
An adjuster must therefore examine the causal mechanism and then determine whether a Special Form exclusion applies.
Among the four choices, Windstorm is the covered cause of loss.
Therefore, D is correct.
NEW QUESTION # 99
Which is NOT a type of bond?
Answer: C
Explanation:
The correct answer is A - Obligee. An obligee is not a type of surety bond; it is one of the three parties to a surety bond. The three parties are the principal, the obligee, and the surety. The principal is the party whose performance or obligation is guaranteed. The obligee is the party requiring and benefiting from the bond. The surety is the organization that guarantees the principal's obligation according to the bond terms.
By contrast, bid bonds and performance bonds are recognized types of contract surety bonds. A bid bond supports the bidder's commitment to enter the contract and furnish required security if awarded the job. A performance bond guarantees that the principal will perform the contractual obligations covered by the bond.
"Court bond" is commonly used as a broad description for bonds required in judicial proceedings. The official Series 17-70 outline categorizes these as judicial bonds and separately lists such forms as attachment, replevin, appeal, injunction, and cost bonds.
The Series 17-70 outline makes the distinction explicit: it lists Principal, Obligee, and Surety under "Parties of a surety bond," while Bid and Performance appear under types of contract bonds, and judicial bonds appear as another bond category.
NEW QUESTION # 100
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