NY Claims Adjuster study materials
NY Claims Adjuster study resources

NY Claims Adjuster study plan

NY Claims Adjuster · Give each week a clear focus.

8 weeks · About 6 hours per week

Week 1

New York Insurance Law and Regulations & Claims Handling Practices and Procedures

  • Build a one-page calendar of New York claim-handling deadlines (acknowledgment, investigation status, payment, denial) drawn from the Insurance Law and Regulation 64, stating each deadline in days.

  • Recite from memory the claim-relevant provisions of the New York Insurance Law covering prompt payment, claim-file documentation, and fraud reporting, and match each to a section number.

  • Summarize the no-fault claim submission and payment timelines under Regulation 68 (11 NYCRR 65) and identify which deadlines apply to the insurer versus the applicant.

  • Distinguish first-party and third-party claim obligations under New York law and write two paragraphs explaining how each affects the adjuster's duty to the claimant.

  • Answer 30 practice questions on Domain 2 and log every miss beside the rule it tested.

Your checkpoint

A one-page New York deadline cheat sheet plus a scored 30-question Domain 2 log showing at least 80% accuracy.

Week 2

Property Insurance Policy Provisions and Coverage & Casualty Insurance Policy Provisions and Coverage

  • Outline the structure of a standard homeowners policy and label each section (declarations, insuring agreement, exclusions, conditions) with what a claim adjuster must verify in each.

  • Calculate actual cash value, replacement cost, and deductible application for three sample property losses, showing the arithmetic step by step.

  • Explain coinsurance, the mortgagee clause, and debris-removal or other additional coverages well enough to state who gets paid and in what order.

  • Map the commercial general liability insuring agreement, occurrence trigger, limits structure, and supplementary payments, and identify two scenarios where coverage does not attach.

  • Compare personal auto and commercial auto coverage parts and identify which part responds to each of five described loss scenarios.

Your checkpoint

A side-by-side coverage matrix of at least 15 policy provisions listing trigger, limit or sublimit, key exclusion, and who is paid.

Week 3

Claims Handling Practices and Procedures & Investigation, Evaluation, Negotiation, and Settlement

  • Sequence the full claim lifecycle from first notice of loss through closing, naming the documentation required at each stage.

  • Draft a recorded-statement outline and a proof-of-loss request that capture all elements needed to evaluate a first-party property claim.

  • Apply a structured damage evaluation method to a sample casualty claim, separating special damages, general damages, and liability percentage.

  • Identify the reservation-of-rights and denial-letter elements required to preserve the insurer's position while staying compliant with New York practice.

  • Practice three negotiation openings (anchor, range, and interest-based) and note which fits a represented versus unrepresented claimant.

Your checkpoint

A complete sample claim file packet for one hypothetical loss containing an investigation plan, statement outline, damage evaluation worksheet, and settlement-authority memo.

Week 4

Investigation, Evaluation, Negotiation, and Settlement & Fiduciary Duties, Ethics, and Unfair Claims Settlement Practices

  • Classify ten described adjuster behaviors as fair or unfair claim settlement practices under New York regulation and state the corrective action for each.

  • Explain the fiduciary and good-faith duties an adjuster owes the insurer and the insured, and identify three conflicts of interest that commonly arise.

  • Build a settlement rationale that documents liability analysis, damage computation, and negotiation range so a supervisor could approve it without follow-up.

  • Demonstrate the handling of a time-limited demand and a claimant's request for policy-limits information in a way that avoids extra-contractual exposure.

  • Complete 25 mixed Domain 6 and Domain 7 questions and rewrite every missed question's rationale in your own words.

Your checkpoint

A written ethics and settlement portfolio: ten classified conduct scenarios with corrective actions plus one fully documented settlement rationale at 85%+ on the 25-question set.

Week 5

Insurance Principles and Concepts & New York Insurance Law and Regulations

  • Define the core insurance principles (indemnity, insurable interest, utmost good faith, subrogation, proximate cause) and apply each to one claim example.

  • Distinguish representations, warranties, and concealment, and state how each affects claim payment under New York law.

  • Re-read the New York law notes from Week 1 and correct or expand every entry using a second pass through the material.

  • Explain how the New York Insurance Law treats claim-related examinations under oath, proofs of loss, and late notice of claim.

Your checkpoint

A revised and expanded New York law cheat sheet plus a one-page glossary of 20 insurance principles with a claim example for each.

Week 6

Property Insurance Policy Provisions and Coverage & Casualty Insurance Policy Provisions and Coverage

  • Resolve six coverage scenarios by writing the coverage analysis in the order of insuring agreement, exclusion, exception, then condition.

  • Identify subrogation and salvage opportunities in three property losses and state the recovery steps and deadlines.

  • Explain additional-insured and contractual-liability issues in a construction defect scenario well enough to state whether the claim is covered.

  • Differentiate uninsured and underinsured motorist claims and describe the proof required for each in New York.

Your checkpoint

Six written coverage opinions, each following the four-step analysis format and ending with a clear covered, not covered, or reserved conclusion.

Week 7

Fiduciary Duties, Ethics, and Unfair Claims Settlement Practices & Insurance Principles and Concepts

  • List the acts that constitute unfair claim settlement practices in New York and pair each with a realistic adjuster mistake that would violate it.

  • Describe the regulator's examination and market-conduct review process and what records an adjuster must be able to produce.

  • Apply insurable interest and indemnity principles to three claims involving possible moral hazard or inflated damages.

  • Write a response to a Department of Financial Services consumer complaint that is factual, complete, and non-adversarial in tone.

Your checkpoint

A compliance packet containing the unfair-practices list with examples and one model consumer-complaint response letter.

Week 8

New York Insurance Law and Regulations & Claims Handling Practices and Procedures

  • Take two full-length timed practice exams and record the score by domain to find any remaining weak area.

  • Re-drill every missed question from Weeks 1 through 7 and rewrite the governing rule for each until it is recalled without notes.

  • Rehearse the New York deadline cheat sheet and the coverage matrix from memory in a single 30-minute self-test.

  • Finalize a one-page exam-day reference covering domain weightings, deadline rules, and the coverage analysis sequence.

Your checkpoint

Two completed timed practice exams scoring at least 85% overall with no domain below 75%, plus a final one-page exam-day reference sheet.

Milestones

Week 2: New York deadline cheat sheet complete and Domain 2 practice score at 80% or higher.

Week 4: Coverage matrix, sample claim file packet, and settlement portfolio all complete; Domain 6 and 7 practice at 85% or higher.

Week 6: Six written coverage opinions finished and scored against the four-step analysis rubric.

Week 8: Two timed full-length exams at 85% overall with no single domain below 75%.