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Timestamp: 2019-01-19 16:28:37
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Allyson Beverley Kelly
1 Your Exam Content Outline The following outline describes the content of one of the New York insurance examinations. The examination will contain questions on the subjects contained in the outline. The percentages indicate the relative weight assigned to each section of the examination. For example, 10 percent means that 6 questions will be drawn from the section on a 60-question exam, 10 will be drawn on a 100-question exam and 15 will be drawn on a 150-question exam. New York Property and Casualty Insurance Consultant Examination Series questions 2.5-hour time limit Live Date- September 7 th, Insurance Regulation 10% 1.1 Licensing Process (2103(d i)) Producer definition (2101(k)) Who should be licensed (2101(k)) Home state (2101(l)) Negotiate (2101(m)) Sell (2101(n)) Solicit (2101(o)) Types of licensees Agents (2101(a, k); 2103; Reg 6, Part 22.2; Reg 7, Part 23.2) Brokers (2101(c, h, k); 2104) Consultants (2107) Adjusters (2101(g), 2108) Nonresident (2101(d, e); 2103(g)(5, 11); 2136) Business entities (2101(p), 2103(e)) Temporary (2109; Regs 9, 18, 29, Part 20.1) Maintenance and duration Renewal (2103(j); Reg 5, Part 21.2) Continuing education (2108, 2132) Assumed names (2102(f)) Change of address (all addresses, including ) (2134; Reg 5, Part 21.4; Reg 6, Part, 22.3; Reg 7, Part 23.4) Reporting of actions (2110(i)(j)) Disciplinary actions Hearings-Notice and Process (2405, 2406, Financial Services 305) Suspension, revocation, and nonrenewal (2110) Penalties (2127, 109) 1.2 State regulation Superintendent's general duties and powers (2404, Financial Services 201, 202, 301) Company regulation Certificate of authority (1102) Solvency (307) Unfair claim settlement practices (2601; Reg 64, Part ) Appointment of agent (2112(a c)) Termination of agent appointment (2112(d); Regs 9, 18, 29, Part 20.2) Unfair and prohibited practices Misrepresentation (2123; Reg 64, Part 216.3) False advertising (2603) Defamation of insurer (2604) Unfair discrimination ( , 2612) Rebating (2324) Licensee regulation Controlled business (2103(i)) Sharing commissions (2121, 2128) Fiduciary responsibility (2120; Regs 9, 18, 29, Parts 20.3, 20.4) License display (Reg 125, Part 34.5) Commissions and compensation (2102(e), , 2119; Regs 9, 18, 29, Part 20.6; Reg 194, Part 30) Termination responsibilities of producer (2112(g)) Examination of books and records (2404; Reg 152, Parts to 243.3) Insurance Frauds Prevention Act ( , Financial Services ) Aiding Unauthorized Insurer (2117) Prohibitions (403) Reporting (405) Consumer privacy regulation (Reg 169, Parts to ) Producer Compensation Transparency (Reg 194, Parts 30.1 to 30.5) 1.3 Federal regulation Fair Credit Reporting Act (15 USC 1681a 1681d) Fraud and false statements including 1033 waiver (18 USC 1033, 1034) 2.0 General Insurance 10% 2.1 Concepts Risk management key terms Risk (pure and speculative) Exposure Hazard (physical, moral, morale) Peril Loss Methods of handling risk Avoidance Retention Sharing Reduction 1
2 Transfer (by contractual liability or insurance contract) Elements of insurable risks Adverse selection Law of large numbers Reinsurance 2.2 Insurers Types of insurers Stock companies Mutual companies Fraternal benefit societies Lloyd's associations Private versus government insurers Admitted versus nonadmitted insurers Domestic, foreign and alien insurers Financial status (independent rating services) Marketing (distribution) systems 2.3 Agents and general rules of agency Insurer as principal Agent/insurer relationship Authority and powers of agents Express Implied Apparent Responsibilities to the applicant/insured 2.4 Contracts Elements of a legal contract Offer and acceptance Consideration Competent parties Legal purpose Characteristics of insurance contracts Contract of adhesion Aleatory contract Personal contract Unilateral contract Conditional contract Legal concepts and interpretations affecting contracts Reasonable expectations Indemnity Utmost good faith Representations/misrepresentations (3105) Warranties (3106) Rescission Concealment Fraud Waiver and estoppel 3.0 Property and Casualty Insurance Basics 16% 3.1 Principles and concepts Insurable interest Underwriting Function Prohibition of geographical redlining (3429, 3429-a, 3430, 3433; Reg 90, Parts to 218.7) Insurance Risk Score (credit scoring) Rates Types Loss costs Components Negligence Elements of a negligent act Defenses against negligence Damages Compensatory special versus general Punitive Absolute or Strict liability Vicarious liability Causes of loss (perils) Proximate cause Named perils versus special (open) perils Direct loss Consequential or indirect loss Blanket versus specific insurance Basic types of construction Loss valuation Actual cash value Replacement cost Guaranteed Functional Market value Agreed value Stated amount 3.2 Policy structure Declarations Insuring agreement or clause Additional/supplementary coverage Conditions Endorsements 3.3 Common policy provisions Insureds named, first named, additional, defined Policy period Policy territory Cancellation and nonrenewal (3425, 3426) Earned premium calculation Pro rata, short rate, and flat cancellation Deductibles Self Insured Retention (SIR) Other insurance Primary Excess Pro rata share Limits of liability Per occurrence (accident) Per person Per project Per location Aggregate Sublimit Split Combined single Ordinance or law provision Vacancy vs non-occupancy First Named insured provisions Duties after loss Assignment Abandonment Insurer provisions 2
3 Liberalization Subrogation Salvage Loss settlement options Duty to defend Coinsurance Third-party provisions Standard mortgage clause Loss payable clause No benefit to the bailee 3.4 Terrorism Risk Insurance Act of 2002 and Extension Act of 2015 (15 USC 6701; S467) 3.5 Certificates of Insurance ( ) 4.0 Dwelling (2002) Policy 6% 4.1 Purpose and eligibility 4.2 forms Perils insured against Basic Broad Special 4.3 Property coverages A Dwelling B Other structures C Personal property D Fair rental value E Additional living expense Other coverages 4.4 General exclusions 4.5 Conditions 4.6 Special provisions New York (DP 01 31) Broad theft endorsement (DP 04 83) Dwelling under construction (DP 11 43) 4.7 Personal liability supplement 5.0 Homeowners (2011) Policy 15% 5.1 Purpose and eligibility 5.2 forms HO-2 through HO-6, HO Section I Property coverages A Dwelling B Other structures C Personal property D Loss of use Additional coverages 5.5 Section II Liability coverages E Personal liability F Medical payments to others Additional coverages 5.6 Perils insured against Conditions 5.9 Special provisions New York (HO 01 31) Earthquake (HO 04 54) Identity fraud expense (HO 04 55) Scheduled personal property (HO 04 61) Personal property replacement cost (HO 04 90) Home business (HO 07 01) Personal injury New York (HO 24 86) Workers' compensation certain residence employees New York (HO 24 93) Water Back Up and Sump Discharge or Overflow (HO 23 85) 6.0 Auto Insurance 10% 6.1 Laws New York Motor Vehicle Financial Responsibility Law Required limits of liability (Veh & Traf 333) Required proof of insurance (Veh & Traf 311(3)) Insurance Information and Enforcement System (IIES) notification to DMV (Veh & Traf 313(2)) New York Automobile Insurance Plan (Assigned Risk) ( ) Purpose Eligibility Binding authority Comprehensive Motor Vehicle Insurance Reparations Act (PIP) ( ) Notice of claim Medical Rehabilitation Loss of earnings Funeral Substitution services Tort limitation/verbal threshold Optional coverages OBEL Additional PIP Motor Vehicle Accident Indemnification Corporation Act ( ) Uninsured/Underinsured motorist (3420(f)) Bodily injury only Required limits Mandatory coverage Supplementary uninsured/underinsured motorist coverage (3420(f)(2)(A)(B); Reg 35-A, Parts to ) Optional Nonstacking limits Mandatory inspection requirements for private passenger automobiles (Reg 79, Parts 67.0 to 67.11) Cancellation/nonrenewal (3425) Grounds Notice Choice of repair shop (2610) Supplemental spousal liability (3420(g)) 6.2 Personal (2005) auto policy Purpose and eligibility Liability coverage Bodily injury and property damage Supplementary payments Who is insured 3
4 Medical payments coverage for damage to your auto Collision Other than collision/comprehensive Deductibles Transportation expenses Duties after an accident or loss General provisions Amendment of policy provisions New York (PP 01 79) Towing and labor costs (PP 03 03) Miscellaneous type vehicle New York (PP 03 29) Named non-owner coverage New York (PP 03 30) Rental vehicle coverage New York (PP 03 46) Joint ownership coverage New York (PP 03 78) Out of state coverage 6.3 Commercial auto (2010) Commercial auto coverage forms Business auto Garage Motor carrier form sections Covered autos Liability coverage Garagekeepers coverage Physical damage coverage Conditions Hired auto and non-owned auto liability - New York Lessor additional insured and loss payee (CA 20 01) Mobile equipment (CA 20 24) Auto medical payments coverage (CA 99 03) Drive other car coverage (CA 99 10) Individual named insured (CA 99 17) Employees as insureds (CA 99 33) Commercial carrier regulations The Motor Carrier Act of 1980 Endorsement for motor carrier policies of insurance for public liability (MCS-90) 7.0 Commercial Package Policy (CPP) 10% 7.1 Components of a commercial policy Common policy declarations Common policy conditions First named insured Monoline versus package 7.2 Commercial general liability (2013) Bodily injury and property damage liability Premises and operations Products and completed operations Personal and advertising injury liability Damage to Rented Premises (Fire Legal Liability) Medical payments coverage Supplementary payments Who is an insured Limits of insurance Conditions Insured contract Occurrence versus claims-made Claims-made and reported Claims made features (Reg 121, Part 73) Trigger Retroactive date Extended reporting periods basic versus supplemental Claim information Owners and contractors protective liability 7.3 Commercial property (2012) Commercial property conditions (CP 00 90) forms Building and personal property Condominium association Condominium commercial unit-owners Builders risk (CP 11 21) Business income Business Interruption Legal liability Extra expense Causes of loss forms Basic Broad Special Ordinance or law (CP 04 05) Spoilage (CP 04 40) Earthquake and volcanic eruption (CP 10 40) Flood coverage (CP 10 65) Ordinance of law (CP 04 05) 7.4 Commercial crime (2013) General definitions Burglary Theft Robbery trigger discovery and loss sustained Crime coverage forms Commercial crime coverage forms Government crime coverage forms s Employee theft Forgery or alteration Inside the premises theft of money and securities Inside the premises robbery or safe burglary of other property Outside the premises Computer fraud Funds transfer fraud Money orders and counterfeit money Identity theft 4
5 7.5 Commercial inland marine Nationwide marine definition Commercial inland marine conditions forms Commercial inland marine coverage forms Contractors equipment floater Electronic data processing Motor truck cargo 7.6 Equipment breakdown protection coverage form (EB 00 20) 7.7 Farm coverage Farm property coverage forms (2003) A Dwellings B Other private structures C Household personal property D Loss of use E Scheduled farm personal property F Unscheduled farm personal property G Other farm structures Farm liability coverage forms (2006) H Bodily injury and property damage liability I Personal and advertising injury liability J Medical payments 8.0 Businessowners (2010) Policy 8% 8.1 Purpose and eligibility 8.2 Businessowners property coverage Causes of loss Limits of insurance Deductibles Loss conditions General conditions Optional coverages Additional coverages 8.3 Businessowners liability coverage form s Who is an insured Limits of insurance General conditions 8.4 Businessowners common policy conditions form 8.5 Hired auto and non-owned auto liability New York (BP 04 36) Named Perils (BP 10 09) 9.0 Workers Compensation Insurance 5% 9.1 Workers compensation laws Types of laws Monopolistic versus competitive Compulsory versus elective New York Workers Compensation Law Exclusive remedy (WC 11) Employment covered (required, voluntary) (WC 2(3, 4, 5), 10) Independent/Subcontractor Covered injuries (WC 2(7), 10, 13, 18) Grave injuries (WC 11) Occupational disease (WC 3(2), 37 48) Benefits provided (WC 12 16) Claims reporting requirements (Workers' Compensation Board Regulation Part 314.7) Federal workers' compensation laws Federal Employers Liability Act (FELA) (45 USC 51 60) U.S. Longshore and Harbor Workers' Compensation Act (33 USC 904) The Jones Act (46 USC 688) 9.2 Workers' compensation and employers liability insurance policy General section Part One Workers' compensation insurance Part Two Employers liability insurance Part Three Other states insurance Part Four Your duties if injury occurs Part Five Premium Part Six Conditions Waiver of subrogation 9.3 Volunteer Firefighters/Ambulance endorsement (WC A, WC A) 9.4 Premium computation Job classification-payroll and rates Experience modification factor Premium discounts Participation (dividend) plans 9.5 Other sources of coverage New York State Insurance Fund (WC ) Self-insured employers and employer groups (WC 50, a; Workers' Compensation Board Regulation, Parts to ) 9.6 New York State Disability Benefits Law Purpose Employment covered Benefits 10.0 Other s and Options 10% 10.1 Umbrella/excess liability policies Umbrella policies Personal (DL 98 01) Commercial (CU 00 01) Underlying Limits Excess coverage Stand alone Follow form 10.2 Specialty liability insurance Errors and omissions Professional liability Directors and officers liability Fiduciary liability Liquor liability Employment practices liability Environmental liability 5
6 Cyber Liability 10.3 Excess lines (Reg 41, Part 27) Definition of Excess Lines (nonadmitted market) Licensing requirements (2105) Total cost form Affidavit Export list Disclosure (no guaranty fund) 10.4 Surety bonds Principal, obligee, surety Types of obligations Bonds vs. Insurance 10.7 National Flood Insurance Program Eligibility Flood definition Forms Dwelling General Residential Condominium Building Association Policy 10.8 Other policies Watercraft 10.9 New York Property Insurance Underwriting Association (FAIR PLAN) ( ) Purpose Coastal Market Assistance Program (C-MAP) Risk retention and risk purchasing groups 6
All objectives for Section IV - Commercial Coverages are based on the ISO Commercial Lines program for all coverages available through ISO.
OVERVIEW Section 1677 of the California Insurance Code requires that the broker-agent examination be of sufficient scope to satisfy the Insurance Commissioner that an applicant has sufficient knowledge
California Department of Insurance Insurance Adjuster (Independent) Examination Objectives
Overview The authorizing act for an insurance adjuster (independent) is in Section 14021 of the California Insurance Code (CIC) and states, in part, that an insurance adjuster is a person other than a