License Exam Updated 2026 | 250+ Practice
Questions & Verified Answers | Comprehensive
Study Guide, Exam Prep Test Bank, New York
Insurance Law, Property & Casualty Insurance,
Claims Investigation, Policy Coverage Analysis,
Loss Adjusting, Claims Settlement, Liability,
Ethics, Insurance Regulations, Detailed
Rationales, Licensing Exam Success
Question 1: Under the New York Insurance Law, what is the maximum penalty
for a willful violation of an order of the Superintendent of Financial Services
regarding unfair claim settlement practices?
A. A fine of up to $5,000 per violation
B. A fine of up to $10,000 per violation
C. A fine of up to $25,000 per violation
D. A fine of up to $50,000 per violation
CORRECT ANSWER: A. A fine of up to $5,000 per violation
Rationale:Under New York Insurance Law Section 2601, the Superintendent may
impose a penalty of up to $5,000 for each willful violation of an order related to unfair
claim settlement practices. This is a specific statutory cap designed to deter misconduct
without being overly punitive for isolated errors.
Question 2: In the context of New York property insurance, which of the
following best defines "actual cash value" (ACV) as interpreted by New York
courts?
A. The original purchase price of the property minus depreciation
B. The replacement cost of the property without any deduction for depreciation
C. The fair market value of the property at the time of the loss
D. The cost to repair or replace the property with like kind and quality, less depreciation
CORRECT ANSWER: D. The cost to repair or replace the property with like
kind and quality, less depreciation
Rationale:New York courts generally define ACV as the replacement cost minus
depreciation. While market value can be a factor, the predominant and accepted
standard in New York is replacement cost less depreciation, as established in cases like
McAnarney v. Newark Fire Ins. Co.
,Question 3: According to NYDFS Regulation 68 (11 NYCRR 216), what is the
maximum time frame for an insurer to acknowledge receipt of a claim and
commence an investigation?
A. 5 business days
B. 10 business days
C. 15 calendar days
D. 15 working days
CORRECT ANSWER: C. 15 calendar days
Rationale:11 NYCRR 216.6(c) mandates that an insurer must acknowledge receipt of a
claim and commence an investigation within 15 calendar days of receiving the notice of
claim. This is a strict timeline for initial communication.
Question 4: A general adjuster in New York is handling a claim involving a
fraudulent fire. What is the adjuster's PRIMARY duty regarding the evidence?
A. To destroy the evidence to prevent further damage
B. To preserve and secure the evidence for potential legal proceedings
C. To return the evidence to the insured immediately
D. To ignore the evidence if it is not directly related to the policy
CORRECT ANSWER: B. To preserve and secure the evidence for potential legal
proceedings
Rationale:In cases of suspected fraud, the adjuster has a duty to preserve the chain of
custody and secure evidence. This is crucial for the insurer's defense against a
fraudulent claim and for potential referral to law enforcement or the NYDFS Fraud
Bureau.
Question 5: Under the New York Workers' Compensation Law, what is the
primary responsibility of a general adjuster regarding Form C-2 (Employer's
Report of Work-Related Injury/Illness)?
A. To complete the form on behalf of the employer
B. To ensure the employer files the form with the Workers' Compensation Board within
10 days
C. To deny the claim immediately upon receipt of the form
D. To forward the form to the claimant's personal attorney
CORRECT ANSWER: B. To ensure the employer files the form with the
Workers' Compensation Board within 10 days
Rationale:The adjuster is responsible for coordinating with the employer to ensure
Form C-2 is filed with the NY Workers' Compensation Board within 10 days of the
,injury. The adjuster's role is to facilitate compliance, not to complete the form
themselves in most cases.
Question 6: What is the "anti-concurrent causation" clause designed to do in a
New York property insurance policy?
A. To broaden coverage for all perils
B. To exclude coverage when a covered peril and an excluded peril combine to cause a
loss
C. To allow for concurrent payment of benefits for multiple claims
D. To waive the deductible in cases of concurrent weather events
CORRECT ANSWER: B. To exclude coverage when a covered peril and an
excluded peril combine to cause a loss
Rationale:The anti-concurrent causation clause states that if a loss is caused by a
combination of covered and excluded perils, the entire loss is excluded. This is
frequently litigated in New York in cases involving wind vs. flood.
Question 7: According to the New York Insurance Law, what is the maximum
allowable administrative fee that can be charged to a premium finance
company by an insurer?
A. 1% of the premium
B. 5% of the premium
C. 10% of the premium
D. The fee is not regulated by the Insurance Law
CORRECT ANSWER: D. The fee is not regulated by the Insurance Law
Rationale:The Insurance Law does not specifically cap administrative fees charged to
premium finance companies. However, such fees are subject to general contract law and
the Banking Law if they are considered interest, but the Insurance Law itself is silent on
a specific cap.
Question 8: In New York, what is the "proof of loss" required time frame for a
property insurance claim?
A. Within 30 days of the loss
B. Within 60 days of the loss
C. Within 90 days of the loss
D. Within the time frame specified in the policy, which is often 60 days
CORRECT ANSWER: D. Within the time frame specified in the policy, which is
often 60 days
, Rationale:NY Insurance Law requires that policies specify a reasonable time for
submitting proof of loss. Standard fire policies often require it within 60 days of the loss,
but the exact timeline is governed by the policy terms. The adjuster must verify the
specific policy.
Question 9: A general adjuster in New York discovers that a claimant has
submitted a fraudulent medical bill. What is the adjuster's mandatory
obligation?
A. To pay the bill and note the file internally
B. To confront the claimant directly without legal counsel
C. To refer the matter to the New York Insurance Frauds Bureau
D. To ignore the fraud if the bill is under $1,000
CORRECT ANSWER: C. To refer the matter to the New York Insurance Frauds
Bureau
Rationale:Under NY Insurance Law Section 405, an insurer must report suspected
fraudulent acts to the Insurance Frauds Bureau. Failure to do so can result in penalties.
The adjuster must act as a fiduciary of the insurer to uphold this obligation.
Question 10: How is "stick-built" construction typically distinguished from
"manufactured" construction for underwriting purposes in New York?
A. Stick-built is built entirely on-site, while manufactured is built off-site and transported
B. Stick-built is built off-site, while manufactured is built on-site
C. Stick-built uses wood, while manufactured must use steel
D. There is no difference in the New York Insurance Code
CORRECT ANSWER: A. Stick-built is built entirely on-site, while manufactured
is built off-site and transported
Rationale:Stick-built refers to traditional construction where materials are assembled
on the permanent site. Manufactured housing is constructed in a factory and moved to
the site. This distinction affects rating, eligibility, and policy forms in NY.
Question 11: Under New York Insurance Law, what is the legal status of a
"binder" issued by an authorized insurer?
A. It is a temporary contract of insurance that is not legally binding
B. It is a legally binding temporary contract of insurance
C. It is only valid for auto insurance
D. It is a request for a policy but does not provide coverage
CORRECT ANSWER: B. It is a legally binding temporary contract of insurance