New York Accident & Health Insurance Exam 2025/2026 with Solution

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New York Accident & Health Insurance
Exam

Independent Adjuster
A person, firm or corporation acts on behalf of an insurer. (For profit) Insurance
Company




Public Adjuster
A person, firm or corporation acts on behalf of an insured. Negotiating certain
claims for loss of damage to property.




Cancellable Health Insurance
Insurance policies provide insurer right to cancel coverage at any time. Giving
number of days notice. (as little as five days)




Noncancellable Health Inusurance
Contracts can't be cancelled by an insurer for any reason. Exceptions include
fraudulent claim or non-payment of premium.




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Conditionally Renewable
Policies provide insurer with the right to refuse to renew coverage for certain
conditions stated in the policy. Can't refuse to renew on basis of declining health.




ERISA
Employee Retirement Income Security Act (1974)




Insured's Notice of Claim
Policyholder must give notice of a claim within 20 days or as soon as reasonably
possible.




Standard Claim Forms
15 days after notice of claim




Proof of Loss




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Required 90 days after the end of a period which the insurer is liable.




Permanent total disability
Most severe, insurer will never work again.




Temporary total disability
Renders insurer incapable of working for a certain time-frame. Recovery is seen




Permanent partial disability
Injury that is permanent but won't stop the individual from returning to work.
(loss of leg, arm etc)




Temporary partial disability
Least severe, keeps individual out of work for a few days.




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