NYS 17-63 Independent Accident and
Health Insurance Adjuster Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. What is the primary role of an independent accident and health
insurance adjuster?
A. To sell insurance policies
B. To underwrite new policies
C. To investigate and adjust claims on behalf of insurers
D. To provide legal representation to claimants
Correct Answer: C
Rationale: Independent adjusters are hired by insurers to investigate,
evaluate, and settle claims, not to sell or underwrite insurance.
, 2. Which type of insurance primarily covers medical expenses resulting
from illness or injury?
A. Life insurance
B. Property insurance
C. Casualty insurance
D. Accident and health insurance
Correct Answer: D
Rationale: Accident and health insurance is designed to cover medical
costs, disability income, and related expenses from illness or injury.
3. In New York, who licenses independent accident and health insurance
adjusters?
A. New York State Legislature
B. New York State Department of Financial Services (DFS)
C. National Association of Insurance Commissioners
D. New York State Insurance Exchange
Correct Answer: B
Rationale: The NYS Department of Financial Services regulates and licenses
insurance professionals in New York.
4. What is the purpose of a deductible in an accident and health
insurance policy?
, A. To increase premiums
B. To require the insured to share in the cost of claims
C. To limit coverage to specific illnesses
D. To eliminate small claims
Correct Answer: B
Rationale: A deductible is the amount the insured must pay before the
insurer begins paying benefits, encouraging cost sharing.
5. Which policy provision describes situations that are not covered by the
policy?
A. Insuring clause
B. Conditions
C. Exclusions
D. Riders
Correct Answer: C
Rationale: Exclusions specify losses or conditions that the policy does not
cover.
6. What does “coordination of benefits” refer to in health insurance?
A. Payment of claims in advance
B. Preventing duplicate payments when more than one policy covers
an insured
, C. Adjusting premiums annually
D. Combining life and health benefits
Correct Answer: B
Rationale: Coordination of benefits ensures total payments do not exceed
the actual cost when multiple policies apply.
7. Which principle requires an adjuster to act honestly and fairly?
A. Indemnity
B. Subrogation
C. Good faith
D. Consideration
Correct Answer: C
Rationale: Adjusters are legally and ethically required to act in good faith
when handling claims.
8. What is subrogation?
A. Waiving the deductible
B. The insurer’s right to recover from a responsible third party
C. Sharing losses among insurers
D. Assigning benefits to a provider
Health Insurance Adjuster Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. What is the primary role of an independent accident and health
insurance adjuster?
A. To sell insurance policies
B. To underwrite new policies
C. To investigate and adjust claims on behalf of insurers
D. To provide legal representation to claimants
Correct Answer: C
Rationale: Independent adjusters are hired by insurers to investigate,
evaluate, and settle claims, not to sell or underwrite insurance.
, 2. Which type of insurance primarily covers medical expenses resulting
from illness or injury?
A. Life insurance
B. Property insurance
C. Casualty insurance
D. Accident and health insurance
Correct Answer: D
Rationale: Accident and health insurance is designed to cover medical
costs, disability income, and related expenses from illness or injury.
3. In New York, who licenses independent accident and health insurance
adjusters?
A. New York State Legislature
B. New York State Department of Financial Services (DFS)
C. National Association of Insurance Commissioners
D. New York State Insurance Exchange
Correct Answer: B
Rationale: The NYS Department of Financial Services regulates and licenses
insurance professionals in New York.
4. What is the purpose of a deductible in an accident and health
insurance policy?
, A. To increase premiums
B. To require the insured to share in the cost of claims
C. To limit coverage to specific illnesses
D. To eliminate small claims
Correct Answer: B
Rationale: A deductible is the amount the insured must pay before the
insurer begins paying benefits, encouraging cost sharing.
5. Which policy provision describes situations that are not covered by the
policy?
A. Insuring clause
B. Conditions
C. Exclusions
D. Riders
Correct Answer: C
Rationale: Exclusions specify losses or conditions that the policy does not
cover.
6. What does “coordination of benefits” refer to in health insurance?
A. Payment of claims in advance
B. Preventing duplicate payments when more than one policy covers
an insured
, C. Adjusting premiums annually
D. Combining life and health benefits
Correct Answer: B
Rationale: Coordination of benefits ensures total payments do not exceed
the actual cost when multiple policies apply.
7. Which principle requires an adjuster to act honestly and fairly?
A. Indemnity
B. Subrogation
C. Good faith
D. Consideration
Correct Answer: C
Rationale: Adjusters are legally and ethically required to act in good faith
when handling claims.
8. What is subrogation?
A. Waiving the deductible
B. The insurer’s right to recover from a responsible third party
C. Sharing losses among insurers
D. Assigning benefits to a provider
