Insurance Coverage and Claims Analysis, Exams of General Surgery

Download Insurance Coverage and Claims Analysis and more Exams General Surgery in PDF only on Docsity! New York Independent Adjuster General Test Exam Questions with Verified Solutions. 1. All of the following statements are true regarding the Federal Employers Liability Act (FELA), EXCEPT: - ANS It provides workers' compensation coverage for employees working in federal government buildings. 2. Property damage to an insured's work that arises out of the work and is part of the products-completed operations hazard, as defined in a commercial umbrella liability policy is: - ANS Usually excluded unless the work out of which the damage arose was done by a subcontractor rather than the insured. 3. The insured car dealer carries dealer's physical damage coverage with comprehensive and collision coverage. One of the salesmen allows an old customer to test drive a van. The customer steals the car and it is later found heavily damaged in an accident. The adjuster will: - ANS deny the claim unless the insured carries "false pretense" coverage. 4. The limit for "medical and rehabilitation expenses" under the New York automobile "No-Fault" law is: - ANS $50,000. 5. All of the following types of signs can be covered by the Sign Coverage Form, except: - ANS Signs carved in stone or brick 6. Which of the following is used to bring a standardized insurance form into compliance with state laws? - ANS Endorsements. 7. Most crop insurance in the United States is written by: - ANS Private stock and mutual companies. 8. Under a standardized NCCI workers' compensation policy, the insurance company will pay to the insured, as part of any claim, proceeding, or suit defended, all of the following expenses, EXCEPT: - ANS Loss of earnings. 9. Homeowner’s policies cover all of the following, EXCEPT: - ANS a 2-family dwelling occupied by tenants who are renting the covered premises from the named insured. 10.Gavin operates a small manufacturing plant and is covered under a Commercial Property Business Income form. Under which of the following scenarios will Gavin be covered? - ANS His loss of profit while out of business as a result of a fire loss. 11.An insured has his home covered under dwelling policies with three different insurance companies. Company A provides 50% of the coverage, Company B provides 45% of the coverage, and Company C provides 5% of the coverage. When settling a claim for $10,000 worth of damage to the dwelling, what will Company C pay? - ANS $500 12.Which of the following is true regarding the dealers' physical damage coverage under the Garage policy? - ANS The coverage is provided by a blanket limit for covered autos. 13.The most common method of settling liability insurance claims is through: - ANS Negotiated settlement. 14.The purpose of liability insurance is to protect an insured from financial loss: - ANS Arising out of liability claims by transferring the burden of financial loss from the individual to the insurance company. 15.Which of the following is NOT covered by liability coverage under a Homeowner policy? - ANS A snowmobile in a park. 16.Which of the following correctly describes "Included Operations" as it relates to Automobile Physical Damage claims? - ANS The separate tasks that are included as part of a repair procedure, and the labor cost to perform these procedures. 17.All of the following would be considered an "insured" on a Homeowners policy, EXCEPT: - ANS A non-related tenant living in the insured residence... 18.Which of the following is a type of "voluntary loss" taken to save the property from further loss? - ANS General Average Loss. 19.A typical directors and officers liability policy covers each of the following, EXCEPT: 20.Your answer - ANS the Corporation for suits brought against it because of the actions of the officers and directors 21.Which of the following is NOT covered under a premise burglary claim? - ANS Fire to the building caused from the break in. 22.The retroactive date on a claims-made CGL form specifies: - ANS that losses occurring before the date will not be covered by the policy... 23. "Sinkhole collapse" is a peril covered under which of the following ISO Commercial Property Cause of Loss forms? - ANS The Basic, Broad and Special forms 24.All of the following items would be covered under a Personal Property Replacement Cost Endorsement attached to a Homeowners policy, EXCEPT: - 47.Coverage E -- Personal Liability of the standard Homeowners policies covers the insured for all of the following, EXCEPT: - ANS Business activities 48.Under a "claims-made" CGL policy, which of the following events would eliminate coverage: - ANS Injury or damage which occurred prior to the retroactive date 49.An unendorsed blanket fidelity bond: - ANS Does not list the names of the employees 50.All of the following are EXCLUDED under the Earthquake Endorsement to a Homeowners policy, EXCEPT: - ANS Land shock waves 51.Which of the following would be covered under the Commercial Property Builders Risk Coverage Form? - ANS All of the responses are correct 52.Which of the following is most likely to be uninsurable? - ANS The purchaser of a new home wants to protect herself from a possible drop in housing prices 53.Most aircraft hull policies are written on a: - ANS Valued basis 54.A Bailee customers' policy: - ANS Covers damage to customers' property when the insured is liable 55.Which of the following workers' compensation reserves will be used to pay the expenses associated with IMEs? - ANS Expense reserves 56.When would the Personal Auto policy respond to a loss with an all-terrain three- wheeled vehicle? - ANS When used in an emergency situation 57.Which of the following types of crops would a "small grain" crop policy cover? - ANS Barley 58.Which of the following produces images from different angles that a computer uses to produce a cross-sectional image to detect tumors, bone displacement, and fluid retention. - ANS Computerized tomography (CT or CAT) 59.Which of the following statements is FALSE regarding a released bill of lading? - ANS The carrier agrees to over insure the cargo so that the shipper will be compensated for all losses 60.The Part B - Medical Payments coverage under a standard Personal Auto policy will cover the insured if he/she is injured while a passenger on a: - ANS Bus 61.All of the following can act as the security deposit required in New York for an employer to self-insure for workers' compensation, EXCEPT: - ANS a promissory note made out to the Department of Financial Services 62.The Home Business Insurance Endorsement is available to cover certain businesses, when attached to a Homeowners policy. Which of the following coverage’s is NOT included on this endorsement form? - ANS Professional Liability coverage 63.Which of the following describes a "verbal threshold" as it is used in the New York Comprehensive Motor Vehicle Insurance Reparations Act (No-Fault / PIP)? - ANS The threshold of injury that must be exceeded before an injured person may bring a lawsuit for "non-economic" losses 64.Which of the following resins is used to replace heavier metals when manufacturing or repairing automobile parts? - ANS High Density Polyethylene’s (HDPEs) 65.Homeowner policies typically provide coverage for all of the following, EXCEPT: - ANS Personal injury 66.Under a standard ISO Identity Fraud Expense endorsement, what is the maximum amount that will be paid, PER DAY, for lost income? - ANS $200 67.A settlement in which the claimant receives payment in installments over a period of time instead of a lump sum is: - ANS a Structured Settlement 68.All of the following are examples of insurable interest in property, EXCEPT: - ANS the interest an individual has in the property her parents will someday leave to her. 69.Carpal Tunnel Syndrome is an example of a - ANS Repetitive Motion Injury 70.This Ocean Marine insurance coverage protects the vessel owner in the event that cargo shipping costs are not paid. - ANS Freight Insurance 71.Which of the following is used to differentiate various types of treatment on an Accident & Health claim form? - ANS Current Procedural Terminology (CPT) 72.Which type of damages is not intended to indemnify the plaintiff? - ANS Punitive damages 73.The ISO standardized ISO HO-2 broad cause of loss form provides coverage for "vandalism and malicious mischief", unless the premises has been vacant for _____ days or more. The New York statutory HO-2 form, provides this coverage only if the premises has not been vacant for more than ______ days. - ANS 60 days / 30 days 74.Billy has his commercial interests covered with a Commercial Package policy. He would like to modify one of his coverage parts. This change will be made by: - ANS Adding an endorsement to the coverage part he would like to change 75.Difference-in-Conditions insurance: - ANS Must be written in conjunction with other commercial property coverage 76.What is the term for the integration of financing and delivery of healthcare into an organized system? - ANS Managed care 77.An insured carries a general liability policy and has hired a trucking company to transport equipment to the business location. The trucking company carries a commercial auto policy. The insured loads a piece of machinery onto the truck and fails to secure it properly. The trucking company is transporting the cargo and it falls off the truck and hits another car. Which policy or policies would cover this claim? - ANS The trucking company's commercial auto policy would cover the claim 78.All of the following are factors in establishing negligence, EXCEPT: - ANS Others involved 79.When a Homeowners policy has been in effect for 60 days in New York, an insurer can cancel at any time for any of the following reasons, EXCEPT: - ANS A large loss has occurred 80.Which type of Crop Insurance Policy covers the entire farm instead of an individual crop? 81.Your answer - ANS Adjusted Gross Revenue 82.Which of the following NFIP policies is required to include the Increased Cost of Compliance (ICC) coverage? - ANS An NFIP Dwelling policy under the Regular Program 83.Which of the following is a true statement regarding the "law of large numbers"? 84.Your answer - ANS As the number of insured units increases, the ability to predict losses increases 85.Eddie added a return of premium rider to his non-cancellable, individual, long term disability policy. How often, and how much premium can Eddie expect to be returned to him? - ANS 80% every 10 years, at age 65 and at death 86. In 2011 Ace Agency writes a fidelity bond for Doe Carpeting. Two months later a claim for theft by one of Doe's employees that occurred back in 2008 is brought