New York Accident & Health Insurance Adjuster Latest 2023 Graded A+

New York Accident & Health Insurance Adjuster Latest 2023 Graded A+ The New York Superintendent of Insurance is Appointed by the governor of New York The primary responsibility of the Superintendent of Insurance is Enforcing the state insurance laws and regulations. An independent adjuster A person who acts on behalf of an insurer in investigating and adjusting claims and/ or performing any duties required by the insurer. A public adjuster A person who acts on behalf of an insured in negotiating the settlement of certain claims for loss or damage to property. The qualifications for obtaining a New York Accident & Health Adjuster license are: Must be 18, submit to finger printing, and must be approved by at least five reputable citizens of the community Following the occurrence of a legitimate, within what period of time can an insured bring legal action against the insurer for failure to promptly and properly settle the claim? Within two years after the inception of the loss Failing to acknowledge reasonable communication with respect to claims arising out of policies is an example of: Unfair claims practices New York residents securing any type of insurance adjuster license must meet the following qualifications: Pass the state licensing examination, maintain a $1,000.00 surety bond. A policy holder must give notice of a claim within _________ or as soon as reasonably possible. 20 days New York independent adjuster acts on behalf of an insurer New York public adjuster acts on behalf of the insured The amount of bond required to be filed by an adjuster with the state of New York is: $1,000.00 The intentional failure to disclose known facts is known as Concealment An adjuster's license expires: Biennially on December 31 of even numbered years and may be renewed for an ensuing two calendar years. A business or residential address change must be reported to the insurance department within: 30 days of the change Federal law addressed fraud, material misrepresentation, embezzlement, and misappropriation of monies involving the interstate commerce of insurance. If found guilty, the punishment will be: Imprisonment for up to 15 years When a person is believed to have violated the New York insurance code, the Superintendent will serve the accused a statement of charges and a notice of a hearing. When must the hearing be held? 10 days after the notice is served Statements made by an applicant for an insurance policy which are supposed to be true are referred to as: Representations An act of deliberate deceit with the intent to take property of another or take unfair advantage of another is: Fraud Misrepresentation Leading a client to believe that a policy contains benefits that it does not contain. A temporary adjuster license can be issued by the Superintendent for _____ days. 120 A person that has been found to be in violation of unfair or deceptive acts can be find up to ______ for each offence. $500.00 Concealment The withholding of pertinent information regarding the property or person insured, which if made to the insurer, would cause the insurer to refuse to accept the risk, or demand a higher premium Proof of loss must be submitted by the insured to insurer within ____ of the loss. 90 days The insurer is required to provide claim forms to the insured within _____ of being notified of the loss. 15 days Proof of Loss A formal statement given to an insurer regarding a loss. What action may an insurer take while an insured is residing in a foreign country? Temporarily suspend coverage Medicaid The federal and state funded program for those whose income and resources are insufficient to meet the cost of necessary medical care. No loss-no gain require Replacing health insurance policies to cover any conditions for which there are ongoing claims under existing coverage. S.H.O.P The Small Business Health Options Program double indemnity provides for payment of twice the face amount of the policy in the event of the accidental death of the insured. ERISA requires plans to provide participants with plan information about plan features and funding, provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to obtain benefits An electrocardiogram records the electrical activity of the heart Carpal Tunnel Syndrome is an example of a Repetitive Motion Injury Emphysema is a disease of Lungs Electromyography a medical procedure that measures muscle response to nerve stimulation How many bones make up the human skeleton 206 A medical report referencing a fracture of the right maxillae tells you that this is a fracture of the right cheek bone A medical report referencing a micro-fracture of the T-6 vertebrae tells you that this is specifically a Small fracture of the sixth thoracic vertebrae An injury to the coccyx indicates an injury to The tailbone Plantar flexion occurs at what part of the body? Ankle Circumduction An anatomical term referring to the circular movement of a body part, such as a ball and socket joint is known as Comminuted fracture a type of fracture in which the bone is broken into more than two pieces or crushed MRI a test that provides pictures of organs and structures inside the body by using a magnetic field and pulses of radio wave energy Internal Rotation a rotation of the shoulder or hip that would point the toes or the flexed forearm inwards Flexion a bending movement that decreases the angle between two parts Protrusion often applied to the jaw, is the anterior movement of an object Raising the arms laterally, to the sides, is an example of Abduction Tachycardia The excessive rapidity in the action of the heart usually applied to a heart rate above 100 per minute