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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: New York Unfair Claim Settlement and Prohibited Practices | - Unfair claim settlement practices - New York claim settlement laws and regulations - Terrorism Risk Insurance Act - Insurance fraud and false statements - New York cybersecurity regulation - Consumer privacy requirements | |
| Topic 2: Insurance Principles and Concepts | - Moral hazards - Concealment - Fraud - Insurance contracts - Insurable interest - Morale hazards - Representations and misrepresentations - Physical hazards - Warranties - Waiver and estoppel - Insurance principles and concepts - Hazards | |
| Topic 3: Other Property and Liability Coverages | - Crime insurance - Workers compensation - Inland marine - Ocean marine - Surety and fidelity bonds - Commercial automobile - Flood insurance - Excess liability - Aviation insurance - Personal automobile | |
| Topic 4: Commercial Package Policy | 38% | - Monoline versus package policies - Common policy declarations - First named insured - Common policy conditions - Components of a commercial policy |
| Topic 5: Claims Adjustment Procedures | - Negotiation - Reservation of rights letters - Coverage problems - Subrogation procedures - Execution of releases - Settlement procedures - Claims adjustment procedures - Competitive estimates - Appraisal - Alternative dispute resolution - Releases - Draft authority - Advance payments - Arbitration - Non-waiver agreements - Mediation | |
| Topic 6: Insurance Regulation | - Licensing requirements - Bond requirements - License renewal - Fingerprinting - Licensing process - License maintenance and duration - Temporary adjuster permits - Qualifications | |
| Topic 7: Dwelling and Homeowners Insurance | - Homeowners liability coverage - Homeowners property coverage - Personal liability supplement - Standard Fire Policy - New York specific endorsements - Personal umbrella policies - Dwelling policies | |
| Topic 8: Commercial Property | - Commercial General Liability - Businessowners Policy - Commercial property coverage - Commercial property forms and endorsements - Commercial Package Policy |
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NEW QUESTION # 81
The self-insured portion of an insurance claim is called a
Answer: D
Explanation:
The correct answer is D. A deductible is the portion of an otherwise covered loss that the insured agrees to retain before the insurer becomes responsible for the remaining covered amount. In practical risk-management terms, it represents a form of self-insurance or risk retention because the policyholder absorbs losses up to the deductible amount.
New York Department of Financial Services describes a deductible as the amount the insured agrees to be responsible for when a covered loss occurs. DFS also explains that a higher deductible generally means the insured retains a larger portion of the risk and may receive a lower premium in return.
For example, if covered property damage equals $10,000 and the applicable deductible is $1,000, the insured ordinarily bears $1,000 and the insurer pays $9,000, assuming no other policy limitation applies.
Coinsurance is different; it is an insurance-to-value or cost-sharing mechanism and is not simply the initial dollar amount retained by the insured. "Principal" describes a party or monetary concept in other contractual contexts, while "liability" means legal responsibility.
The Series 17-70 curriculum includes deductibles, loss valuation, policy conditions, and claim settlement concepts.
Therefore, D is correct.
NEW QUESTION # 82
Under an HO-3 Policy, Coverage F - Medical Payments to Others applies to all of the following EXCEPT
Answer: A
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 # 83
Accident-only policies commonly include benefits due to losses related to
Answer: B
Explanation:
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.
NEW QUESTION # 84
A broken bone is the same as a
Answer: A
Explanation:
The correct answer is A - fracture. A fracture is the medical term for a break in a bone. The break may be complete or partial and can be classified in numerous ways, including open versus closed, displaced versus nondisplaced, transverse, oblique, comminuted, stress, or other fracture patterns. MedlinePlus expressly identifies a fracture as a break in a bone and lists "broken bone" as an alternative description.
A dislocation differs because it involves bones being forced out of their normal relationship at a joint. A sprain involves ligaments, while a strain typically involves muscles or tendons. Although a serious traumatic event can produce more than one of these injuries simultaneously-for example, a fracture-dislocation-they remain medically distinct conditions.
For an independent general adjuster, accurate medical terminology is important when reviewing bodily injury claims. A diagnosis of fracture may affect emergency treatment, immobilization, surgery, rehabilitation, duration of disability, medical expenses, and the eventual evaluation of damages. The adjuster should therefore distinguish structural injury to bone from injuries involving joints, ligaments, muscles, and tendons.
Accordingly, the medical equivalent of a broken bone is a fracture, making A the only correct choice.
NEW QUESTION # 85
Long-term care policies cover expenses for care when the insured CANNOT perform all of the following activities of daily living EXCEPT
Answer: A
Explanation:
The correct answer is B - Shopping. Long-term care insurance commonly uses the insured's inability to perform specified Activities of Daily Living (ADLs) as a benefit eligibility trigger. New York DFS identifies the principal ADLs as dressing, eating, bathing, toileting, continence, and transferring. Most long-term care policies require inability to perform a specified number of these activities without substantial assistance before benefits become payable, subject to the contract's precise benefit trigger.
Bathing, option A, is a recognized ADL. Toileting, option C, is also a recognized ADL. Transferring, option D, refers generally to the ability to move into or out of a bed, chair, or similar position and is another standard ADL.
Shopping, by contrast, is generally classified as an Instrumental Activity of Daily Living (IADL). IADLs involve more complex activities necessary for independent community living, such as shopping, housekeeping, transportation, managing finances, meal preparation, and telephone use. New York health guidance similarly distinguishes shopping as an instrumental activity rather than a basic ADL.
Therefore, shopping is the activity that does not belong to the standard basic ADL group.
Series 17-70 reference topics: Other Coverages - Long-Term Care Insurance, Benefit Triggers, Activities of Daily Living, and Eligibility for Benefits.
NEW QUESTION # 86
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