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NY Adjusters License - Chapter 10: New York Independent Accident & Health Adjuster Laws & Regulations

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Superintendent ResponsibilitiesPower to prescribe, withdraw or amend insurance regulations that are not inconsistent with New York Insurance Laws, the Superintendent also has the power to: Govern all duties assigned to the members of the staff of the Department of Financial Services; Prescribe forms and create regulations; Interpreting the provisions of the New York Insurance Code; Governing the procedures to be followed in the procedures of the Department.
Independent AdjusterActs on behalf of an insurer
Public AdjusterActs on behalf of an insured
Licensing Requirements1) 18 years of age 2) Fingerprinting 3) No license will be issued to a convicted felon or to an individual who has been involved in an offense involving fraudulent or dishonest practices, 4) Affidavits from 5 reputable citizens who have known the applicant for at least five years 5) pass the state licensing exam, 6) maintain a $1,000 surety bond
Controlled businessBusiness an agent sells on himself, his family or employees and an agent that sells only this will have their license revoked or suspended
AffiliateAny company that controls, is controlled by, or is under common control with another company
Clear and conspicuousA notice is reasonably understandable and designed to call attention to the nature and significance of the information in the notice
CollectTo obtain information that the licensee organizes or can retrieve by the name of an individual or by identifying number, symbol or other identifying particular assigned to the individual, irrespective of the source of the underlying information.
CompanyA corporation, limited liability company, business trust, general or limited partnership, association, sole proprietorship or similar organization
ConsumerAn individual who, in this State, seeks to obtain, obtains or has obtained an insurance product or service, directly or through a legal representative, from a licensee that is to be used primarily for personal, family, or household purposes, and about whom the licensee has nonpublic personal information.
ControlOwnership
CustomerA consumer who has a customer relationship with a licensee
Customer relationshipA continuing relationship between a consumer and a licensee under which the licensee provides one or more insurance products or services in this State to the consumer that are to be used primarily for personal, family, or household purposes.
Financial institutionAny institution the business of which is engaging in activities that are financial in nature or incidental to such financial activities as described in the Bank Holding Company Act of 1956 (12 U.S.C. 1843(k)).
Financial product or serviceAny product or service that a financial holding company could offer by engaging in an activity that is financial in nature or incidental to such a financial activity under the Bank Holding Company Act of 1956. Financial service includes a financial institution's evaluation or brokerage of information that the financial institution collects in connection with a request or an application from a consumer for a financial product or service.
Health carePreventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, services, procedures, tests or counseling that relates to the physical, mental or behavioral condition of an individual; or affects the structure or function of the human body or any part of the human body, including the banking of blood, sperm, organs, or any other tissue; or prescribing, dispensing, or furnishing to an individual drugs or biologicals, or medical devices or health care equipment and supplies
Health care providerA physician or other health care practitioner licensed, accredited or certified to perform specified health services consistent with state law, or a health care facility
Health informationAny information or data except age or gender, whether oral or recorded in any form, created by or derived from a health care provider or consumer relating to: the past, present or future physical, mental or behavioral health or condition of any individual or a member of the individual's family; the provision of health care to any individual; or payment for the provision of health care to any individual
Insurance product or serviceAny product or service that is offered by a licensee pursuant to the Insurance Laws of this state. Insurance service includes a licensee's evaluation, brokerage or distribution of information that the licensee collects in connection with a request or an application from a consumer for an insurance product or service.
LicenseeA person licensed, or required to be licensed, or authorized, or required to be authorized, or registered, or required to be registered pursuant to the Insurance Law of this State; a health maintenance organization holding, or required to hold, a certificate of authority, or an unauthorized insurer in regard to the excess line business conducted pursuant to state law; but shall not include a registered service contract provider, charitable annuity society, or a licensed viatical settlement company or viatical settlement broker.
Nonaffiliated third partyAny person except: A licensee's affiliate; or a person employed jointly by a licensee and any company that is not the licensee's affiliate
Nonpublic personal informationnonpublic personal financial information and nonpublic personal health information.
Nonpublic personal financial informationPersonally identifiable financial information; and any list, description or other grouping of consumers (and publicly available information pertaining to them) that is derived using any personally identifiable financial information other than publicly available information
Nonpublic personal health informationHealth information: that identifies an individual who is the subject of the information; or with respect to which there is a reasonable basis to believe that the information could be used to identify an individual
Opt OutA direction by a consumer that the licensee not disclose nonpublic personal financial information about the consumer to a nonaffiliated third party
Personally identifiable financial informationAny information: A consumer provides to a licensee to obtain an insurance product or service from the licensee; About a consumer resulting from a transaction involving an insurance product or service between a licensee and a consumer; or A licensee otherwise obtains about a consumer in connection with providing an insurance product or service to that consumer
Publicly available informationAny information that a licensee has a reasonable basis to believe is lawfully made available to the general public from: Federal, state, or local government records; Widely distributed media; or Disclosures to the general public that are required to be made by Federal, state or local law
AnteriorFront (head) of an individual
AnteroposteriorFrom head end to opposite end of body
AppendageA structure that extends (and can move separately) from the main body
ContralateralOn the opposite side
DeepFurther away from the surface
DistalThe tip of an appendage
DorsalBack (spine) of an individual
DorsoventralFrom spinal column (back) to abdomen (front).
IntermediateBetween two other structures
IpsilateralOn the same side
LateralA directional term used as a modifier for both the left and right sides of the body
MedianPoint in the center of the body
MediolateralFrom center of the body to one side or the other.
ParietalPertaining to the wall of a body cavity
PosteriorTail of an individual
ProximalDescribes where an appendage joins the body
ProximodistalFrom the tip of an appendage to where it joins the body
SuperficialNear the outer surface
VentralAbdomen of an individual
VisceralAssociated with organs within the body’s cavities
AbductionA motion that pulls a structure or part away from the midline of the body
AdductionA motion that pulls a structure or part towards the midline of the body.
CircumductionThe circular movement of a body part, such as a ball-and-socket joint or the eye.
DorsiflexionFlexion of the entire foot, as if taking one’s foot off an automobile pedal.
ExtensionA straightening movement that increases the angle between body parts
External (or Lateral) RotationA rotation of the shoulder or hip that would turn the toes or the flexed forearm outwards.
FlexionBending movement that decreases the angle between two parts
Internal (or Medial) RotationA rotation of the shoulder or hip that would point the toes or the flexed forearm inwards.
OppositionA motion involving a grasping motion of the thumb and fingers
Plantar flexionFlexion of the entire foot, as if pressing an automobile pedal. Occurs at ankle
PronationA rotation of the forearm that moves the palm to a facing down position
ProtrusionThe anterior movement of an object. This term is often applied to the jaw
ProtractionAnterior movement of the arms at the shoulders
RepositionTo release an object by spreading the fingers and thumb
RetractionPosterior movement of the arms at the shoulders
RetrusionOpposite of protrusion, moving a part posteriorly
RotationA motion that occurs when a part turns on its axis. The head rotates on the neck
SupinationA rotation of the forearm that moves the palm to a facing up position
Laboratory TestsTests performed in a medical laboratory including blood test and urine tests.
Radiography (X-ray)The making of film records (radiographs) of internal structures of the body by passage of x-rays or gamma rays through the body to act on specially sensitized film.
Magnetic Resonance Imaging (MRI)A test that provides pictures of organs and structures inside the body by using a magnetic field and pulses of radio wave energy
Computerized TomographyA special radiographic technique that uses a computer to assimilate multiple x-ray images into two dimensional cross-sectional images. This can reveal many soft tissue structures not shown by conventional radiography
Electromyography (EMG)A test which measures muscle response to nerve stimulation
Nerve Condition StudiesMeasure how well individual nerves can transmit electrical signals
MyelographyA diagnostic procedure where a radiopaque contrast dye is injected into
ArthroscopyThe introduction of a thin fiber optic scope into a joint space to allow direct visualization of internal structures
Electrocardiogram (EKG)The recording of the electrical activity of the heart on a moving strip of paper
Electroencephalography (EEG)The recording of the electric currents developed in the brain, by means of electrodes applied to the scalp, to the surface of the brain or placed within the substance of the brain


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