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New York Indep. Motor Vehicle No-Fault
and Workers Compensation Health
Services Adjuster (Series 17-72)
An "uninsured motor vehicle" under a personal auto policy does not include: - ✔✔An abandoned car used as a residence.. Which of the following are exempt from certain sections of the New York cybersecurity regulation? - ✔✔All responses listed are correct.. Danny owns an auto body shop and he has received a request from a client to restore his 1964 Ford Mustang. The client has requested a custom mustang horse be painted on the hood of the car. Danny always selects the type of paint most suited for the job, so which of the following paint types will Danny most likely select to paint the horse? - ✔✔Lacquer The root word "glyc" refers to: - ✔✔Sugar. If any person engages in activities in violation of the Federal Insurance Fraud and False Statements regulation, he or she may be subject to which of the following? - ✔✔A civil penalty of not more than $50,000.. What commercial auto form is used to cover taxis and bus companies - ✔✔Motor carrier form. Tom has lost 30% of his hearing in both ears. His doctor has advised him that his hearing loss has been caused by exposure to noise at his workplace for the past 25 years. Tom's hearing loss can be catoragized as a: - ✔✔Cumulative Trauma Disorder. Tearing of a muscle results in an injury known as a: - ✔✔strain In commercial auto physical damage coverage, what "triggers" the coverage that applies to the vehicles?
How would an insured's PAP coverage apply when renting a private passenger auto while on vacation when they have purchased insurance coverage from the rental company? - ✔✔The insured's PAP provides excess liability coverage when the insured drives non-owned autos.. Which of the following statements is true regarding the business auto policy - ✔✔One or more of ten symbols triggers coverage. Under the New York cybersecurity regulation, each covered entity must maintain documentation supporting certification of compliance with the regulation for: - ✔✔5 years The root word "stomat" refers to - ✔✔Mouth What is the purpose of "other states insurance" under a Workers Compensation policy? - ✔✔To provide coverage for exposures which develop in other states during the policy period. After receiving a blow to the head, Alex is released from the hospital after a few hours and told to rest and resume normal activity in 3-4 days. Alex has suffered a brain injury known as: - ✔✔Concussion When an insurer intends to non-renew a homeowners policy in New York, at least _____ advance notice of non-renewal must be sent to the insured - ✔✔45 days The type of auto body frame that is most often used in today's automobile and is a single molded unit, is known as: - ✔✔A unibody frame.. Jim Johnson has an automobile policy with a combined single limit of $50,000. He has an at-fault accident and incurs the following expenses: $30,000 bodily injury judgment; $30,000 property damage judgment; $5,000 damage to traffic light; $6,000 attorney's fees for his defense; $300 in premiums for appeal bond; and $75 in bail bond premiums for related traffic violations. What is the maximum amount his insurance company will pay? - ✔✔$56,375. The policy cannot pay more than its limit of liability. Under supplemental coverages in the policy, the policy will pay the defense costs plus the cost of the premiums on appeal bonds and bail bonds.
An award for pain and suffering to a claimant who was burned when a tractor engine malfunctioned and spewed boiling water would be considered what kind of damages? - ✔✔General Damages. Which of the following losses may not be determined by an adjuster? - ✔✔Use of a rental vehicle What is required when a company wants to self insure for workers compensation? - ✔✔A security bond.. A weather report would be considered what type of evidence? - ✔✔Documentary When a homeowners policy has been in effect for 60 days in New York, an insurer can cancel at anytime for any of the following reasons, EXCEPT - ✔✔A large loss has occurred Which of the following is an official notice of a lawsuit? - ✔✔Summons Which of the following is NOT a correct statement in determining the cost of a "comparable automobile" when a physical damage loss has a occurred? Select the Correct Answer When comparable automobiles are available or were available in the local market area in the last 90 days, the average cost of two or more comparable automobiles. The cost of a comparable automobile as determined by a computerized automobile valuation service that produces statistically valid fair market values within the United States market. When comparable automobiles are not available or were not available in the local market area in the last 90 days, the average of two or more quotations from two or more licensed dealers in the local market area. If not possible to determine the value using standard methods of value determination, the cost of a comparable automobile shall otherwise be supported by documentation and fully explained to - ✔✔The cost of a comparable automobile as determined by a computerized automobile valuation service that produces statistically valid fair market values within the United States market..
Which of the following losses would be paid under the "Other than Collision" coverage of the Personal Auto policy? Gradual corrosion of the grillwork on the insured automobile due to continuous exposure to salty air. The insured automobile was stolen and never recovered. The insured automobile skidded on icy pavement and overturned. The insured automobile was damaged when it was hit by another car that failed to stop at a red traffic light. - ✔✔The insured automobile was stolen and never recovered.. A New York adjuster commits an act of insurance fraud addressed by the Federal Insurance Fraud Act. The fraud does not affect the financial stability of the company. What is the maximum time the adjuster may be confined to prison? - ✔✔10 years During a baseball game, a player was struck in the frontal region of his cranium by a batted ball. This frontal region is known as the: - ✔✔Forehead. Which of the following events, arising out of the use of a covered auto, is covered under the personal auto policy? - ✔✔Damage to a private garage rented by the insured.. The workers compensation policy language is written by the: - ✔✔National Council on Compensation Insurance (NCCI) Cystic fibrosis is a serious and often fatal disease that affects the: - ✔✔Lungs. Vehicle glass, other than the windshield, is made of: - ✔✔Tempered glass. The insured is covered under a personal auto policy and carries liability coverage, other than collision (comprehensive) coverage and collision coverage. He has a large quantity of CDs in the vehicle. The vehicle is broken into and these items are stolen. How will the insurance company handle the claim for the CDs? Deny the claim in full. Pay the claim in full. Pay the claim minus depreciation.
The limit for medical expenses and rehabilitation expenses under the New York no-fault plan is: - ✔✔$50, When a claimant is represented by an attorney, which of the following is prohibited by the adjuster? - ✔✔Contact the claimant without the consent of the attorney Driver 1 and Driver 2 are in an accident. Driver 2 has the following damages: Property Damage - $1, Rental Car Expense - $ Emergency Room Expense - $ Lost Wages - $ The extent of the bodily injury will not be known for six months. How should the adjuster on this claim pay damages for Driver 2? Pay all damage to date, provide a full and final release has been signed by Driver 2. Pay nothing until total of all damages has been determined. Pay the property damage and rental car expense and settle the bodily injury at a later time. None of the responses listed are correct - ✔✔Pay the property damage and rental car expense and settle the bodily injury at a later time. The named insured has a business auto policy issued by Company A and another auto policy issued by Company B. Company A's BAP has a limit of insurance for liability coverage of $100,000. Company B's policy provides $25,000 of liability coverage. If both policies apply to an accident on the same basis, how much of a $100,000 liability loss will Company A pay under its BAP? - ✔✔$80,000.. The two companies provide a combined limit of $125,000. Company A provides 80% of the limits in place. In case of a $100,000 loss, company A would pay $80,000. Which of the following is not a duty of an insurer in case of a loss? - ✔✔Separate the damaged property from the undamaged property and protect the property from further loss
In the event of a loss under a personal auto policy, an insured is required to submit to the insurance company all of the following information, EXCEPT: An appraisal of the damaged property. A list of any known witnesses. A notice of claim. Proof of loss statement if requested. - ✔✔An appraisal of the damaged property. Employers in New York have _____days from the date of the initial penalty for failing to comply with the compliance provisions of workers compensation coverage for eligible employees to appeal the penalty - ✔✔30. What is the primary function of a vehicle cooling system? - ✔✔It keeps the engine from overheating by transferring the heat from the engine to the air. The insured carries auto insurance in New York and has purchased the Supplementary Uninsured Motorist Coverage (SUM). This coverage: - ✔✔Replaces the statutory uninsured motorist coverage. Under the commercial auto policy providing physical damage, which of the following offers the broadest coverage Comprehensive. Specified cause of loss. Named perils. Broad named perils. - ✔✔Comprehensive. The New York Superintendent of Insurance may refuse to renew, suspend or revoke a license as a result of which of the following? I. A violation of any provision of the New York Insurance Code. II. A licensee making a material misstatement in application for license. III. A licensee being found guilty of fraud or dishonest practices. - ✔✔I, II and III
Which one of the following answer choices lists the components used in laminated safety glass? Two pieces of glass of equal thickness and a sheet of safety film. A sheet of safety film and two pieces of tempered glass. Two pieces of tempered glass and rubber caulking. Two sheets of safety film and two pieces of tempered glass - ✔✔Two pieces of glass of equal thickness and a sheet of safety film.. Amelia has suffered a covered collision loss to her vehicle. The insurer requires that her vehicle be repaired at a repair shop of the insurer's choice. The insurer: - ✔✔Is guilty of an unfair claims practice act The BAP uses Symbol 7 to cover "specifically described autos" identified in the declarations. An auto acquired during the policy period will only be covered: Answer If the insured insures all of their vehicles with the company or it replaces a covered auto. Only if it is a private passenger auto Only if it is other than a private passenger auto If reported to the company within 14 days of acquisition - ✔✔If the insured insures all of their vehicles with the company or it replaces a covered auto.. An "uninsured motor vehicle" under a personal auto policy does not include: An abandoned car used as a residence. A "hit and run" driver. A vehicle carrying liability insurance in an amount less than required by a state's financial responsibility law. A car whose bodily injury liability coverage has expired. - ✔✔An abandoned car used as a residence. The required standard deductible for auto physical damage coverage in New York is: - ✔✔$200.00 per occurrence
A manufacturing company is sending two U.S. employees to Russia to discuss their products and visit a Russian plant. They have volunteered for the trip. What coverage would be needed for injuries they may occur in a work-related accident while abroad? - ✔✔Add the Foreign Coverage Endorsement to the company's workers compensation policy Under the Motor Carrier Act, how long are goods being transported covered for loss? - ✔✔Until they are unloaded and placed in a designated place.. Each of the following is true about work-related injury cases which fall outside the scope of the workers compensation law, EXCEPT: The employer cannot be held liable for such injuries. Common law defenses are retained by the employer. Damages may be paid if negligence or legal liability is established. Pain and suffering damages may be awarded in a court of law. - ✔✔The employer cannot be held liable for such injuries In the determination of damages, which of the following will the workers compensation adjuster not attempt to evaluate? - ✔✔The party at fault Which term best describes the word 'anterior' when used to denote a portion of the body? - ✔✔Front Under the Terrorism Risk Insurance Program Reauthorization Act of 2015, what is the "trigger limit" before claims are paid for the year 2018? - ✔✔$160 million. What is the penalty for an individual committing workers compensation fraud in New York? - ✔✔5, fine and four years imprisonment No act will be certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, as an act of terrorism under the Terrorism Risk Reauthorization Act of 2015 unless: the losses relate to life and health insurance. the act is committed as part of the course of war declared by Congress.
All of the following are considered to be family members on the PAP, EXCEPT: - ✔✔Insured's mother who doesn't live in the household What can happen when an independent contractor is injured while working and files a claim stating that they were actually an employee? The claim will be denied. The claim will be paid as if the insured is "self insured." Only a portion of the claim will be paid. The insurance carrier can charge an additional premium for the exposure. - ✔✔The insurance carrier can charge an additional premium for the exposure. Which of the following is NOT a correct statement in determining the cost of a "comparable automobile" when a physical damage loss has a occurred? - ✔✔The cost of a comparable automobile as determined by a computerized automobile valuation service that produces statistically valid fair market values within the United States market.. The named insured is an auto dealer with a single insured location. Physical damage coverage under the insured's garage policy is written on a reporting basis. On the date of the insured's last report, the value of covered autos at the insured's location was $400,000; the insured's report on that date showed values of $300,000. A covered loss occurs, with damage totaling $80,000. How much of this loss will the garage insurer pay? $80, $60, $40, $0 - ✔✔$60,000 The insured will suffer a penalty equal to the percentage of the under reporting of the inventory bears to the actual inventory. The insured reported 25% less than the actual inventory and would be paid $60,000 instead of the $80,000 loss. Which of the following best describes an abnormal condition in which a clot develops within a blood vessel? - ✔✔Thrombosis
Commercial Auto insurance applies to accidents or losses in all of the following locations, EXCEPT: - ✔✔Mexico. A person that has been found to be committing unfair or deceptive acts in the business of insurance can be fined up to ______ per day for each offence. - ✔✔$ Cars driven by Sue Trent and Jim Higgins were involved in an automobile accident where Mr. Higgins was at fault. Sue Trent's car was a total loss and valued at $6,000, plus she sustained bodily injuries totaling $25,000. Scott Finley, Ms. Trent's passenger, was injured and incurred $6,000 in medical expenses. Mr. Higgins, the responsible party, carries bodily injury coverage with limits of $15,000 per person and $30,000 per accident, and property damage coverage of $5,000. His policy will pay a maximum of: $26, $29, $35, $39,000 - ✔✔$26,000 Mr. Higgins' policy will pay a maximum of $26,000. The maximum per person limit that can be paid to any one person as a result of Mr. Higgins' negligence is $15,000. Therefore, Sue Trent will receive only $15,000 and Scott Finley will receive $6,000. This amounts to $21,000 in bodily injury payments. The property damage limit carried by Mr. Higgins is only $5,000. Therefore, the most that can be paid for the total loss to Sue Trent's vehicle is $5,000 even though her vehicle is worth $6,000. The total of $21,000 plus the $5,000 is $26, An employee of a metal fabricating employer was injured while moving metal sheeting an fractured his right ulna and radial bones, and his right tibia and fibula. What regions of this employee's body was injured? - ✔✔This employee fractured his right forearm and his right lower leg. The insured is covered under a personal auto policy with collision coverage and a $500. deductible. He is involved in an at-fault accident. The loss involves $4,000 damage to the vehicle and a $45.00 storage fee. How much will the insurer pay $3, $4, $3, $4,045 - ✔✔$3, The supplementary payments under the personal auto policy:
Muscle - ✔✔Body What name(s) can be used in the issuance of an adjuster license in New York? An assumed name A name of a business not approved by the Commissioner The licensee's own legal name A trademark with a slogan - ✔✔The licensee's own legal name The root word "pathos" means: Growth or formation Abnormal condition Sickness or disease Tumor or swelling - ✔✔Sickness or disease Under the Federal Insurance Fraud and False Statements Act, if someone is prohibited from doing business in a state, approval to resume transacting business must be granted by: - ✔✔Submitting a 1033 waiver form and having it approved by an insurance regulatory official in his or her state Which of the following items are advantages of enamel automobile paint over lacquer paint? I. Enamel is thicker than lacquer. II. Enamel does not attract insects. III. Enamel evaporates a much smaller portion of its chemistry into the atmosphere, making it less toxic than lacquer. IV. Enamel is better suited to custom automobile painting. - ✔✔I and III only. Joann, an adjuster who holds a resident adjuster license in New York, has had administrative action taken against her in another state where she holds a nonresident license. What are her responsibilities to the New York Department of Insurance? - ✔✔Once the administrative action has reached it final conclusion, she must report the final disposition of the matter to the New York Superintendent within 30 days.
is a straightening movement allowed by certain joints of the skeleton that increases the angle between two adjoining bones. Flexion Rotation Extension Gliding - ✔✔Extension A vehicle rolled over exiting the interstate. The insured carries collision coverage with a $1, deductible and other than collision coverage with a $500 deductible. The damage to the vehicle is $2,000. What amount is the insurer responsible to pay? $2, $1, $1, Nothing - ✔✔$1, Under the liability coverage of the commercial auto policy, which of the following would NOT be covered? A third party claim occurred a week after products were finally delivered to a customer. A third party claim that occurred in a warehouse as an employee was using a hand truck to load a delivery truck. A third party claim that occurred while the truck was being loaded by the use of a mechanical device attached to the truck. A third party claim as a result of a truck being unloaded by hand. - ✔✔A third party claim occurred a week after products were finally delivered to a customer Under which of the following claims settlements are the claim invoices presented and paid with no attempt to obtain a separate release? A partial release A walk-away release An open-end release
The mortgagee is paid $150,000. The insured is paid $150,000 for the personal property loss. Since the loss is from an intentional act of the insured the entire loss is denied. - ✔✔The mortgagee is paid $150, After proof of loss has been received, a New York insurance company has how many days to pay the claim 30 45 60 90 - ✔✔ 30 If an insurer intends to cancel a workers compensation policy issued in New York for other than nonpayment of premium, a ___ day advance notice must be sent to the insured. - ✔✔ 30 You are the adjuster and you are contacted by a claimant and advised that he has fired his attorney and wants to proceed to negotiate the claim directly with you. As an adjuster, what should you do? - ✔✔Request a "drop letter" After receiving an inquiry from the New York Department of Insurance regarding a claim, an insurer must respond within: - ✔✔10 business days John does not own a vehicle and borrows a friend's car and has an accident. John carries named non- owned auto coverage. Which of the following applies to the accident? John's coverage is excess The friend's coverage is excess since John has coverage Both companies would share in the claim equally John's coverage would pay the majority of the claim - ✔✔John's coverage is excess Who determines legal liability? - ✔✔The court/jury/judge
An insurance professional that is accused of dishonesty or breach of trust involving interstate commerce under the Federal Fraud and False Statement Regulation of the United States Code (USC 1033) will be prosecuted by: - ✔✔The U.S. Attorney general The insured owns a motor home that 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? - ✔✔Miscellaneous Type Vehicle endorsement. Duplicate recovery under New York No-Fault coverage is not permitted. If the employee is covered under the employer's auto policy what might be done to the employee's personal auto insurance coverage: - ✔✔Endorsement PP 05 92 can be added to the employees personal auto policy. For all but small employers, premiums in a Workers Compensation policy include an adjustment, upwards or downwards, based upon how the employer's actual loss experience compares to that expected of employers which do similar work. What is the name of the factor that accounts for this adjustment? - ✔✔The experience modification factor Workers compensation insurance is a contract between: - ✔✔Insurance company and the employer. A tornado blows over a wall of a barn which, in turn, knocks over a lamp and starts a fire. What is the proximate cause of loss? Tornado Smoke Fire Water Damage - ✔✔Tornado What is the first thing an insurance company staff adjuster must determine in handling a workers compensation injury claim? - ✔✔Whether coverage was in effect at the time of the injury The human respiratory system supplies oxygen and removes _____ from the body - ✔✔carbon dioxide
