New York Independent Adjuster Course Notes

Loss adjustment is a fact-and-policy process: identify the contract, secure time-sensitive evidence, establish cause and damage, analyze liability or coverage, value the supported loss, and document the basis for the disposition. Settlement authority begins with a supported coverage and damage evaluation. The adjuster then applies the correct valuation method, deductible, limits, other-insurance terms, liability assessment, and available settlement procedure. Dispute-resolution mechanisms solve different problems. The adjuster must know whether the dispute concerns amount of loss, coverage, liability, or negotiated settlement and then use the procedure authorized by policy, agreement, or law.

• Jumping to causation or liability before preserving time-sensitive evidence.

• When two facts conflict, prefer the answer that preserves and reconciles evidence rather than the one that assumes a conclusion.

Homeowners questions are usually solved by identifying the correct section and coverage letter, then applying the actual cause-of-loss, exclusion, condition, limit, deductible, and endorsement language. Endorsements are part of the issued homeowners contract and can add coverage, restrict coverage, change limits, change valuation, or change conditions. New York-specific and optional endorsements must be read together with the base form.

• Mixing Coverage A/B/C/D property interests or Coverage E/F liability functions.

• Identify the damaged interest first: dwelling, detached structure, contents, loss of use, liability, or medical payments.

New York auto claims require you to keep several systems separate: liability, first-party No-Fault/PIP, uninsured-motorist protection, optional supplementary underinsured-motorist protection, and physical damage. Personal and commercial auto claims require separate analysis of insured status, covered auto, liability, No-Fault/first-party benefits, UM/SUM, physical damage, and policy conditions. Vehicle-damage questions test scope, repairability, valuation, parts, labor, shop choice, total-loss methodology, supplements, prior damage, and claim documentation under New York auto claim rules.

• Using No-Fault/PIP to pay vehicle property damage.

• Classify the loss first: bodily injury economic loss, third-party liability, uninsured/underinsured injury, or vehicle damage.

A Commercial Package Policy is a collection of coverage parts. The package label never replaces analysis of the specific commercial property, CGL, crime, inland marine, equipment breakdown, or other coverage form. This CPP objective tests whether you can route a business loss to the correct specialized coverage part. Crime, inland marine, equipment breakdown, and farm forms insure different interests and causes.

• Using 'CPP' as the coverage conclusion instead of identifying the coverage part.

• Name the coverage part before discussing payment.

A Businessowners Policy packages property and liability protection for eligible businesses, but each coverage section still has its own trigger, limits, exclusions, conditions, valuation rules, and endorsements. BOP liability covers specified third-party exposures but remains governed by definitions, exclusions, conditions, limits, supplementary payments, and endorsements.

• Assuming a BOP covers every business exposure.

• Use this order: covered property → cause of loss → exclusions/conditions → valuation → deductible/limit → other insurance.

This objective groups nonstandard and excess coverages. The exam tests whether you identify the insured interest, layer, and trigger rather than forcing the loss into a familiar homeowners, auto, or CGL category. These are distinct specialty property/liability coverages. The candidate should identify the asset and insured interest before applying a familiar auto or homeowners rule.

• Confusing excess with umbrella without reading attachment/follow-form wording.

• First ask: what interest is insured—underlying liability layer, professional liability, building/contents flood, hull, cargo, freight, or maritime liability?

New York independent-adjuster authority is a licensing question before it is a claim question. Series 17-70 is the Independent General Adjuster examination category, and New York Insurance Law §2108 governs adjuster licensing and key exceptions/temporary authority. New York claim-settlement questions test prompt, fair, evidence-based handling under Insurance Law and Regulation 64/Part 216 principles for applicable claims. Privacy and federal-requirement questions test whether the adjuster collects, uses, secures, and discloses claim information for a legitimate purpose while complying with New York and federal restrictions.

• Confusing an independent adjuster with a public adjuster.

• When licensing is the issue, identify: who is represented, what activity is performed, what license/exception applies, and whether current authority exists.

Insurance basics supply the logic used in every later domain: contract formation and characteristics, indemnity, good faith, representations and warranties, insurable interest, hazards, negligence, causation, damages, and policy interpretation. Coverage and valuation require reading the entire policy as an integrated contract. A correct claim analysis connects declarations, definitions, insuring agreement, covered property, causes of loss, exclusions, conditions, endorsements, valuation, deductible, limits, and other insurance.

• Treating a policy limit as the value of the loss.

• Translate abstract terms into the facts before choosing an answer.

Accident and health questions test whether the loss fits the policy's covered accident/sickness or benefit definition and whether the claimant has supplied evidence required to support the benefit. Accident-and-health claim handling moves from notice and proof to investigation, benefit determination, payment/denial, and documentation under the specific policy and governing law.

• Assuming proof of loss equals automatic payment.

• Identify the benefit being claimed, then the definition/trigger, exclusions, proof, and financial provisions.

Dwelling-policy questions test the property coverage letters, peril structure, loss-of-use provisions, valuation, and endorsements for a residence that may not fit a standard homeowners form. Dwelling endorsements and conditions modify the base property form. The exam tests whether you apply the issued construction, theft, liability, valuation, or New York-specific modification rather than assuming another policy's terms.

• Importing homeowners-form rules into a dwelling policy.

• Memorize the property interests, not just letters.

New York workers’ compensation is primarily a statutory no-fault benefit system for qualifying work-related injury and occupational disease. Ordinary employee negligence does not decide compensability the way it would in a tort claim. Workers’ Compensation and Employers Liability are related but distinct parts of the standard workers’ compensation policy. Part One responds to statutory workers’ compensation benefits; Part Two addresses specified employer liability exposures outside the workers’ compensation benefit obligation.

• Applying ordinary negligence/comparative-fault analysis to statutory compensability.

• Build a checklist: employment → work connection → notice/filing → medical causation → disability → wages → benefit rule → current evidence.

Medical-report questions test comprehension, not diagnosis. The adjuster must understand what body structure, symptom, test, diagnosis, restriction, or prognosis is being described and relate it to the claimed mechanism and timeline. Diagnostic evidence is used to test mechanism, timing, severity, causation, disability, and damages. The adjuster weighs it with the history and other claim evidence rather than treating one test as conclusive.

• Making an independent diagnosis from a report.

• Translate the term, locate the anatomy, relate it to mechanism/timeline, then decide what clarification is needed.

Fidelity/crime forms can use different temporal triggers. The decisive issue is not simply 'when did someone notify the insurer?' but which policy form applies, when the covered loss was sustained, when it was discovered, and what discovery/prior-loss periods the contract allows. Fidelity coverage protects against specified dishonest or financial-institution losses. The adjuster must identify the exact insuring agreement, actor, property, direct-loss requirement, timing trigger, exclusions, limit, deductible, and proof.

• Reducing loss-sustained versus discovery to 'damage' versus 'notification.'

• Build a timeline with act date, loss date, discovery date, policy periods, and any prior-loss/extended-discovery provision.

Aviation hull is first-party physical-damage coverage for the insured aircraft. The exam separates named-peril hull from broader comprehensive/all-risk hull treatment and from aircraft liability. Aviation physical-damage settlement requires the aircraft hull form's deductible and valuation mechanics. Do not import automobile collision/comprehensive rules unless the aircraft policy itself uses comparable concepts.

• Importing New York auto No-Fault or collision rules into aircraft hull coverage.

• Identify the insured aircraft and physical-damage form first.

Aircraft liability is a third-party liability domain distinct from aviation hull. The outline specifically separates bodily injury excluding passengers, property damage, passenger bodily injury liability, and medical payments. An admitted-liability feature in aircraft insurance is a policy-defined payment mechanism for specified small liability losses or categories when its conditions are met. It does not authorize the adjuster to promise payment before confirming the provision applies.

• Using automobile No-Fault concepts for aircraft passenger or medical coverage.

• Identify who was injured or whose property was damaged before choosing the coverage.

Surety is a three-party contractual relationship rather than ordinary two-party indemnity insurance. Identifying the parties correctly solves many bond questions. Surety questions move from the three-party structure to the function of specific bonds. The bond guarantees a principal's specified obligation to an obligee subject to the bond's terms.

• Reversing principal and obligee.

• Find the underlying duty: who must perform it, who benefits, who guarantees it?