Download New York Insurance Adjuster Terms (2025) || Questions & Answers (100% Verified) and more Exams Insurance law in PDF only on Docsity!
New York Insurance Adjuster Terms
(2025) || Questions & Answers (100%
Verified)
Does basic form cover vandalism> - ANSWER - No it only coverage for theft but does cover building damage caused by the breaking or exiting of burglars Basic form (perils) - ANSWER - Vandalism Sprinkler Linkage Sinkhole Collapse Volcanic action aircraft or vehicles hail or windstorm smoke fire lightning riot and civil commotion Broad form (perils) - ANSWER - Everything from the basic with
- Falling objects
- Weight of ice, snow, or sleet
- Water damage from accidental discharge Special form (open perils) - ANSWER - open perils basis no coverage -damage steam boilers and equipment -damage to the interior of the building caused by rain, snow, sleet, ice, sand, or dust unless the outside building or structure first sustains damage -inventory shortage -unless endorsement (machinery and tools) -personal property
Under the commercial Property coverage, personal property of others coverage only applies - ANSWER - if the property is the care, custody, or control of the named insured and located in or on a building shown on the declaration, in the open within 100 feet of the described premises. Additional Personal Injury protection - ANSWER - The company will pay additional first party benefits to reimburse for extended economic loss on account of personal injuries sustained by an eligible injured person and caused by an accident arising out of the use or operation of a motor vehicle or a motorcycle during the policy period. This coverage applies only to motor vehicle accidents within the United States of America, its territories or possessions or Canada. New York Mandatory Personal Injury Protection - ANSWER - account of personal injuries caused by an accident arising out of the use or operation of the insured motorcycle. Auto Medical Payments coverage Endorsement - ANSWER - pay reasonable expenses incurred for necessary medical and funeral services to or for an "insured" who sustains "bodily injury" caused by "accident". We will pay only those expenses incurred, for services rendered within three years from the date of the "accident". Employees as Insured Endorsement - ANSWER - used to extend nonowner liability coverage to cover the individual liability of employees while they are using their own autos in the employer's business. Without this endorsement, the auto coverage forms specifically exclude coverage for the liability of an employee if the covered auto is owned by that employee or a member of his or her household. Miscellaneous Type Vehicle Endorsement - ANSWER - This is used to extend insurance coverage to recreational vehicles, motor homes, motorcycles, motorized golf carts and other miscellaneous vehicles that are not already covered under the policy. Named non-owner Coverage Endorsement - ANSWER - A personal auto policy (PAP) or an endorsement to a PAP that provides auto liability coverage for an individual who does not own a car but may operate borrowed or rented vehicles. Supplemental Spousal liability - ANSWER - Coverage against the liability of an insured because of death of, or injury to, his or her spouse up to the liability insurance limits provided under the policy even where the injured spouse, to be entitled to recover, must prove the culpable conduct of the insured spouse. Who may cancel a commercial package policy and how - ANSWER - The first named insured has the right to cancel the policy and it can only be cancelled when written notice is given
If the Superintendent believes a person has committed, or is committing a violation of law with respect to unfair methods of competition and unfair and deceptive acts and practices, the hearing must be held - ANSWER - within 10 days Cease and desist - ANSWER - ordering the person to refrain from engaging in the prohibited practice -penalty for violation is 5,000 per violation Before a resident license can be revoked or suspended, the superintendent must give the licensee and all sub licensees a hearing - ANSWER - 10 days advance notice If the superintendent determines a licensee is liable for a civil penalty, he/she may enter a judgement against the licensee within - ANSWER - 120 days Instead of revoking or suspending an insurance license, the Superintendent may - ANSWER - requite a licensee to pay a penalty up to -500 per offense with a max of 2,500 for all offenses How many days after the registered mailing of an order by the Superintendent does a licensee have to pay - ANSWER - 20 days The Superintendent is responsible for - ANSWER - Ensuring the solvency of this state insurers Eliminating insurance fraud, criminal abuse of insurance industry unethical conduct in the transaction of insurance in the state Request information from a person under investigation by how many days - ANSWER - 15 days If the peson fails to provide a good faith response within the required time frame the superintendent may levy a civil penalty up to: - ANSWER - 500 per day for each day the response to late with a max of 10, If the superintendent levies 5 separate penalties against any 1 person for failure to comply within a 5 year period, he/she may levy an additional civil penalty up to - ANSWER - 50,000 after notice and a hearing certificate of Authority - ANSWER - is a license issued to an insurance company authorizing it to transact insurance in the state Penalty for transacting insurance without certificate of authority - ANSWER - 1000 for the first violation and 2,500 for each subsequent violation
Any insurer that willfully fails to file and annual statement may be subjected to a penalty up to - ANSWER - 250 per day for each delay and subject to a maximum of 25, If an agent appointment is terminated for cause, insurer, fraternal benefit societies, and HMO transacting insurance in this state must: - ANSWER - File with the superintendent a statement containing the reason for termination with 30 days of termination insurer must mail within 15 days Any additional information that would have been reportable had it been known it must be provide the information to the superintendent within 15 days An insurance producer may have his/her license suspended or revoked by earning commission for business written on his/her property and risks if the commissions received are more than what percentage of the licensee's net aggregate commission during the preceding 12 months - ANSWER - 10% Licensee must maintain records for - ANSWER - at least 3 fiscal year Insurance Fraud Prevention Act - ANSWER - is any act committed by a person who, knowingly and intentionally plans to defraud an insurer, self-insurer, a agent by submitting any written statement in connection with an insurance application, certification for insurance The maximum penalty that can be imposed under the Insurance Frauds Prevention act for a single violation - ANSWER - 5, Insurance Frauds Bureau - ANSWER - detecting, investigating, and preventing insurance fraud and referring fraudsters for prosecution. Which of the following statements best describes the manner in which a licensee must provide a clear and conspicuous notice to its customers that accurately reflects its privacy policies and practices - ANSWER - the notice must be provided at the time the insurance application is taken and annually thereafter Redlining - ANSWER - a discriminatory practice used by underwriters to deny access to loans and insurance within particular geographic areas without any sound underwriting or actuarial bases. Personal lines Insurance, including coverage that insures - ANSWER - Real property- (residential purposes) Personal Property-(natual person has an insurable interest and not used for business) Personal Liability Excess Personal Liability
Under commerical lines, after a covered policy has been in effect for first 60 days an insurer can cancel a policy must provide - ANSWER - 15 days advance written notice Insurers may cancel a commerical lines policy if they have reason to believe, in good faith and sufficient cause, the insured is likely to destroy or permit the destruction of insured property for the sole purpose of collecting the insurance proceeds. A notice of cancellation - ANSWER - 10 days If an insurer chooses to non-renew a homeowner's policy, how many days advance written notice must it provide - ANSWER - 45 days If a commercial lines policy has been in force for 6 months, the insurer may cancel it for non-payment of premium by giving the first named insured how many days advance written notice - ANSWER - 15 days Special Provisions- (DP 01 31) - ANSWER - -Policy insures breakage of glass or safety glazing material caused directly by earth movement -Cost incurred by the insured because an ordinance or law that requires the demolition, remodeling, or repair of a covered building damaged by insured peril- 10% of the coverage A -Requires the insurer to pay certain tax liens before paying for any loss caused by fire if a loss to a 3 to 4 family dwelling A sub-limit of insurance applies to personal property located in self-storage facilities - ANSWER - a limit of 10% of coverage C limit of liability for personal property or 1000 (whichever is greater) does not apply: -moved from residence premises due to repaired, renovated, or rebuilt -located in an insured's residence other than the residence premises In order for a student to be covered while living away from home what are the requirements - ANSWER - the student has to be present at the student's residence during the 90 days immediately before the loss. Water damage exclusions - ANSWER - Tidal wave and tsunami Storm surge Escape, overflow, or discharge for any rny reason of water or waterborne material from a dam, levee, seawall Special Provision-(H0 01 31) - ANSWER - -Credit card, electronic fund transfer or access device forgery and counterfeit money (provides 1000 of coverage)
-The written estimate must include all applicable deductibles and must be proved within 30 days after the insured's request Identify Fraud Expense Coverage (H0 04 55) - ANSWER - provides up to 15,000 of insurance for the expenses the insured incurs as the direct result of any identity fraud first discovered during the policy period -Cost for notarizing -costs for certified mail for law enforcements agencies -Lost of income for time off from work (200 per day and max of 5,000) -Loan application fees for reapplication -reasonable attorney fees -Charges for long distance phone call Scheduled Personal Property (H0 04 61) - ANSWER - The insurer provides coverage against risks of direct loss to described property only if that loss is a physical loss to property -25% of the amount of insurance for the class of property or
- 10, Earthquake (H0 04 54) - ANSWER - We insure for direct physical loss to property covered under Section I caused by earthquake, including land shock waves or tremors before, during or after a volcanic eruption. One or more earthquake shocks that occur within a 72 period constitute a single earthquake. Home business Endorsement (H0 07 01) - ANSWER - provides property and liability coverage for the insured's business -business must be conducted from the residence premises -business must be owned by either *named insured on the dec page *partnership of which the named insured and his/her relative are the only partners Personal Injury (H0 24 86) - ANSWER - an injury arising out of one ore more of the following offenses but only if the offense was committed during the policy period -False arrest, detention, or imprisonment
Financial Responsibility Law - ANSWER - a person who is able to respond financially when declared liable for damages that arise out of ownership, maintenance or use of a motor vehicle Requirement for Auto Liability - ANSWER - for bodily injury 2500 per person in any one accident, 50,000 for all person injured in any one accident for death 50,000 per person, 100,000 for all persons killed for property damage 10,000 for all damage resulting from any one accident Proof of financial responsibility - ANSWER - Liability insurance that meets the min requirements of state law Financial security bond for each vehicle financial security deposit of 25,000 per motor vehicle in cash or securities, or other amount Evidence of self-insurance Insurance Information and Enforcement System (IIES) - ANSWER - was developed for use by the insurance industry to report certain auto insurance transactions to the department Termination -30 day with possible 15 day extension Issued- 7 day with possible 7 day extension New York Automobile Insurance Plan (assigned Risk) - ANSWER - make auto insurance available to applicants who are entitled to auto insurance but unable to obtain it through the standard insurance marketplace. Comprehensive Motor Vehicle Insurance Reparations Act(PIP) - ANSWER - Provides no-fault or personal injury protection benefits individuals who are injured in car accidents. Coverage must be provided regardless of fault or negligence, subject to various provisions of the Act Basic economic loss- up to 50,000 per person for one or more of the following items -All necessary expenses incurred for medical, hospital, surgical, nursing (coverage is provided without time limit)
-Loss of earnings from work the person wuld have performed if not injured up to 2000 per month for a max of 3 years Name a couple of uncommon personal property items that fall under the homeowners policy Section 1 - ANSWER - Watercraft of all types Trailers Property on the residence used for business purposes Deeds, Evidence of debt, notes other the bank notes, manuscripts, engines Under the national flood Insurance program, assuming the premium has been paid, coverage becomes effective when? - ANSWER - On the 30th calendar day after completion of the application National flood insurance program covers - ANSWER - Overflow of inland or tidal waterways Unusual and rapid accumulation or runoff of surface waters Mudslides cause by the accumulation of water What is the size limit for sailing vessel owned by the insured the insured to be covered under the Section II of the homeowners Policy - ANSWER - 26 feet or more in length Under Section II of the homeowners Policy which outboard motorboat owned by the insured is excluded? - ANSWER - 26 horsepower or more Name some odd locations that are insured under section II of the homeowner's Policy - ANSWER - Vacant land, not used for farming, owned by rented to the insured Cemetery burial plots or vaults Supplemental Payments are - ANSWER - normally defined to include such items as first aid expenses, premiums for appeal and bail bonds, pre- and postjudgment interest, and reasonable travel expenses incurred by the insured at the insurer's request when assisting in the defense of a claim. The homeowners polic coverage for endangered property from the insured premises for up to - ANSWER - 30 days What properties are elgible for the FAIR plan? - ANSWER - Condominiums Cooperative housing Single family dwellings A policy issed through the FAIR plan is effective for how many months - ANSWER - 12 months An auto policy's Medical Payments provides benefits for which individual - ANSWER - The insured, family members, and anyone else whole occupying the insured auto
If a person owns a 60 ft sailboat, which policy would provide the best coverage - ANSWER - A Yacht Policy An insured who wants to verify the deductible on Section 1 of his Homeowners policy should look at which section of the policy - ANSWER - Declarations What is covered under the National flood Insurance Program - ANSWER - -Overflow of tidal waves -Collapse of land along a lake shore resulting from the effects of waves exceeding normal cycles -rapid accumulation of surface waters What type of bond guarantees that a contractor will faithfully complete a contractual obligation - ANSWER - Performance Under the BOP Policy what is the other insurance considered - ANSWER - Primary Within what time period must an injured person submit a Worker's Compensation claim, and be covered - ANSWER - 2 years Contribution by equal shares - ANSWER - Each insurer contributes equal until the loss is settled or the insurer limits are exhausted Business Owner coverage - ANSWER - Apartment Buildings (associations) Office Buildings Service or Processing (ex Bakeries, laundromats, dry cleaners, funeral homes) Contractors Restaurants Motels Convenience food/Gas stations Self Storage Facilities Condominium Commercial What type of coverage does the preservation of property additional coverage of the BusinessOwners policy provide - ANSWER - Open peril coverage for 30 days Under what conditions are claims paid under the Occurrence form of the commercial general liability Policy - ANSWER - The loss occurred during the policy period regardless of when the claim is filed What is true about a Umbrella Policy - ANSWER - -Coverage is excess over underlying policies -specific minimum limits for the underlying coverage are required
-Certain losses exceeding the underlying coverage are covered Medical Payments coverage under the farm liability coverage form covers injuries to which person - ANSWER - Residence employee In surety bonds who is the person responsible for fulfilling the obligation - ANSWER - Principal In surety bonds, which party benefits from the bond - ANSWER - Obligee An article includes false statements regarding another company - ANSWER - Defamation
