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| Section | Weight | Objectives |
|---|---|---|
| Ethics & Professional Responsibility | 15% | - Fraud detection and reporting obligations - Fiduciary duty, conflict of interest, and confidentiality - Fair claims handling standards and professional conduct |
| Claims Investigation & Adjusting Procedures | 20% | - Loss valuation, damage assessment, and estimating - Evidence gathering, coverage analysis, and policy interpretation - Settlement negotiation, reservation of rights, and denial procedures - Claim intake, notice of loss, and initial investigation |
| Property & Casualty Coverages | 25% | - General Liability and Commercial General Liability - Specialty lines โ Inland Marine, Flood, Workers' Compensation, Crime - Dwelling and Homeowners policies - Commercial Property and Businessowners policies - Automobile coverages โ Personal and Commercial |
| New York Insurance Law & Regulations | 25% | - Unfair Claims Settlement Practices Act / Regulation 64 - Licensing requirements, eligibility, and examination rules - NY Insurance Law Articles and DFS regulations - State-specific policy provisions and mandatory endorsements |
| Insurance Fundamentals & General Principles | 15% | - Insurance contract elements and legal structure - Indemnity, subrogation, utmost good faith - Risk management and insurable interest |
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NEW QUESTION # 101
Under a Homeowners policy, which of the following is an insured location?
Answer: D
NEW QUESTION # 102
A homeowners policy debris removal clause covers
Answer: B
Explanation:
The correct answer is D. Homeowners Debris Removal coverage does not pay merely because a tree has fallen somewhere on the residence premises. The coverage generally requires that the loss satisfy the specific policy conditions governing fallen-tree removal.
Under standard homeowners principles, reasonable tree-removal expenses can be covered when a tree is felled by an applicable insured peril and damages a covered structure. Certain forms also provide coverage where a qualifying tree blocks a driveway or specified accessibility route. A state insurance regulator's homeowners guidance similarly explains that debris removal includes qualifying trees felled by a covered peril when they damage a covered structure or meet specified access-blocking requirements.
Option A is much too broad because a tree falling harmlessly in the yard does not automatically generate insurance coverage. Option B is likewise incorrect because "natural disaster" is not itself a policy coverage trigger; the cause must fall within the applicable insured-peril wording. Option C confuses the tree-removal sublimit with the requirement that the tree cause a particular dollar amount of property damage. The policy does not require exactly $1,000 of structural damage.
The Series 17-70 outline specifically tests Homeowners Additional Coverages, Perils Insured Against, Exclusions, and Conditions.
Therefore, D is the best answer.
NEW QUESTION # 103
In a subrogation process, the role of the adjuster is to
Answer: C
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 # 104
A policy that limits coverage to specific causes of loss is called
Answer: A
Explanation:
The correct answer is D - named perils. A named-perils policy provides coverage only when the direct physical loss is caused by a peril specifically identified in the contract. Typical named perils can include fire, lightning, windstorm, hail, explosion, smoke, vandalism, or other causes expressly listed in the applicable form. If the cause of loss is not among the listed covered perils, coverage generally does not apply unless another provision or endorsement extends protection.
This contrasts with an open-perils, sometimes historically called "all risk," form. An open-perils contract generally covers direct physical loss unless the cause is specifically excluded or limited. The burden of analyzing the loss therefore differs substantially between named-perils and open-perils structures.
Option A is incorrect because exclusions remove or restrict coverage rather than define a policy that affirmatively insures only specifically listed causes. Option B concerns loss valuation rather than the scope of insured perils. Option C describes the opposite coverage approach.
The official Series 17-70 outline specifically includes "Named perils versus special (open) perils," direct loss, consequential loss, policy structure, exclusions, and conditions as tested Insurance Basics concepts.
NEW QUESTION # 105
What is NOT an element of verifying coverage?
Answer: A
Explanation:
The correct answer is D - The value of the claim. Coverage verification is performed to determine whether the insurance contract potentially responds to the reported occurrence. The adjuster first confirms that the policy was in force on the date of loss, because a loss occurring outside the effective policy period normally cannot trigger that contract. The adjuster must also establish that the claimant or affected party qualifies as the named insured or another insured person under the applicable provisions.
For a property claim, the adjuster must verify that the damaged property is property insured by the contract, at an insured location where applicable, and subject to the relevant coverage. These are fundamental coverage questions.
The value of the claim, however, concerns loss measurement rather than initial coverage verification. Once coverage has been established, the adjuster evaluates the extent of damage, repair or replacement costs, actual cash value or replacement cost provisions, depreciation, deductibles, limits, coinsurance, and other valuation considerations.
Coverage and valuation must therefore be distinguished. A loss may be covered even though its final monetary value has not yet been determined.
Series 17-70 reference topics: Insurance Basics - Policy Period, Named Insured, Covered Property, Coverage Analysis, Loss Adjustment, and Claim Valuation.
NEW QUESTION # 106
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