Pass the Insurance Licensing New York Insurance NY-Independent-General-Adjuster Questions and answers with ExamsMirror

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.

The correct answer is A. After coverage has been verified, the loss investigated, evidence gathered, damages measured, and applicable policy provisions applied, the claim normally advances to settlement and payment. At this stage, the adjuster communicates the valuation and seeks resolution of the amount payable under the policy.

A contemporary claims-process description characterizes the final stage as arranging resolution: once damages and costs are established, the adjuster discusses settlement and arranges payment.

Option B is incorrect because a historical loss run is an underwriting or loss-history document, not a mandatory final step in settling an individual claim. Option C is also incorrect; insurers are subject to regulatory reporting requirements, but an adjuster does not ordinarily submit every final claim payment to the state insurance department as the concluding step of each claim. Option D occurs earlier. Reserves are established and modified throughout investigation as the expected claim cost becomes clearer.

The official Series 17-70 outline specifically identifies Claims Adjustment Procedures, Settlement Procedures, Negotiation, Releases, Advance Payments, Draft Authority, Appraisal, and Alternative Dispute Resolution.

Therefore, A accurately describes the normal final settlement phase.

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.

The correct answer is C — submitting surveys of the insured business to the insurer. The CPP Common Policy Conditions grant the first named insured several special rights and responsibilities. The first named insured may cancel the policy by providing the required written notice, is the party to whom applicable premium refunds are sent, and is authorized to make policy changes with the insurer's consent. Therefore, requesting an adjustment to policy limits falls within the first named insured's authority to seek policy changes.

The Inspections and Surveys condition operates differently. It gives the insurer the right, but generally not the obligation, to make inspections and surveys, provide reports concerning conditions found, and recommend changes. The policy does not impose a standard responsibility on the first named insured to prepare and submit surveys of the business. Standard common-policy wording expressly assigns the inspection-and-survey right to the insurer.

The first named insured also has important premium-related functions. Standard CPP wording provides for return premiums to be sent to the first named insured and recognizes the first named insured's cancellation authority.

The Series 17-70 outline specifically tests CPP components, Common Policy Declarations, Common Policy Conditions, and the First Named Insured.

The intended answer is B. Under the dwelling broad form, the two named-peril provisions carrying the vacancy limitation tested by this item are Damage by Burglars and Accidental Discharge or Overflow of Water or Steam. Older DP 00 02 language provided that damage by burglars was not covered when the dwelling had been vacant for more than 30 consecutive days, and the accidental-discharge peril contained the same 30-day vacancy restriction.

Falling Objects and Weight of Ice, Snow, or Sleet have their own coverage limitations, but the specific vacancy restriction presented here does not apply to those perils. Freezing is controlled by separate requirements concerning reasonable care to maintain heat or shut off the water supply and drain the systems.

For Series 17-70 accuracy, there is an important edition distinction: the official New York outline identifies the Dwelling (2014) Policy, and ISO DP 00 02 07 14 changed the comparable vacancy period to 60 consecutive days, not 30. The same two relevant perils remain Damage by Burglars and Accidental Discharge/Overflow of Water or Steam.

Thus, B is the intended answer, while the video's “30 consecutive days” language reflects the older dwelling-form edition.

The correct answer is C. Part One — Workers Compensation Insurance does not operate with a conventional policy liability limit such as $100,000 or $500,000. Instead, the insurer agrees to pay the workers' compensation benefits that the employer is required to provide under the workers' compensation law applicable to a state listed in the policy.

The New York Compensation Insurance Rating Board states this directly: there is no limit of liability in the Standard Policy for Part One — Workers' Compensation; the contract provides all benefits required by the applicable workers' compensation law.

Options A and B are therefore incorrect because they resemble liability-limit amounts rather than statutory Workers Compensation Part One benefits. Option D is also incorrect. The Information Page identifies the relevant states and other policy data, but it does not transform Part One into a fixed-dollar-limit coverage.

This must also be distinguished from Part Two — Employers Liability Insurance, where limits of liability are relevant. New York has additional state-specific rules concerning employers liability, but those should not be confused with the statutory-benefit structure of Part One.

The Series 17-70 outline expressly tests the Workers Compensation and Employers Liability policy, including Part One—Workers Compensation Insurance and Part Two—Employers Liability Insurance.

Therefore, C is correct.

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.

The correct answer is D — Flood. Standard homeowners insurance does not treat flood as one of its basic insured perils. Flood is generally excluded from ordinary homeowners property coverage and normally requires separate flood insurance, such as coverage obtained through the National Flood Insurance Program or an eligible private flood insurer.

By contrast, riot or civil commotion, smoke, and volcanic eruption are among the standard named causes of loss appearing in homeowners forms. The Insurance Information Institute's comparison of homeowners perils identifies riot/civil commotion, smoke, and volcanic eruption as covered causes while explaining that flood requires separate protection.

The exclusion of flood is particularly important for adjusters because “water damage” is not a single coverage category. The adjuster must determine the actual mechanism and source of water—such as plumbing leakage, rain entering through covered storm damage, surface water, tidal overflow, sewer backup, or flood—and then apply the specific policy language.

The official Series 17-70 outline requires knowledge of the Homeowners 2011 Policy, including perils insured against, exclusions, and conditions. It separately identifies the National Flood Insurance Program elsewhere in the broader property curriculum.

Therefore, the peril that is not a basic homeowners peril is D — Flood.

The correct answer is A — an attorney except with permission. Once an insured or claimant is represented by counsel regarding a particular claim or dispute, communications concerning that represented matter must respect the attorney-client relationship. New York's Rule of Professional Conduct 4.2 prohibits an attorney from communicating, or causing another person to communicate, about the subject of the representation with a person known to be represented by another lawyer unless prior consent is obtained from that lawyer or the communication is otherwise authorized by law.

For adjusters, this means claim communications involving a represented claimant should ordinarily be routed through the claimant's attorney when the representation encompasses the matter being adjusted. The purpose is to prevent interference with legal representation, inappropriate direct negotiation, or uncounseled disclosure concerning the claim.

Retention of an appraiser, physician, or private investigator does not automatically establish the same restriction. Those professionals may participate in valuation, treatment, or investigation, but they do not substitute for legal counsel.

The Series 17-70 outline expressly tests the role and responsibilities of the adjuster and the adjuster's relationship to the legal profession, making recognition of represented parties an important claims-handling principle.

Therefore, A is correct.

The correct answer is C — principal. A surety arrangement involves distinct parties. The principal is the person whose obligation or performance is being guaranteed. In a bail bond transaction, the criminal defendant is the principal because the bond guarantees the defendant's compliance with the conditions of release, particularly appearance before the court when required.

The surety is the party guaranteeing the obligation and potentially becoming liable under the bond when its terms are breached. The obligee is the party in whose favor the obligation runs—typically the court or governmental authority in a bail context. An indemnitor is a person who agrees to reimburse the surety for losses arising from issuance of the bond. “Indemnity” itself refers to the reimbursement obligation or agreement, not the defendant's party designation.

The New York PSI licensing outline identifies the parties to a surety bond as principal, indemnitor for principal, obligee, and surety. It also specifically uses the phrase “Surrender of principal (defendant),” directly confirming that the defendant is the principal in bail-bond terminology.

Understanding these roles is essential because each party has distinct contractual rights, duties, and financial responsibilities.

Therefore, the defendant on a bail bond is the principal, making C correct.