NY Claims Adjuster study plan
NY Claims Adjuster · Give each week a clear focus.
8 weeks · About 6 hours per week
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.
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.
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.
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.
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.
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.
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.
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%.