New York Indep. Motor Vehicle No-Fault and Workers Compensation Health Services Adjuster (Series 17-72)

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: $26,000 $29,000 $35,000 $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 $26,000

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 $3,545 $4,000 $3,500 $4,045

$3,545

What limit of liability would be needed for a risk that transports radio active materials as required by the Motor Carrier Act under the MCS-90 endorsement?

$5,000,000

The limit for medical expenses and rehabilitation expenses under the New York no-fault plan is:

$50,000

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.

$500

Tachycardia is a condition in which the heart contracts at a rate greater than ____ beats per minute.

100

A New York insurance licensee must advise the Insurance Department of a change of address within:

30 days of the change.

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..

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

The ____ glands produce hormones required by the body such as estrogen and progesterone and chemicals such as adrenalin.

Adrenal

You are at home having your roof repaired. An employee of the roofing company needs to go to the hardware store to purchase supplies. Your car is blocking the driveway so you allow him to use your car to go to the store. While driving your car, he is at-fault in an auto accident. Your insurance policy will protect: All of the parties would be protected by your policy. Only you the insured will be protected. Only the employee will be protected. Both you and the insured will be protected

All of the parties would be protected by your policy.

An "uninsured motor vehicle" under a personal auto policy does not include:

An abandoned car used as a residence. .

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.

All of the following are included in an insurance property estimate of damages, EXCEPT:

Depreciation

A weather report would be considered what type of evidence?

Documentary

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 term best describes the word 'anterior' when used to denote a portion of the body?

Front

The commercial auto policy form provides for "worldwide liability coverage" for private passenger autos that the insured: Hires, leases, rents or borrows without a driver. Purchases. Sells. Occupies.

Hires, leases, rents or borrows without a driver.

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

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.

Cystic fibrosis is a serious and often fatal disease that affects the:

Lungs.

Which of the following statements is true regarding the business auto policy

One or more of ten symbols triggers coverage.

The root word "glyc" refers to:

Sugar.

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. .

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

All of the following are examples of a "door" in an automobile, EXCEPT: A panel that opens to allow access to the interior of the vehicle. The hood of the vehicle. The floor pan of the vehicle. The trunk lid of the vehicle.

The floor pan of the vehicle.

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. .

In the determination of damages, which of the following will the workers compensation adjuster not attempt to evaluate?

The party at fault

Under the Motor Carrier Act, how long are goods being transported covered for loss?

Until they are unloaded and placed in a designated place..

Which of the following losses may not be determined by an adjuster?

Use of a rental vehicle

Tearing of a muscle results in an injury known as a:

strain

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.

Mr. York had his pickup truck stolen while it was parked in a "no parking" zone outside his office. The value of the truck was $18,500. In addition, tools valued at $200, extra tires and hubcaps for the truck valued at $550 and a tarp worth $50 were in the truck. Mr. York has a collision deductible of $500 and a comprehensive deductible of $250. The insurance company will pay what amount

$18,800. The loss of the truck plus the extra tires and hubcaps would be considered in this claim. These total $19,050 less the deductible of $250 equals $18,800.

The required standard deductible for auto physical damage coverage in New York is:

$200.00 per occurrence

Supplementary payments under the liability section of a commercial auto policy include reasonable expenses incurred by the insured including loss of earnings up to ___ per day. $50 $150 $250 $500

$250

In addition to the minimum auto limits, all auto policies written in New York must also include a limit for wrongful death. The limit is:

$50/100.

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.

Before revoking or suspending a license, the Superintendent must first send _____ notice and give the accused an opportunity for a hearing.

10 days.

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

The mandatory recoupment of the federal share through policyholder surcharges under Terrorism Risk Insurance Program Reauthorization Act of 2015 was increased from 133% to

140%

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.

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

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

What is required when a company wants to self insure for workers compensation?

A security bond..

is a condition resulting from the lack of oxygen to the brain which can cause paralysis, speech problems or dementia.

A stroke

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..

Which of the following insurance companies MUST participate in a state's automobile assigned risk plan All licensed insurance companies that sell auto insurance in the state. Only companies that sell more than 1,000 auto policies per year in the state. Only the ten largest auto insurance companies in the state. Only excess lines insurance companies that sell auto insurance in the state.

All licensed insurance companies that sell auto insurance in the state.

Which of the following are exempt from certain sections of the New York cybersecurity regulation?

All responses listed are correct..

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 suffix "somatic" refers to: Brain Body Tissue Muscle

Body

The Terrorism Risk Insurance Program Reauthorization Act of 2015 excludes all of the following, EXCEPT:

Commercial Property

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.

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

An insured auto dealer has purchased garage policy physical damage coverage against specified causes of loss. Which of the following losses will not be covered by the policy?

Damage resulting from the collision of the truck carrying a covered auto with another vehicle.

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 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. Pay the claim minus the deductible.

Deny the claim in full.

Which of the following are covered by the Federal Employers' Liability Act (FELA)?

Employees of interstate railroads.

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.

The medical term for high arterial blood pressure is:

Hypertension

All of the following are considered to be family members on the PAP, EXCEPT:

Insured's mother who doesn't live in the household

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

Commercial Auto insurance applies to accidents or losses in all of the following locations, EXCEPT:

Mexico.

Driver 1 and Driver 2 are in an accident. Driver 2 has the following damages: Property Damage - $1,000 Rental Car Expense - $500 Emergency Room Expense - $400 Lost Wages - $300 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.

Which of the following pollution losses would be covered by garage policy liability coverage? Pollution of a stream caused by gasoline leaking from the ruptured fuel tank of a covered auto following a collision. Escape of toxic sludge from a dump site used by the named insured to store waste produced in its garage operations. The cost of a governmentally ordered clean-up of the pollution from a dump site used by the named insured. None of the losses described would be covered.

Pollution of a stream caused by gasoline leaking from the ruptured fuel tank of a covered auto following a collision..

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.

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

Which of the following is an official notice of a lawsuit?

Summons

In commercial auto physical damage coverage, what "triggers" the coverage that applies to the vehicles?

Symbols

Vehicle glass, other than the windshield, is made of:

Tempered glass.

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 claimant.

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. .

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 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..

In New York, property damage to a rental car is paid under which of the following automobile coverage? The insured's property damage coverage. The insured's physical damage coverage. By the attachment of a special endorsement. Coverage can only be purchased and provided by the rental car company.

The insured's property damage coverage

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

All of the following circumstances would be covered under workers compensation, EXCEPT:

The worker was injured while violating a company rule at lunch break.

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.

Which of the following best describes an abnormal condition in which a clot develops within a blood vessel?

Thrombosis

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 .

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..

When would the personal auto policy respond to a loss with a three wheeler

When used in an emergency situation

The supplementary payments under the personal auto policy: Will pay the insured up to $200 per day for loss of earnings due to testifying at a trial concerning an accident caused by the insured Will not pay for loss of earnings while testifying at a trial Will pay the insured $100 per day for loss of earnings while testifying at trial None of the responses are correct.

Will pay the insured up to $200 per day for loss of earnings due to testifying at a trial concerning an accident caused by the insured

Garagekeepers specified causes of loss coverage would apply to each of the following, EXCEPT:

Windstorm.

Which of the following lines of insurance are covered under the Terrorism Risk Insurance Act, now referred to as the Terrorism Risk Insurance Extension Act of 2015?

Workers compensation

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. the losses that have occurred related to personal property insurance. the losses that occur relate to commercial property and specified casualty risks.

the losses that occur relate to commercial property and specified casualty risks..

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.

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? $80,000 $60,000 $40,000 $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.

Anyone who threatens, forces or corruptly influences, obstructs or impedes the due and proper administration of the fraud law relating to the insurance business may be fined and/or imprisoned up to:

10 years

New York is one of a few states that mandates benefits for employees who suffer nonoccupational disabilities. To be eligible for benefits, an employee must have been in the employ of a covered employer for at least ______ before the disability.

4 consecutive weeks

Under the New York cybersecurity regulation, each covered entity must maintain documentation supporting certification of compliance with the regulation for:

5 years

What is the penalty for an individual committing workers compensation fraud in New York?

5,000 fine and four years imprisonment

Which of the following is true regarding Independent Medical Examinations (IMEs) requested by an insurer while adjusting a workers compensation claim? The results found in an IME are confidential and cannot be shared with the insurer. The results of the IME are confidential and can only be shared with the insurer with the injured worker's consent. The results of an IME will only be shared with the insurer if the findings conflict with the findings of the treating physician. An IME does not create a doctor-patient relationship, therefore the findings of the IME are not confidential and can be shared with the adjuster and insurance company.

An IME does not create a doctor-patient relationship, therefore the findings of the IME are not confidential and can be shared with the adjuster and insurance company.

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

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.

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

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. .

There are four people in the Smith family: Mr. Smith, Mrs. Smith, Susan Smith (Mr. and Mrs. Smith's daughter), and Mrs. Hillman (Mrs. Smith's mother). The Smiths own a family car which is covered by a personal auto policy. Mrs. Hillman also has a 1995 Chevy Impala on which she carries no insurance (it is not listed on the Smith's policy). Which of the following injuries would NOT be eligible for medical payments coverage under the Smith's personal auto policy?

Injuries sustained by Mrs. Hillman when she is driving her own car. .

What commercial auto form is used to cover taxis and bus companies

Motor carrier form.

The root word "stomat" refers to

Mouth

The workers compensation policy language is written by the:

National Council on Compensation Insurance (NCCI)