New York · Insurance Adjuster Sample Interactive Mind Map

New York Adjuster Regulations

A visual breakdown of the New York rules an independent adjuster is tested on — and held to.

New York doesn't issue one adjuster license — it issues eleven, and the boundaries between them are the most reliably tested thing on the exam. This map lays out those boundaries alongside the deadlines New York actually holds you to: Regulation 64's business-day claim clock, the no-fault 30/45/90, and the statutory fire policy.

So explore it. Click through the clusters, then take the scenario quiz at the end and see which numbers have actually stuck.

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New York does not issue an all-lines adjuster license. It issues ELEVEN — and which one you hold decides which claims you may legally touch.
11 NYCRR 26.3 sorts independent adjuster authority by kind of claim. The boundaries between those types are the most reliably tested thing on the New York adjuster exam.

🏢 Independent Adjuster

🏠 Public Adjuster

Acts on behalf of

The insurer — § 2101(g)(1)

Acts on behalf of

The insured — § 2101(g)(2), property claims only

Regulation

11 NYCRR Part 26 = Regulation 25

Regulation

11 NYCRR Part 25 = Regulation 10

Prelicensing

None

Prelicensing

40 hours, or 1 year of insurance experience

Bond & character letters

Neither — both were eliminated

Bond & character letters

$1,000 bond and five certificates

Continuing education

None

Continuing education

15 credits biennially + $10 filing fee

Compensation

Paid by the carrier — no cap

Compensation

Capped at 12.5% of the recovery

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The Part / Regulation numbers are deliberately confusing

Part 26 is Regulation 25 and governs independent adjusters. Part 25 is Regulation 10 and governs public adjusters. The numbers do not match and the Parts are adjacent. Read the question twice.

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The Eleven License Types — 11 NYCRR 26.3

Each one defined by the kinds of insurance whose claims you may adjust

(a) Fire — fire, miscellaneous property damage, water damage, collision
(b) Inland marine · (c) Aviation
(d) Automobile — auto liability, property damage liability, collision, theft, comprehensive
(e) Motor vehicle no-fault & workers' comp health service charges
(f) Automobile damage or theft appraisals
(g) Casualty — liability, burglary & theft, glass, workers' comp, boiler & machinery, elevator, credit, animal, collision, legal services, water damage
(h) Fidelity and surety · (i) Accident and health
(j) General — authority over (a) through (g)
(k) Multi-peril crop — USDA-reinsured policies

How they test thisTwo boundaries, asked over and over. General covers (a)–(g) only — it does not reach fidelity and surety, accident and health, or multi-peril crop. And casualty expressly EXCLUDES motor vehicle and aircraft losses, so a casualty-only licensee cannot work an auto claim.

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Eleven licenses, ten exams

11 NYCRR 26.4 prescribes an examination for every type except multi-peril crop. That one is earned by Federal Crop Adjuster Proficiency Program accreditation instead.

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Series 17-62 to 17-72

17-70 is General — 100 questions, 2 hours. Every other adjuster line is 60 questions, 1 hour. Public adjuster is 17-62. Legacy materials number the same exams 10-62 to 10-72.

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Staff adjusters are exempt

An officer, director, or regular salaried employee of an authorized insurer is outside the definition — unless acting as an auto body repair estimator. Unlike Texas or Florida, New York does not license company adjusters.

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Other exclusions

Licensed New York attorneys; average adjusters and adjusters of maritime losses; insurer-owned adjustment bureaus; and an agency's own agent adjusting its own policies for no more than $50 per loss.

The trap they setBeing a licensed New York attorney keeps you from needing an adjuster license — it is not a way into one. A New York attorney who wants to be named a sublicensee of a corporate independent adjuster must still pass the examination under § 2108(f)(1).

No prelicensing. No continuing education. No reciprocity. A fixed expiration date that ignores when you started.
New York asks very little of an independent adjuster after the exam — but the things it does ask carry 30-day deadlines and real discipline behind them.

Step 1

Pass the exam

70% to pass. $40 per attempt, non-refundable. No prelicensing course required. Result is good for 2 years.

Step 2

Get fingerprinted

IdentoGO, DFS service code 1544S3. Every applicant and every sublicensee. Fee is the vendor's, paid at the appointment.

Step 3

Apply & print

Through the DFS portal. $100 if the period runs over a year, $50 if a year or less. DFS does not mail licenses — print your own.

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December 31 of an Even-Numbered Year

§ 2108(j)(1) — the fixed term, and what falls out of it

Every adjuster license expires 12/31 of an even year — no exceptions, no birthday cycle
Because the endpoint is fixed, a first license may run up to 30 months to reach it
That is why the fee is $100 or $50: the statute charges $50 per year or fraction of a year
One license fee covers as many independent adjuster types as you qualify for — § 2108(i)(3)
A timely-filed renewal keeps the old license in force until the new one issues, or 5 days after refusal

The trap they setNew York agent and broker licenses renew on the licensee's birthday in an odd or even year matching the birth year. Adjusters do not. Any answer applying a birthday rule to an adjuster license is testing whether you conflated the two.

⏰ Two 30-day duties

26.6 — notify DFS of any change of business or residence address within 30 days

26.7 — report any administrative action in another jurisdiction within 30 days of final disposition, with the order attached

§ 405 — report suspected fraud within 30 days of your determination

🚫 What you may not do

26.5 — no fee splitting with anyone who was not a licensed independent adjuster when the loss occurred

26.5 — no association with anyone whose adjuster license was revoked

§ 2108(o) — no misrepresentation of facts, and no advising anyone on questions of law

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The Catastrophe Permit — § 2108(n)

120 days, no exam, no fee — and you cannot apply for it

For widespread property losses arising out of a conflagration or catastrophe — not a busy hail season
Term not exceeding 120 days, renewable as necessary to adjust those claims
Open to residents and nonresidents; no examination, no fee
The sponsoring authorized insurer applies and certifies the adjuster is qualified by experience and training
Tied to one declared catastrophe; a State of Emergency is required for a natural disaster; each carrier files its own application

Do not confuse the two permits§ 2108(n) is the catastrophe permit above. § 2108(h) is a different temporary permit — also 120 days — for someone who has already applied for a license and has 5 years of claims experience with an authorized insurer, or a DMV estimator's license. Same cap, different trigger.

Reciprocity: there is noneNew York issues no adjuster license on the strength of a home-state one. A nonresident needs New York exam data from within 2 years, the same fingerprints, and the same application. The reciprocal nonresident pathway DFS publishes is written for agents and brokers and does not reach adjusters.

Regulation 64 runs on BUSINESS DAYS. Almost every other state counts calendar days.
11 NYCRR Part 216 is where New York turns “handle claims promptly” into a number. An adjuster who diaries these as calendar days answers the exam question wrong — and works the file wrong.

business dayscalendar days

§ 216.4 & 216.5 — Trigger	Deadline	What it means
Notification of a claim	15 biz	Acknowledge receipt. May be by any means — but note it in the file. Notice to an agent is notice to the insurer.
Notice of claim	15 biz	Commence investigation AND send the claimant notification of all items, statements and forms you will require. No trickling requests.
All other pertinent communications	15 biz	An appropriate reply.
Inquiry from DFS about a claim	10 biz	Furnish the available information requested. The shortest number in the regulation — and the one regulators enforce.

§ 216.6 — Trigger	Deadline	What it means
Properly executed proof of loss + all requested items received	15 biz	Advise the claimant in writing of acceptance or rejection.
Same, where arson is suspected	30 biz	Insurance Law § 2601 doubles the window.
You need more time to decide	15 biz	Written notice stating the reasons more time is needed.
Claim still unsettled, not in litigation or arbitration	every 90	Further letters setting out why, from the date of the first delay letter.
Amount finally agreed upon in settlement	5 biz	Pay it — from receipt of the agreement or the claimant's performance of any condition, whichever is later.
You determine there is no policy, or you are disclaiming	as soon as determined	Written notice, with your specific reasons. Not a day count — a standard.

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Three § 216.6 rules adjusters violate without meaning to

(e) Pay the undisputed part. Where elements of a claim are not in dispute, pay them even while others are disputed — withholding as leverage is a violation on its face.
(g) No release by endorsement. A first-party check may not carry language making acceptance a final settlement or release of future obligations — and no release may be broader than the scope of the settlement.
Tell them the clock. On rejection, notify the claimant in writing of any policy provision limiting the right to sue — on a New York fire policy, that is the 24-month clause.

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§ 216.7 — Motor Vehicle Physical Damage Moves Faster

And § 216.6(c) does not apply to it at all

6 business days from notice of claim to inspect the vehicle AND make a good faith offer — miss it and you forfeit the right to inspect before repairs
2 business days for a second inspection on hidden damage; 4 business days for sublet repairs
5 business days to pay after the insured accepts — or 3 business days after a completed proof of loss
25th calendar day after notice of loss to make the offer on an unrecovered theft
35 calendar days right of recourse after mailing the claim payment; 30 calendar days to pay the insured's pro-rata share of a subrogation recovery

How they test thisAnswering an auto physical damage question with the 15-business-day proof-of-loss rule is the wrong answer — § 216.6(c) is expressly carved out of physical damage claims. Watch the switch to calendar days for theft, recourse, subrogation, and delay letters.

Two New York claim regimes with their own statutory clocks: no-fault under Regulation 68, and the standard fire policy printed in the Insurance Law itself.
Regulation 64 does not govern either one's core timetable. Know which clock you are on before you diary the file.

Regulation 68 — what the CLAIMANT must do	Deadline	Source
Written notice of the accident to the company	30 cal	65-1.1 — unless written proof gives clear and reasonable justification for delay
Written proof of claim for health service expenses	45 cal	65-1.1 — from the date services are rendered
Written proof of claim for work loss and other necessary expenses	90 cal	65-1.1 — from when the loss is incurred or services rendered

Regulation 68 — what YOU must do	Deadline	Source
Forward the prescribed verification forms after the NF-2	10 biz	65-3.5(a)
Request any additional verification	15 biz	65-3.5(b) — need not be on any prescribed form
Schedule a medical examination	30 cal	65-3.5(d)
Pay or deny the claim in whole or in part	30 cal	65-3.8(c) — from receipt of proof of claim
Notice of a coverage-based denial on the prescribed form	10 biz	65-3.8(e)
Applicant's outside limit to supply verification	120 cal	65-3.5(o); 65-3.8(b)(3) allows denial after it

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Two percent per month — the most expensive deadline in New York claims

Under Insurance Law § 5106(a), overdue first-party benefits bear interest at 2% per month — 24% a year, uncompounded — plus the claimant's reasonable attorney's fee. 11 NYCRR 65-3.9 computes it pro rata on a 30-day month, requires payment without demand where interest exceeds $5, and forbids conditioning settlement on waiver of the interest. And under 65-3.8(l), your own procedural deviation shortens the 30 days — it never restores them.

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The New York Standard Fire Policy — Insurance Law § 3404

Most states approve a form. New York writes one, and prints it in the statute.

Proof of loss — 60 days

Signed and sworn, within 60 days after the loss unless extended in writing. But § 3407 flips the practical burden: failure to file does not invalidate the claim unless the insurer gives written notice that it wants proofs, with a blank form — and the insured then has 60 days from that notice.

Appraisal — 20 then 15

On written demand of either party where they fail to agree on ACV or amount of loss: each names a competent, disinterested appraiser within 20 days; the appraisers pick an umpire within 15 days or a court does. Any two agreeing sets the amount. Amount only — never coverage or causation.

Loss payable 60 days after proof of loss is received and the amount is ascertained by written agreement or a filed award
Suit within 24 months next after INCEPTION OF THE LOSS — not from denial, not from accrual
30 days for the company to give notice of intent to repair, rebuild, or replace
Concealment or fraud voids the ENTIRE policy, before or after a loss — but only where the concealment was wilful and the fact material

⚖️ Liability — § 3420

(d)(2) Disclaim as soon as is reasonably possible — in writing, to the insured AND the injured person

(d)(1) Confirm coverage and limits on written request within 60 days (45/45 if information is insufficient)

(a)(2) Direct action once a judgment is unsatisfied 30 days after notice of entry

⚖️ Fault — CPLR § 1411

General rule: pure comparative — a claimant 99% at fault still recovers 1%

2026 carve-out (§ 1411(b)): in Article 51 motor vehicle personal injury actions, fault greater than the defendants' bars recovery — so 50/50 still recovers

Wrongful death and property damage stay pure comparative, even in auto cases

Currency checkThe same 2026 legislation cut the serious injury categories in § 5102(d) from nine to eight by repealing the 90/180-day category. Material still listing nine categories, or calling New York flatly “pure comparative,” predates the amendment — though the 90/180 category still governs suits commenced before the effective date.

Regulation 10 governs the adjuster across the table from you — and one of its rules binds YOU, not them.
Then there is § 405: a personal, 30-day, statutory duty to report suspected fraud that runs against you as a licensee.

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Public Adjusters — 11 NYCRR Part 25 (Regulation 10)

The cap, the contract, and the three-day escape hatch

12.5% of the recovery maximum fee — except up to 20% on a supplemental claim, provided the aggregate stays at or below 12.5% of the full claim payment (§ 25.7(a))
Referral compensation counts against the cap — money from a contractor is deemed money from the insured (§ 25.7(b))
Compensation solely under a written agreement on the prescribed Form 1, signed by both, in the same language as the oral negotiations (§ 25.6)
The insured may cancel until midnight of the third business day after signing — by mail, effective when deposited, in any form showing intent not to be bound (§ 25.8)
A detachable NOTICE OF CANCELLATION in 12-point type must be attached, and the adjuster must say it out loud at signing — until then the 3 days never start (§ 25.9)
No soliciting between 6:00 p.m. and 8:00 a.m. by any method (§ 25.3(a))
Records kept at least 3 years from completion of services (§ 25.11(a))

Two rules that bind the CARRIER§ 25.11(b): where an insured is represented by a public adjuster, the insurer must include that public adjuster in any communication it initiates with the insured, unless the insured says otherwise in writing. Going around them is a violation by the carrier. § 25.12: without a signed direction to pay letter, an insurer may not make a claim check payable to the public adjuster.

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Insurance Law § 405 — your own 30-day clock

Any person licensed under the Insurance Law — which includes you — who has reason to believe a transaction may be fraudulent shall, within 30 days after determining it appears fraudulent, report it to the Superintendent on the prescribed form. The trigger is reason to believe, not proof, and the clock starts on your determination, not a supervisor's sign-off. 11 NYCRR Part 86 (Regulation 95) implements it.

Regulation 64 § 216.5(b) relieves an insurer of Part 216's deadlines where there is a reasonable, specifically-supported basis to believe the claimant caused the loss fraudulently — but only if the Part 86 report is filed. In New York the fraud defense and the fraud report travel together.

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Two warning statements

§ 86.4 prescribes exact language — one version for non-automobile claim forms and commercial and A&H applications, a separate, longer one for automobile that also reaches false reports of theft or damage to the DMV or police.

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Where it goes

Immediately above the signature space, in conspicuous type. Where someone other than the claimant signs, it goes at the top of the first page or on the instructions page. Substantially similar wording needs prior approval.

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Penal Law Article 176

Fifth degree is a Class A misdemeanor at any amount. Then $1,000 → E felony, $3,000 → D, $50,000 → C, $1,000,000 → B. Aggravated insurance fraud on a prior Article 176 conviction within 5 years.

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Staged accidents

As of May 27, 2026, a fraudulent insurance act reaches one who will hire, request, encourage, orchestrate, or invite another to stage a motor vehicle accident.

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Top Exam Tips — New York Adjuster Regulations

1. Eleven licenses, ten exams. Multi-peril crop has no examination — it takes federal crop adjuster accreditation.
2. General covers (a)–(g) only. Not fidelity and surety, not accident and health, not crop. And casualty excludes motor vehicle and aircraft.
3. Salaried company adjusters need no license — unless acting as an auto body repair estimator. That carve-back appears throughout § 2101(g).
4. Adjusters are fingerprinted; New York producers are not. The usual pattern is reversed.
5. December 31 of an even year, always — which is why a first license can run 30 months and why the fee is $100 or $50. Producers use a birthday cycle; adjusters never do.
6. No prelicensing, no CE, no bond, no character letters, no reciprocity for independent adjusters. Public adjusters have all five.
7. Regulation 64 counts business days. 15 to acknowledge, 15 to investigate and list required items, 10 for a DFS inquiry, 15 to accept or reject (30 on suspected arson), 5 to pay what is agreed.
8. Auto physical damage is 6 business days to inspect and offer — and § 216.6(c) does not apply to it at all.
9. No-fault: 30 / 45 / 90 for the claimant; 30 calendar days to pay or deny; 2% per month if you are late.
10. Fire policy: 60-day proof, 20/15 appraisal, 60-day payment, 24 months from INCEPTION OF THE LOSS.
11. Public adjusters: 12.5% — up to 20% on a supplemental claim if the aggregate stays within 12.5% — and a three-business-day right to cancel that never starts until the adjuster gives the notice and says it aloud.
12. § 405: 30 days from your determination to report suspected fraud. It is your duty, not the carrier's alone.

Exam vocabulary

Key Terms to Know

Independent Adjuster

One who, for compensation, acts in this state on behalf of an insurer investigating and adjusting claims — § 2101(g)(1).

Public Adjuster

One who, for compensation, acts on behalf of the insured in negotiating or effecting settlement of a property claim — § 2101(g)(2).

Sublicensee

An individual named on an entity's adjuster license. A corporation may name only officers and directors; a firm only its members. Each qualifies individually.

General License — 26.3(j)

Independent adjuster authority over subdivisions (a) through (g). Excludes fidelity and surety, accident and health, and multi-peril crop.

Regulation 25 (Part 26)

The independent adjuster regulation — license types, examinations, business practices, and the two 30-day reporting duties.

Regulation 10 (Part 25)

The public adjuster regulation — 12.5% cap, Form 1 contract, three-business-day cancellation, 6 p.m.–8 a.m. solicitation curfew.

Regulation 64 (Part 216)

Unfair Claims Settlement Practices — New York's claim clock, counted in business days.

Regulation 68 (Part 65)

No-Fault — the claimant's 30/45/90 deadlines and the insurer's 30-calendar-day pay-or-deny rule.

Regulation 95 (Part 86)

Fraud reporting to the Department and the prescribed warning statements on applications and claim forms.

Temporary Adjuster Permit

§ 2108(n) catastrophe permit — 120 days, renewable, no exam, no fee, and the insurer applies.

Standard Fire Policy

The statutory policy text in Insurance Law § 3404(e) — 60-day proof, 20/15 appraisal, 60-day payment, 24-month suit from inception of the loss.

Appraisal

Statutory mechanism resolving a dispute over actual cash value or amount of loss only. Demanded in writing by either party.

Overdue No-Fault Benefit

Unpaid more than 30 calendar days after proof of claim. Bears interest at 2% per month, paid without demand over $5.

Direction to Pay Letter

Form 4 under Part 25. Without it, an insurer may not make a claim check payable to a public adjuster.

Auto Body Repair Estimator

The activity that cancels the salaried-employee and adjustment-bureau exclusions from the independent adjuster definition.

Serious Injury — § 5102(d)

The threshold for suing in tort for pain and suffering. Eight categories since the 2026 repeal of the 90/180-day category.

Like learning this way? There's a whole library of them.

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