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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Property & Casualty Coverages | 25% | - Dwelling and Homeowners policies - Automobile coverages — Personal and Commercial - Commercial Property and Businessowners policies - General Liability and Commercial General Liability - Specialty lines — Inland Marine, Flood, Workers' Compensation, Crime |
| Topic 2: Insurance Fundamentals & General Principles | 15% | - Insurance contract elements and legal structure - Risk management and insurable interest - Indemnity, subrogation, utmost good faith |
| Topic 3: Claims Investigation & Adjusting Procedures | 20% | - Settlement negotiation, reservation of rights, and denial procedures - Loss valuation, damage assessment, and estimating - Evidence gathering, coverage analysis, and policy interpretation - Claim intake, notice of loss, and initial investigation |
| Topic 4: Ethics & Professional Responsibility | 15% | - Fair claims handling standards and professional conduct - Fraud detection and reporting obligations - Fiduciary duty, conflict of interest, and confidentiality |
| Topic 5: New York Insurance Law & Regulations | 25% | - Licensing requirements, eligibility, and examination rules - Unfair Claims Settlement Practices Act / Regulation 64 - NY Insurance Law Articles and DFS regulations - State-specific policy provisions and mandatory endorsements |
>> 100% NY-Independent-General-Adjuster Correct Answers <<
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NEW QUESTION # 62
Homeowner Policies exclude coverage for
Answer: B
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 # 63
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: A
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 # 64
Which of the following would be considered an unforeseen act which causes bodily harm?
Answer: B
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 # 65
What is the purpose of the Insurance Frauds Prevention Act?
Answer: B
Explanation:
The correct answer is C. New York Insurance Law Article 4 is expressly titled the Insurance Frauds Prevention Act. Its legislative findings recognize that insurance transactions-including organization and licensing, issuance of policies, and the adjustment and payment of claims and losses-have potential for abuse and illegal activity. The statutory framework is intended to prevent, detect, investigate, and penalize fraudulent insurance conduct.
Therefore, option C most accurately expresses the purpose among the available choices: protecting the insurance system and consumers from illegal and fraudulent conduct associated with policy and claim transactions.
Option A concerns underwriting standards and risk selection rather than insurance-fraud prevention. Option B concerns insurance advertising regulation, which is governed through separate statutes and regulations.
Option D concerns insurer financial reporting and solvency regulation, not the core purpose of Article 4.
New York DFS emphasizes that insurance fraud affects consumers through higher premiums and costs and encourages detection and reporting of suspected fraudulent activity. Article 4 also requires reporting of suspected fraudulent insurance transactions and authorizes investigation and enforcement.
Accordingly, C is the correct examination answer.
NEW QUESTION # 66
What is the policy limit for personal liability supplement under Coverage L of a dwelling policy?
Answer: D
Explanation:
The correct examination answer is B - $100,000. A standard Dwelling Policy primarily provides property insurance; personal liability protection is added through the Personal Liability Supplement. Under that supplement, Coverage L - Personal Liability responds when an insured becomes legally liable for bodily injury or property damage caused by a covered occurrence. Coverage M separately provides Medical Payments to Others. The Series 17-70 outline expressly identifies the Personal Liability Supplement as a tested Dwelling Policy endorsement.
The traditional standard limit associated with Coverage L in licensing material is $100,000 per occurrence.
Policy analyses of the ISO dwelling liability supplement also illustrate Coverage L using a $100,000 limit.
A technical distinction is important for claims practice: the actual contractual limit is ultimately the amount shown in the policy declarations or Personal Liability Schedule. Therefore, higher limits may be purchased when offered by the insurer. The question is testing the standard/default licensing-exam limit rather than asserting that every dwelling liability supplement is permanently restricted to $100,000.
Coverage L also generally includes the insurer's defense obligation in addition to covered damages, subject to the policy's exclusions and conditions.
Therefore, the required answer is B.
NEW QUESTION # 67
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