NYS 17-63 Independent Accident and Health
Insurance Adjuster Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A |
SECTION 1: NYS LICENSING, REGULATION, AND ETHICS (Questions 1-25)
1. The New York Superintendent of Financial Services is:
A) Elected by the residents of New York State
B) Appointed by the New York State Senate
C) Appointed by the Governor of New York State
D) A position appointed by the federal government
Answer: C) Appointed by the Governor of New York State
Explanation: The Superintendent of the New York State Department of Financial Services
(NY DFS) is a member of the Governor's cabinet and is appointed by the Governor .
2. The primary responsibility of the New York Superintendent of Financial Services is:
A) Setting interest rates for the state
B) Enforcing New York State insurance laws and regulations
C) Approving all new insurance policies sold in the U.S.
D) Managing the federal Social Security program
Answer: B) Enforcing New York State insurance laws and regulations
Explanation: The Superintendent is the head of the NY DFS and is responsible for
administering and enforcing the state's insurance laws and regulations, as well as banking laws
.
3. An independent adjuster is best defined as a person who:
A) Acts on behalf of the insured in negotiating a claim settlement
B) Acts on behalf of an insurer in investigating and adjusting claims
C) Works exclusively for a single insurance company as an employee
D) Represents the state in insurance regulatory matters
Answer: B) Acts on behalf of an insurer in investigating and adjusting claims
Explanation: An independent adjuster is hired by an insurance company (on a contract or fee
basis) to investigate, evaluate, and settle claims on the insurer's behalf .
4. A public adjuster is best defined as a person who:
A) Acts on behalf of an insurer in investigating claims
B) Is a salaried employee of a government agency
C) Acts on behalf of an insured in negotiating the settlement of a claim
, D) Arbitrates disputes between an insurer and an insured
Answer: C) Acts on behalf of an insured in negotiating the settlement of a claim
Explanation: Unlike an independent adjuster who works for the insurance company, a public
adjuster is hired by the policyholder (the insured) to help them prepare, present, and negotiate
their claim with their own insurance company .
5. Which of the following is a basic qualification for obtaining a New York Accident & Health
Adjuster license?
A) Be at least 21 years of age
B) Be a resident of New York State for at least 5 years
C) Be approved by at least five reputable citizens of the community
D) Have a bachelor's degree in a related field
Answer: C) Be approved by at least five reputable citizens of the community
Explanation: Along with being 18, passing the exam, and submitting to fingerprinting, an
applicant for a New York adjuster license must provide character references approved by five
reputable citizens .
6. New York residents securing an insurance adjuster license must meet all of the following
qualifications EXCEPT:
A) Pass the state licensing examination
B) Maintain a $5,000.00 surety bond
C) Be at least 18 years of age
D) Submit to fingerprinting
Answer: B) Maintain a $5,000.00 surety bond
Explanation: While a bond is required, the amount mandated by New York for an adjuster
license is $1,000, not $5,000 .
7. The amount of the surety bond required to be filed by an adjuster with the state of New York
is:
A) $500
B) $1,000
C) $5,000
D) $10,000
Answer: B) $1,000
Explanation: The specific amount for the surety bond required for an adjuster license in New
York is one thousand dollars ($1,000) .
8. Following the occurrence of a legitimate loss, within what period of time can an insured
generally bring legal action against the insurer for failure to promptly and properly settle the
claim?
A) Within one year after the inception of the loss
B) Within two years after the inception of the loss
C) Within three years after the inception of the loss
D) Within five years after the inception of the loss
, Answer: B) Within two years after the inception of the loss
Explanation: Insurance policies and New York law typically include a "statute of limitations"
provision, often allowing the insured up to two years from the date of loss to file a lawsuit .
9. Failing to acknowledge reasonable communications with respect to claims arising out of
policies is an example of:
A) A clerical error
B) A fair claims practice
C) An unfair claims practice
D) A necessary part of the investigation process
Answer: C) An unfair claims practice
Explanation: Ignoring or failing to promptly respond to communications from a policyholder
regarding their claim is a defined unfair claims settlement practice under state regulations .
10. The intentional failure to disclose known facts relevant to an insurance application is known
as:
A) Warranting
B) Concealment
C) Misrepresentation
D) Fraud
Answer: B) Concealment
Explanation: Concealment is the deliberate withholding of material facts that, if known to the
insurer, would have influenced their decision to accept the risk or the premium charged .
11. A temporary adjuster license can be issued by the Superintendent for a period of up to
_____ days.
A) 60
B) 90
C) 120
D) 180
Answer: C) 120
Explanation: In specific circumstances, such as a state of emergency or to handle a large
volume of claims, the Superintendent may issue a temporary license valid for up to 120 days .
12. A person that has been found to be in violation of unfair or deceptive acts can be fined up to
______ for each offence.
A) $100
B) $250
C) $500
D) $1,000
Answer: C) $500
Explanation: The New York Insurance Law provides for a penalty of up to $500 for each
violation of provisions relating to unfair and deceptive acts and practices .
, 13. A policyholder must give notice of a claim to the insurer within _________ or as soon as
reasonably possible.
A) 10 days
B) 20 days
C) 30 days
D) 60 days
Answer: B) 20 days
Explanation: Standard policy provisions require the insured to notify the insurer or its agent of
a loss "within 20 days or as soon as reasonably possible" after the occurrence .
14. Proof of loss (a formal sworn statement providing details of the loss) must be submitted by
the insured to the insurer within ____ of the loss.
A) 30 days
B) 60 days
C) 90 days
D) 120 days
Answer: C) 90 days
Explanation: The standard policy provision requires that written proof of loss be furnished to
the insurer within 90 days after the date of such loss .
15. The insurer is required to provide claim forms to the insured within _____ of being notified of
the loss.
A) 5 days
B) 10 days
C) 15 days
D) 20 days
Answer: C) 15 days
Explanation: Upon receiving notice of a claim, the insurer is obligated to send the insured the
necessary forms for filing a proof of loss within 15 days .
16. Which federal law requires employer-sponsored health plans to provide participants with
plan information, establish a grievance and appeals process, and sets fiduciary responsibilities?
A) HIPAA (Health Insurance Portability and Accountability Act)
B) ERISA (Employee Retirement Income Security Act)
C) COBRA (Consolidated Omnibus Budget Reconciliation Act)
D) ACA (Affordable Care Act)
Answer: B) ERISA (Employee Retirement Income Security Act)
Explanation: ERISA sets minimum standards for most voluntarily established retirement and
health plans in private industry to protect individuals in these plans .
17. S.H.O.P. (The Small Business Health Options Program) is a provision of which federal act?
A) ERISA
B) COBRA
C) The Affordable Care Act (ACA)
Insurance Adjuster Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A |
SECTION 1: NYS LICENSING, REGULATION, AND ETHICS (Questions 1-25)
1. The New York Superintendent of Financial Services is:
A) Elected by the residents of New York State
B) Appointed by the New York State Senate
C) Appointed by the Governor of New York State
D) A position appointed by the federal government
Answer: C) Appointed by the Governor of New York State
Explanation: The Superintendent of the New York State Department of Financial Services
(NY DFS) is a member of the Governor's cabinet and is appointed by the Governor .
2. The primary responsibility of the New York Superintendent of Financial Services is:
A) Setting interest rates for the state
B) Enforcing New York State insurance laws and regulations
C) Approving all new insurance policies sold in the U.S.
D) Managing the federal Social Security program
Answer: B) Enforcing New York State insurance laws and regulations
Explanation: The Superintendent is the head of the NY DFS and is responsible for
administering and enforcing the state's insurance laws and regulations, as well as banking laws
.
3. An independent adjuster is best defined as a person who:
A) Acts on behalf of the insured in negotiating a claim settlement
B) Acts on behalf of an insurer in investigating and adjusting claims
C) Works exclusively for a single insurance company as an employee
D) Represents the state in insurance regulatory matters
Answer: B) Acts on behalf of an insurer in investigating and adjusting claims
Explanation: An independent adjuster is hired by an insurance company (on a contract or fee
basis) to investigate, evaluate, and settle claims on the insurer's behalf .
4. A public adjuster is best defined as a person who:
A) Acts on behalf of an insurer in investigating claims
B) Is a salaried employee of a government agency
C) Acts on behalf of an insured in negotiating the settlement of a claim
, D) Arbitrates disputes between an insurer and an insured
Answer: C) Acts on behalf of an insured in negotiating the settlement of a claim
Explanation: Unlike an independent adjuster who works for the insurance company, a public
adjuster is hired by the policyholder (the insured) to help them prepare, present, and negotiate
their claim with their own insurance company .
5. Which of the following is a basic qualification for obtaining a New York Accident & Health
Adjuster license?
A) Be at least 21 years of age
B) Be a resident of New York State for at least 5 years
C) Be approved by at least five reputable citizens of the community
D) Have a bachelor's degree in a related field
Answer: C) Be approved by at least five reputable citizens of the community
Explanation: Along with being 18, passing the exam, and submitting to fingerprinting, an
applicant for a New York adjuster license must provide character references approved by five
reputable citizens .
6. New York residents securing an insurance adjuster license must meet all of the following
qualifications EXCEPT:
A) Pass the state licensing examination
B) Maintain a $5,000.00 surety bond
C) Be at least 18 years of age
D) Submit to fingerprinting
Answer: B) Maintain a $5,000.00 surety bond
Explanation: While a bond is required, the amount mandated by New York for an adjuster
license is $1,000, not $5,000 .
7. The amount of the surety bond required to be filed by an adjuster with the state of New York
is:
A) $500
B) $1,000
C) $5,000
D) $10,000
Answer: B) $1,000
Explanation: The specific amount for the surety bond required for an adjuster license in New
York is one thousand dollars ($1,000) .
8. Following the occurrence of a legitimate loss, within what period of time can an insured
generally bring legal action against the insurer for failure to promptly and properly settle the
claim?
A) Within one year after the inception of the loss
B) Within two years after the inception of the loss
C) Within three years after the inception of the loss
D) Within five years after the inception of the loss
, Answer: B) Within two years after the inception of the loss
Explanation: Insurance policies and New York law typically include a "statute of limitations"
provision, often allowing the insured up to two years from the date of loss to file a lawsuit .
9. Failing to acknowledge reasonable communications with respect to claims arising out of
policies is an example of:
A) A clerical error
B) A fair claims practice
C) An unfair claims practice
D) A necessary part of the investigation process
Answer: C) An unfair claims practice
Explanation: Ignoring or failing to promptly respond to communications from a policyholder
regarding their claim is a defined unfair claims settlement practice under state regulations .
10. The intentional failure to disclose known facts relevant to an insurance application is known
as:
A) Warranting
B) Concealment
C) Misrepresentation
D) Fraud
Answer: B) Concealment
Explanation: Concealment is the deliberate withholding of material facts that, if known to the
insurer, would have influenced their decision to accept the risk or the premium charged .
11. A temporary adjuster license can be issued by the Superintendent for a period of up to
_____ days.
A) 60
B) 90
C) 120
D) 180
Answer: C) 120
Explanation: In specific circumstances, such as a state of emergency or to handle a large
volume of claims, the Superintendent may issue a temporary license valid for up to 120 days .
12. A person that has been found to be in violation of unfair or deceptive acts can be fined up to
______ for each offence.
A) $100
B) $250
C) $500
D) $1,000
Answer: C) $500
Explanation: The New York Insurance Law provides for a penalty of up to $500 for each
violation of provisions relating to unfair and deceptive acts and practices .
, 13. A policyholder must give notice of a claim to the insurer within _________ or as soon as
reasonably possible.
A) 10 days
B) 20 days
C) 30 days
D) 60 days
Answer: B) 20 days
Explanation: Standard policy provisions require the insured to notify the insurer or its agent of
a loss "within 20 days or as soon as reasonably possible" after the occurrence .
14. Proof of loss (a formal sworn statement providing details of the loss) must be submitted by
the insured to the insurer within ____ of the loss.
A) 30 days
B) 60 days
C) 90 days
D) 120 days
Answer: C) 90 days
Explanation: The standard policy provision requires that written proof of loss be furnished to
the insurer within 90 days after the date of such loss .
15. The insurer is required to provide claim forms to the insured within _____ of being notified of
the loss.
A) 5 days
B) 10 days
C) 15 days
D) 20 days
Answer: C) 15 days
Explanation: Upon receiving notice of a claim, the insurer is obligated to send the insured the
necessary forms for filing a proof of loss within 15 days .
16. Which federal law requires employer-sponsored health plans to provide participants with
plan information, establish a grievance and appeals process, and sets fiduciary responsibilities?
A) HIPAA (Health Insurance Portability and Accountability Act)
B) ERISA (Employee Retirement Income Security Act)
C) COBRA (Consolidated Omnibus Budget Reconciliation Act)
D) ACA (Affordable Care Act)
Answer: B) ERISA (Employee Retirement Income Security Act)
Explanation: ERISA sets minimum standards for most voluntarily established retirement and
health plans in private industry to protect individuals in these plans .
17. S.H.O.P. (The Small Business Health Options Program) is a provision of which federal act?
A) ERISA
B) COBRA
C) The Affordable Care Act (ACA)
