NY General Adjuster Test (10-70)
Terms in this set (165)
12/1 - even numbered yrs
On what date does an adjuster's license need to be renewed?
What is the amount of bond that must be posted to obtain and adjuster's license?
Not until hearing held
When can the Superintendent of Insurance revoke an adjuster's license?
a. anytime b. by sending a 30 day notice of the renovation c. not until a hearing is held d. When proof of offense has been received
Example of unfair claim settlement act
Failing to acknowledge within a reasonable time, communications w/ respect to claims arising out of the insurer's policies
An ins regulatory official such as Superintendent of Insurance
If found guilty of Fed Insurance fraud, who can permit a guilty individual to return to the insurance business?
a. federal official b. no one since this is federal offense c.an ins regulatory official i.e. Super of Ins d. only court of law after proper hearing
To provide some form of compulsory insurance
What is the reason for the NY financial responsibility law?
Is a mandatory coverage
In NY must uninsured motorist coverage: a. is optional b. mandatory c. doesn't require sign off for > limits d. doesn't cover "hit & run" drivers
The insured's property damage coverage
Damage to a rental car is paid in NY under which of the following coverages: a. insured's physical damage b. property damage covg c. special endorsement d. must be purchased from rental agency
Who must belong to the assigned risk plan?
All admitted auto insurers selling auto insurance in NY
Covers the employer when the employee is using their vehicle on company business.
What does the employer's non-ownership coverage cover?Covers the employer when the employee is using their vehicle on company business.
Pain & Suffering
Which is not covered under worker's comp coverage?
a. med expenses b. pain & suffering c. loss of wages d. funeral expenses
Who makes a declaratory judgment as to the merits of a claim?
a. claims adj b. insurer attorney c. court d. claimants attorney
What type of liability does an employer assume through their employees? a. primary b. contingent c. vicarious d. no fault
The insuring agreement
What part of the policy contains the promises made by the insurance company to the insured? a. conditions clause b. definitions c. exceptions to exclusions d. insuring agreement
At the time of the loss
In property & casualty insurance, when must a person absolutely have an insurable interest? a. time of app completion b. time of loss c. at any time d. insuring agreement
Definition of consideration
Something that has value in the eyes of the law in which a promise receives something in return for a promise
The promise by one party that is conditioned on a fortuitous event and the values given by the parties are unequal is called?
a. executory b. aleatory c. speculation d. a static risk
Violent act that is dangerous to human life and property
What constitutes an act of terrorism
Losses over $5,000,000
How much property and casualty los must be sustained to be considered an act of terrorism to be covered by the Terrorism Risk Insurance Act of 2002
Act of terrorism & covered under Terrorism Risk Act of 2002, act must be committed by?
Individual(s) acting on behalf of any foreign person or interest in an effort to coerce the civilian pop. of USA
A friend helping insured lay carpet
Who would be covered under homeowner med payments?
a. friend helping insured lay carpet b. foreign exchange student living w/ insured c. tenant of insured's residence d. son of insured bitten by family dog
Which personal insurance policy covers w/out endorsement, both personal property & personal liability coverages?
a. DP-3 form b. personal articles floater c. homeowner policy d. personal property floater
An abrupt falling down or caving in of the structure
Under new 2000 homeowner forms, what is definition of collapse?
A golf cart used to play golf off insured's premises
Which of the following would be covered under the HO policy of liability? a. golf cart used to play golf on premises b. unlicensed recreational dirt bike used in state park c. 50 hp motor boat owned by insured d. antique car used in parade
When stored on the insured's premises in a garage
Under what circumstances would the liability section of the homeowner policy cover an inboard motor boat owned by the insured? a. when used on fresh water rivers & lakes b. when hp is 25hp or less c. when stored in garage on premises d. when loaned to friend
Which of the following would be covered under the other than collision coverage of a personal auto policy? a. wear & tear
b. freezing c. punctured tire d. lightning
Pickup truck used in any business
Which of the following is not considered a covered auto?
A commercial liability policy has a $600K aggregate limit and a $200,000/occurrence limit. They had one claim for $300K and a 2nd for $200K. How much coverage is available if the insured company has a 3rd claim?
Under new 2000 HO forms, how much will be paid under claims expense for loss of earnings to assist the insurer in the investigation or defense of a claim?
Under a commercial umbrella policy, what is the reaction limit?
The deductible that applies when the underlying coverage does not apply but the umbrella coverage does
Which of the following would not be a prospect for errors and omissions insurance? a. dentist b. insurance agents c. real estate agents d. lawyers
Which of the following cannot be covered under a BOP?
a. credit union b. office buildings c. apartment buildings d. small gift shop
What do we call a person that takes a blank deposit to a bank as respects to crime insurance?
a. custodian b. cashier c. messenger d. manager
Under the discovery condition loss sustained form, how long are losses covered after the bond has expired?
Who has the responsibility to see that a ship is seaworthy?
Under the appraisal clause, if the appraisers cannot agree on an umpire, who can make the decision?
Under the BOP, up to how many years can the insurer request the insured's books and records?
As required by law
Under the workers comp endorsement available under the 2000 HO forms, resident employees can be covered: a. as required by law b. as needed by policy holder c. subject to policy limits of liability d. provides for limited recovery of injuries
When can excess lines insurance be written?
When no admitted, authorized insurer offers the particular line of insurance needed in the date
25/50/10 with 50/100 for death
What are the Financial Responsibility limits in the State of NY?
If the adjuster's license is revoked, how long must he or she wait to reapply?
How many years must a business be in business before they can qualify as a self-insurer for worker's comp?
Appraising betterment of a vehicle
Which of the following is an appraiser prohibited from performing?
Only 1 party shares in loss
Clause "particular average" in ocean marine policy means:
In addition to the policy limits
Which of the following is eligible for the BOP? A. auto repair shop B. tavern C. funeral home D. amusement park
A farmer has accidentally libeled a neighboring farmer by stating that the neighbor's dairy products are inferior to his. This is an example of:
The insured has severely damaged his/her vehicle. In case the insured rents a car for 11 days, what would be the reimbursement to the insured provided physical damage coverage is carried?
How long does someone have to submit medical payment claims under the Homeowner medical payments coverage?
An other than collision
A tree has fallen on the insured's vehicle. This is an example of__loss.
Subrogation occurs when:
The insurance company assumes the rights of the insured
None of the above
Who is not eligible for med pay coverage under the HO policy? A. insured B. insured's children C. tentant D. None
The failure to do what a reasonably prudent person would do under the circumstances is:
An uninterrupted chain of events resulting from negligence results in injury or damage
In which part of an insurance contract would you expect to find a description of the duties and obligations of the insured?
At the time of the loss*
In the property and casualty insurance field, when must interest exist in order for a loss to be covered?
What constitutes "agreement" to enter valid contract?
A specific offer by 1 party and acceptance by the other
Employee of named insured while transporting passengers for a fee
Under personal auto policy, which of the following persons would be excluded from coverage for bodily injury and property damage liability?
Under the physical damage portion of a personal auto policy, if the insured's car is stolen, transportation expenses will be provided after waiting period of:
Which is not eligible for insurance under personal auto policy? A. farm pickup, wt 4k lbs B. station wagon C. Motorcycle D. Jeep
T/F Concerning the business auto coverage: Med pay coverage is automatically provided
T/F Concerning liability portion of personal auto policy: Bodily injury arising out of operation a pickup used for farming is not covered.
What is the max amount payable for bail bonds under the supplementary payments provided by a personal auto policy
Uninsured motorist coverage:
Covers injuries caused by hit-and-run drivers
Named non-owner coverage, provides insurance for:
Someone who does not own an automobile, but who drives borrowed or rented autos.
Loss to radar detection equipment
Under a business auto policy, which of the following types of physical damage loss is not covered?
The owner of a trailer borrowed by named insured
Which of the following is not an "insured" under business auto liability coverage?
Coverage of non-owned autos
Which of the following coverages would apply to a rental car used by an insured executive while on vacation
Negligence must be established when concerning no-fault auto insurance
Restores an insured to the same condition enjoyed before a loss
Liability Insurance-"Occurrence" means:
An accident; continuous or repeated exposure to the same conditions
Per person, per accident
In commercial auto insurance, med payments limits apply:
For each separate accident
The limit of liability for business auto coverage may be paid:
A private messenger auto
Which of the following vehicles could be insured under the business auto coverage part?
Uninsured motorist's coverage applies when:
Some other party does not have a liability coverage and is liable for injury to an insured.
An insured is hit in the rear while stopped at a traffic light. The insured's company pays for his repairs then seeks reimbursement from the responsible party. This is known as:
A non-owned auto policy
What type of automobile coverage does a person need that does not own a vehicle?
Joint ownership endorsement
What personal auto endorsement is needed when 2 persons living in the same household, other than husband and wife who jointly own a private passenger auto or pickup or van?
a. dual ownership endorsement b. combined ownership endorsement c. joint ownership endorsement d. broad form named ownership endorsement
Miscellaneous type vehicles
The insured owns a motor home, which is not covered by the insured's personal auto policy. This vehicle can be added to the policy by using which of the following endorsements?
Employers non-ownership coverage
An employees has been asked to use for their own personal vehicle
Insignificant limitation of use of a body function or system
Under the NY no fault coverage the insured can sue for their injuries for all of the following except?
The death benefit under the NY no-fault plan is:
The limit for med expenses and rehab expense under NY no-fault plan is:
Would be guilty of an unfair claims practice act
An insured suffered a covered collision loss to their vehicle. The insurer has insisted that the insured have the vehicle repaired at a repair shop of the company's choice. The insurer:
Pain & Suffering*
When an insured purchases Opt Basic Economic Loss covg(OBEL), he/she can collect up to an additional $25k covg that pertains to all the following except:
Open peril covg for buildings & personal prop
An HO-5 form provides which of the following covg for dwellings & their contents?
A non owner occupied one family dwelling
Which of the following is not eligible for a homeowner policy?
Deny the claim since water is excluded property
An insured awakes and finds that a water line from his water meter to his home has busted. Water has been running all night. The insured carries an HO-2 homeowner form. If he receives a bill for the lost water, what will insurer do?
Definition: Collapse under HO forms:
An abrupt falling down or caving in of the structure or a part of the structure.
An insured has suffered a theft loss of jewelry. What is the limit that would apply under the HO policy?
An installation floater
What type of covg would heating and cooling contractor need when work has been done on a newly renovated building but not yet accepted by the owner?
If a business self-insures its risk, what do you call the insurance claims exceeding their self-insured limit?
Required by law
Workers comp benefits of this insurance are:
If adjuster has a simple 1st party loss, the initial claims report could also serve as the:
T/F: A temp employee who is furnished to the insured to substitute for a permanent residence employee on leave is an example of a residence employee under HO 2000 forms.
A cemetery lot under the HO 2000 forms is considered to be:
T/F regarding crime/computer fraud covg: Applies to criminal activity wherein the perpetrator gave false electronic instructions to remove insured's funds from bank account.
Provides specific limit of $250 for cost of bail bonds
Under supplementary payments of a CGL policy, which of the following is true?
Under the BOP, how long can a building be vacant and still be fully covered?
Which applies under CGL covg part as related to liability coverage?
Worldwide coverage is provided as long as the product is manufactured in the coverage territory & the claim is brought within the coverage territory.
Defines claims covered under CGL policy for products/completed operations?
Includes claims that occur away from premises owned or operated by the insured
Farm-owner's liability covg; covered under Ad Injury
An insured farmer who unknowingly disparaged the crops grown by another farm
An installation floater
Type of covg for heating & cooling contractor needs when work is complete on newly renovated building but not accepted by owner?
Crop Insurance provides coverage for losses to:
The marketable portion of growing crops
Covg period on crop insurance policies
Limited to growing period for particular crop
Multi-Peril Crop Insurance; covg available only in large agricultural states
Coverage for hail damage
Most common type of crop ins sold prior to creation of MPCI Program
% of max possible loss
Crop insurance limits are usually written
Covg will pay the determined % reduction in yield times amt of insurance/acre, regardless of actual crop size
Crop insurance usually protects a proportion of the reduced yield following an insured loss. "Reduced yield" means:
Define "unit" refer to in crop insurance
All insurable acreage of the crop
Which of the following describes that which is lateral to the center of the body? a. medial b. anterior
c. post anterior d. lateral
Covered under Fed Employees Comp act
a. railroad workers b. dockworkers c. coal miners d. postal workers
Tourists on cruise ship
Which not covered under Jones Act
Insurance Company & employer
Workers comp contract between
Bending over to pick up box and hurting back
Which is not considered occupational disease
Under workers comp med pay are paid:
For an unlimited time w/ no benefit limit
A ligament is torn away from bone is called:
Skin exposure to toxic chemicals
Cannot be gathered from air sampling test
Intoxication and horseplay caused the heart attack
Heart attack would be covered under all of the following except:
Injury to which of the following vertebra could result in paralysis
Workers comp for independent contractor is responsibility of
Violation of federal fraud law?
Making incorrect or false statements in the companies books
Which of following is used to determine if a bone is broken or fractured: a. radiography b. arthroscopy c. CT scan d. MRI
eccylmosis refers to
refers to specified action or result
utilization review used to
Review hospital bills to help control costs
joint at the wrist
test to determine anemia
A CAT scan has advantage over X-ray because:
Shows & produces detailed cross section of tissue
Attaches muscle to bone
Which vertebra is comprised of 5 fused vertebra
joint is bent at an extremity, this is:
Procedure allows one to view inside a joint
A claims adjuster submits a claim for review by 2 or more adjusters to evaluate claim is called:
Workers comp; how are benefits determined for an injured employee?
What workers comp coverage would apply if an injured employee's spouse brings a wrongful death suite against the employer?
B/C Fed Employees Liability act governs Jones Act, statute of limitations for a maritime injury suit is____ from date of injury
Which defines viewing a fractured bone?
A room is 16ftx12ft w/ 8ft ceiling. What is square footage of walls?
Med expense policy covers which of the following?
A roof has shingles that are 5in wide; how many shingles would be required for a row 10 ft long?
Test used to allow direct visualization of internal structures by using a thin fiber optic scope inserted into a joint space?
Flat $ amount for a specific # of days
Under med indemnity policy, which of the following is covered?
complete comparison of the old and new policy
When replacing a med expense policy, what information must be divulged?
Specific excess coverage
Under a self-insured workers comp plan, what covg should be purchased to cover a claim that is more than the per occurrence limit?
What adjuster info would only be available for short period of time after a claim?
a. documentary evidence b. secondary evidence c. critical evidence d. police reports
Employer or the surety
Who may terminate a fidelity bond? a. employee
b. employer c. employer or the surety d. only the surety
Maintain heat in the building or cut off water & drain lines
Under commercial property policy, what must an insured do to be covered for the peril of freezing?
Underinsured motorist coverage covers which situation?
The insured is injured by another driver who carries less coverage than the injuries sustained by the insured.
Commercial crime coverage provides coverage for when money &/or securities are carried off the insured's premises?
Under commercial auto policy providing physical damage, which offers broadest coverage?
Not covered under specified cause of loss physical damage coverage under commercial auto form?
TV repair shop
Needs bailee coverage?
Experience modification factor
In the promulgation of workers comp rates, which is factor in calculation of rates (best answer)
Under commercial umbrella policy, what is self insured retention for insured?
Amount insured must pay when underlying coverage doesn't cover the claim & umbrella policy does.
Insured carries aircraft liability coverage w/ "admitted aircraft liability" coverage. If a passenger is injured in an accident, who negotiates payment of claim?
When there is a question of coverage
Under what circumstances would an insurance company request a declaratory judgment from a court?
Financial guarantee bond
Payment bond is what type of instrument?
a. performance bond b. bid bond c. financial guarantee bond d. fidelity bond
Self funded plan
What type of med insurance is regulated by ERISA?
What type of passenger would not be covered under an aircraft liability policy w/ passenger coverage excluded?
Complete necessary application
What must one do to obtain an emergency adjuster's license in NY?