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Insurance Licensing NY-Independent-General-Adjuster Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Personal Inland Marine13%- Personal Effects Floater
  • 1. Coverage and Loss Settlement
    - Personal Articles Floater
    • 1. Scheduled Personal Property
      - Personal Property Floater
      • 1. Coverage and Eligible Property
        Topic 2: Dwelling Policy6%- Coverage Forms and Perils
        • 1. Covered Perils
          • 2. Basic, Broad and Special Forms
            - Exclusions, Conditions and Endorsements
            • 1. New York and Selected Endorsements
              • 2. General Exclusions and Conditions
                - Property Coverages
                • 1. Personal Property and Loss of Use
                  • 2. Dwelling and Other Structures
                    Topic 3: Medical Reports and Terminology4%- Medical Terminology
                    • 1. Medical Specialties
                      • 2. Prefixes, Suffixes and Abbreviations
                        - Basic Human Anatomy
                        • 1. Cardiovascular and Abdominal Systems
                          • 2. Skeletal, Nervous and Respiratory Systems
                            - Injuries, Diseases and Medical Tests
                            • 1. Common Injuries and Diseases
                              • 2. Diagnostic Tests
                                Topic 4: Insurance Regulation6%- Disciplinary Actions
                                • 1. Penalties and Cease and Desist Orders
                                  • 2. Suspension and Revocation
                                    - Claim Settlement Regulations
                                    • 1. Unfair Claim Practices
                                      • 2. Consumer Privacy
                                        - Licensing Requirements
                                        • 1. Bond and Fingerprinting
                                          • 2. Qualifications and Application
                                            - License Maintenance
                                            • 1. Assumed Names and Reporting
                                              • 2. Renewal and Changes
                                                Topic 5: Accident and Health Insurance Basics6%- Limited Policies
                                                • 1. Accident-Only and Specified Disease
                                                  • 2. Hospital, Dental and Vision Coverage
                                                    - Accident and Health Claims
                                                    • 1. Notice and Proof of Loss
                                                      • 2. Investigation and Payment of Claims
                                                        - Types of Coverage
                                                        • 1. Disability, Medical and Long-Term Care
                                                          • 2. Accidental Injury and Sickness
                                                            Topic 6: Adjusting Losses11%- Role of the Adjuster
                                                            • 1. Independent, Staff and Public Adjusters
                                                              • 2. Duties and Responsibilities
                                                                - Claim Investigation
                                                                • 1. Evidence and Witness Statements
                                                                  • 2. Claim Reporting and Documentation
                                                                    - Claim Settlement
                                                                    • 1. Subrogation, Appraisal and Arbitration
                                                                      • 2. Negotiation and Releases
                                                                        - Property and Liability Losses
                                                                        • 1. Coverage Verification and Loss Evaluation
                                                                          • 2. Estimates, Depreciation and Salvage
                                                                            Topic 7: Commercial Package Policy38%- Commercial Policy Components
                                                                            • 1. Common Policy Conditions
                                                                              • 2. Common Policy Declarations
                                                                                - Commercial Inland Marine
                                                                                • 1. Contractors Equipment and Installation Floaters
                                                                                  • 2. Accounts Receivable and Valuable Papers
                                                                                    • 3. Jewelers Block, Signs and Electronic Data Processing
                                                                                      • 4. Marine Definition and Conditions
                                                                                        - Transportation Coverages
                                                                                        • 1. Common Carrier Legal Liability
                                                                                          • 2. Motor Truck Cargo
                                                                                            • 3. Transit Coverage
                                                                                              Topic 8: Insurance Basics6%- Insurance Principles
                                                                                              • 1. Insurable Interest and Indemnity
                                                                                                • 2. Causes and Valuation of Loss
                                                                                                  • 3. Hazards, Negligence and Liability
                                                                                                    - Policy Structure
                                                                                                    • 1. Limits, Deductibles and Other Insurance
                                                                                                      • 2. Subrogation, Salvage and Loss Settlement
                                                                                                        • 3. Declarations, Conditions and Exclusions
                                                                                                          - Insurance Contracts
                                                                                                          • 1. Elements and Characteristics
                                                                                                            • 2. Representations, Warranties and Concealment
                                                                                                              Topic 9: Homeowners Policy10%- Selected Endorsements
                                                                                                              • 1. Earthquake, Identity Fraud and Home Business
                                                                                                                • 2. New York Special Provisions
                                                                                                                  - Coverage Forms
                                                                                                                  • 1. HO-8
                                                                                                                    • 2. HO-2 through HO-6
                                                                                                                      - Perils, Exclusions and Conditions
                                                                                                                      • 1. Perils Insured Against
                                                                                                                        • 2. Exclusions and Conditions
                                                                                                                          - Property Coverages
                                                                                                                          • 1. Dwelling, Other Structures and Personal Property
                                                                                                                            • 2. Loss of Use and Additional Coverages
                                                                                                                              - Liability Coverages
                                                                                                                              • 1. Personal Liability
                                                                                                                                • 2. Medical Payments to Others

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                                                                                                                                  Popular NY-Independent-General-Adjuster Exams | NY-Independent-General-Adjuster Test Questions Answers

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                                                                                                                                  Insurance Licensing NewYorkIndependent General Adjuster (Series 17-70) Sample Questions (Q106-Q111):

                                                                                                                                  NEW QUESTION # 106
                                                                                                                                  Which of the following factors is NOT used to determine if an injury qualifies for Workers' Compensation coverage?

                                                                                                                                  Answer: B

                                                                                                                                  Explanation:
                                                                                                                                  The correct answer is D - Severity of injury. For an accidental injury to qualify under New York Workers' Compensation Law, the central coverage inquiry is whether the injury arose out of and occurred in the course of employment. The New York Workers' Compensation Board specifically explains that "in the course of employment" concerns whether an injury occurred at a time, place, and under circumstances related to employment.
                                                                                                                                  Accordingly, the time of the accident, its location, and the circumstances surrounding the event are directly relevant to determining whether the necessary employment nexus exists. For example, an injury at the employer's premises while performing assigned work normally presents a much stronger employment connection than an injury sustained during an unrelated personal activity.
                                                                                                                                  The severity of an injury is different. Severity may materially affect medical treatment, disability classification, duration of benefits, permanency, lost wages, and the amount ultimately payable. It does not, however, determine whether the injury initially arose out of and in the course of employment. Even a comparatively minor qualifying workplace injury can fall within Workers Compensation.
                                                                                                                                  The Series 17-70 outline expressly tests employment covered, covered injuries, benefits provided, occupational disease, and New York Workers' Compensation Law.
                                                                                                                                  Therefore, the factor not used to establish the employment relationship of the injury is D.


                                                                                                                                  NEW QUESTION # 107
                                                                                                                                  In a subrogation process, the role of the adjuster is to

                                                                                                                                  Answer: D

                                                                                                                                  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 # 108
                                                                                                                                  Which of the following would be considered an unforeseen act which causes bodily harm?

                                                                                                                                  Answer: A

                                                                                                                                  Explanation:
                                                                                                                                  The correct answer is C - Accidental injury. An accidental injury results from an unintended or unforeseen event producing bodily harm. This characteristic distinguishes an accident from deliberate conduct or an intentionally produced injury. New York's accident-insurance framework treats accident coverage as insurance for death, dismemberment, disability, medical care, or similar loss caused by an accident or specified types of accidents. DFS also requires accident-only policies to make clear that benefits relate to a covered accident, rather than sickness generally.
                                                                                                                                  Options B and D involve intentional self-harm and therefore do not satisfy the ordinary accidental-event concept stated in the question. A suicide attempt is intentionally undertaken even though the eventual degree of injury may not have been intended. A deliberate self-inflicted injury is expressly intentional by definition.
                                                                                                                                  Alcohol abuse is also not itself an unforeseen accidental act producing bodily injury. Although an accident might occur while a person is intoxicated, the abuse itself is not synonymous with an accidental injury and coverage would depend on the actual policy wording and circumstances.
                                                                                                                                  For examination purposes, the defining characteristics are unexpectedness, lack of intent, and resulting bodily harm.
                                                                                                                                  Series 17-70 reference topics: Other Coverages - Accident and Health Concepts, Accidental Injury, Accident-Only Coverage, and Exclusions for Intentional Injury.


                                                                                                                                  NEW QUESTION # 109
                                                                                                                                  The policy benefits are found in what part of an insurance policy?

                                                                                                                                  Answer: C

                                                                                                                                  Explanation:
                                                                                                                                  The correct answer is A - Declarations. The declarations page provides policy-specific information identifying the coverages and benefits selected by the insured, together with applicable limits, deductibles, policy dates, insured information, covered property, vehicles, or locations as appropriate. New York DFS describes the declarations page as a summary of the insured's coverage and requires covered benefits and limits to be accurately reflected there.
                                                                                                                                  The technical distinction is important: the Insuring Agreement contains the insurer's operative contractual promise to pay or perform when the coverage requirements are satisfied. However, because "Insuring Agreement" is not among the answer choices, the declarations page is the correct response to where the policy's selected benefits and coverage amounts are identified.
                                                                                                                                  Option B, Conditions, establishes contractual requirements governing performance of the policy. Option C, the insured's duties, concerns obligations such as providing notice, protecting damaged property, submitting documentation, and cooperating with investigation. Option D, Exclusions, removes or restricts coverage that would otherwise fall within the coverage grant.
                                                                                                                                  An adjuster should never read the declarations page in isolation; it must be interpreted together with the coverage form, definitions, exclusions, conditions, and endorsements.
                                                                                                                                  Series 17-70 reference topics: Insurance Basics - Declarations, Policy Benefits, Coverage Limits, Conditions, Exclusions, and Policy Structure.


                                                                                                                                  NEW QUESTION # 110
                                                                                                                                  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?

                                                                                                                                  Answer: A

                                                                                                                                  Explanation:
                                                                                                                                  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.


                                                                                                                                  NEW QUESTION # 111
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