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| Section | Weight | Objectives |
|---|---|---|
| Ethics & Professional Responsibility | 15% | - Fraud detection and reporting obligations - Fair claims handling standards and professional conduct - Fiduciary duty, conflict of interest, and confidentiality |
| Property & Casualty Coverages | 25% | - Automobile coverages โ Personal and Commercial - Specialty lines โ Inland Marine, Flood, Workers' Compensation, Crime - Dwelling and Homeowners policies - Commercial Property and Businessowners policies - General Liability and Commercial General Liability |
| 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 |
| Claims Investigation & Adjusting Procedures | 20% | - Claim intake, notice of loss, and initial investigation - Evidence gathering, coverage analysis, and policy interpretation - Loss valuation, damage assessment, and estimating - Settlement negotiation, reservation of rights, and denial procedures |
| Insurance Fundamentals & General Principles | 15% | - Indemnity, subrogation, utmost good faith - Insurance contract elements and legal structure - Risk management and insurable interest |
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NEW QUESTION # 15
Regarding insurance coverage for employment practices exposures, which one of the following statements is TRUE?
Answer: D
Explanation:
The correct answer is C. Employment Practices Liability Insurance (EPLI) is specifically designed to address claims arising from wrongful employment-related conduct. Core exposures include wrongful termination, workplace discrimination, sexual harassment, retaliation, and other specified employment practices. Current EPLI coverage descriptions expressly identify discrimination, harassment, and wrongful termination as principal covered allegations.
Option A is incorrect because EPLI may be written as a standalone policy or incorporated within broader management-liability programs. It is not restricted to being an endorsement to Directors and Officers insurance.
Option B is incorrect because the standard Commercial General Liability policy is not basic professional or employment-practices liability insurance. In fact, many employment-related practices exposures are specifically excluded or inadequately addressed under conventional CGL coverage.
Option D concerns occupational bodily injury. An employee physically injured in the course of employment would ordinarily look to Workers Compensation and Employers Liability, not EPLI. EPLI primarily addresses wrongful employment decisions and conduct rather than workplace accident injuries.
The adjuster must therefore distinguish an employment-practices wrongful act from an employment-related bodily injury. One is principally a management/professional liability exposure; the other is a Workers Compensation/employers liability exposure.
Therefore, C accurately describes the purpose of EPLI.
NEW QUESTION # 16
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 # 17
Which coverage form would a condominium unit-owner purchase?
Answer: A
Explanation:
The correct answer is D - HO-6. The HO-6 is the Homeowners Unit-Owners Form, designed specifically for an individual who owns and occupies a condominium unit. The condominium association normally carries a master property policy covering common elements and whatever portions of the building are assigned to the association under its governing documents. The individual unit owner therefore needs separate protection for personal property, personal liability, loss of use, and building items for which the unit owner is responsible.
New York DFS specifically identifies HO-6 as the condominium policy form, while ISO terminology describes HO-6 as the Unit-Owners Form. The Series 17-70 examination outline expressly requires knowledge of HO-2 through HO-6 and HO-8, including their property and liability coverages.
HO-2 and HO-3 are principally designed for owner-occupied houses. HO-4 is the Tenants Form and generally addresses renters rather than condominium unit owners. Although cooperative apartment arrangements can involve somewhat different property interests, the standardized condominium unit-owner form tested here is unequivocally HO-6.
Therefore, the appropriate form is D.
NEW QUESTION # 18
Under an HO-3 Policy, Coverage F - Medical Payments to Others applies to all of the following EXCEPT
Answer: C
Explanation:
The correct answer is C. Coverage F - Medical Payments to Others provides limited no-fault medical- expense protection for qualifying bodily injury to persons other than an insured. Coverage commonly applies to persons injured on an insured location with permission, and in specified situations involving the insured's activities, residence employees, or animals.
A special rule applies to a residence employee. Medical Payments may cover a residence employee away from the insured location when the injury arises out of or in the course of the employee's work for the insured.
However, standard HO-3 analysis excludes a residence employee's injury occurring away from the insured location when the injury is unrelated to that employment.
The nanny in option C is engaged in personal shopping, not performing duties for the insured. The necessary employment connection therefore does not exist.
The meter reader in A is injured on the insured premises, the mail carrier in B has an injury arising from the insured's dog, and the invited family friend in D is injured while on the insured location. Those scenarios fall within the general scope of Coverage F, subject to normal policy conditions and exclusions.
The Series 17-70 outline tests Homeowners Coverage F - Medical Payments to Others, definitions, exclusions, and Section II conditions.
Therefore, C is correct.
NEW QUESTION # 19
Homeowner Policies exclude coverage for
Answer: C
Explanation:
The correct answer is A. Standard homeowners property forms contain a broad earth movement exclusion, encompassing events such as earthquake, landslide, mudslide, earth sinking, rising, or shifting, subject to the precise policy wording and any endorsements purchased. Earthquake coverage ordinarily requires a separate endorsement or policy. The Series 17-70 examination outline specifically requires knowledge of Homeowners Policy additional coverages, perils insured against, exclusions, conditions, and selected endorsements, including an earthquake endorsement.
The remaining choices describe protections commonly appearing as Additional Coverages rather than general exclusions. Debris Removal reimburses reasonable expenses for removing debris of covered property following a covered cause of loss. Insurance-regulator guidance confirms debris removal is ordinarily incorporated into homeowners coverage when the underlying damage results from an insured peril.
Likewise, Property Removed protects covered property against direct loss while it is being removed from endangered premises to safeguard it from an insured peril, subject to the form's time limitations. Fire Department Service Charge provides a specified additional amount when an insured incurs a contractual fire- department service charge. These provisions are standard examples of homeowners additional coverages.
Therefore, among the four choices, earth movement is the excluded cause of loss.
NEW QUESTION # 20
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