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  1. Mileage benefits run out | Ask PIA

    Our client was injured in an automobile accident and has been collecting under his Personal Injury Protection coverage. He has been receiving mileage reimbursements for his trips to get medical treatment. Now the company is stating that he can no longer receive mileage reimbursement as an “other expense” item because...

    The mileage reimbursements are considered to fall under the “other expense” definition in the no-fault law and cannot be paid as medical expenses. As an “other expense” item, mileage is subject to special limitations of $25 per day for not more than one year from the date of the accident...

  2. Cancellation—premium-financed policies | Ask PIA

    Is an insurance company required to issue its own cancellation notice to the policyholder when a premium-financed policy is canceled for nonpayment?

    No. A premium-finance agreement typically contains a limited power-of-attorney agreement by the policyholder permitting the finance company to request cancellation if the policyholder defaults on payment, as if standing in the shoes of the policyholder. From the company’s point of view, this is a request by the policyholder to cancel...

  3. Payroll deduction mass-merchandising | Ask PIA

    We soon will be getting involved in an auto insurance program that is available to the employees of a company on a payroll-deduction basis. If an employer fails to pay the premium after withholding the money from insured’s paychecks, would the policy remain in effect or not?

    Coverage would remain in force until the company has complied with special notice requirements that give the insured a chance to pay the premium directly. The New York State Department of Financial Services, in Regulation 58, has prescribed rules for the mass-merchandising of personal property liability insurance, including nonpayment cancellation...

  4. PIP deductible | Ask PIA

    Is the $200 Personal Injury Protection deductible applied per person in the car? If so, who pays for the passengers’ deductibles? Are the rules the same in the voluntary market and in the New York Automobile Insurance Plan?

    Personal Injury Protection coverage must be offered either: without a deductible; or with a family deductible of up to $200 (which shall apply only to the loss of the named insured and members of that household) [Section 5103 of the Insurance Law]. As the law states, the $200 deductible...

  5. Force-placed coverage | Ask PIA

    We have a client who had homeowners insurance since 1993 through an insurer with less than an A rating from A.M. Best. The mortgage was acquired last year by a mortgage company that required an A-rated carrier, and informed the homeowner of this new requirement. For a little over five...

    Probably, assuming that the coverage the mortgage company obtained was designed to protect its interest in the insured property. New York’s standard mortgage agreement and its interpretation are found in the Real Property Law Section 254.4. The wording in the agreement whereby the mortgagee agrees to keep the buildings...

  6. Agent’s role in claims | Ask PIA

    How do we handle a situation in which clients either do not have collision coverage, or don’t want to use the collision coverage they have, when the other driver is at fault? Sometimes we are asked to help a client recover from the at-fault driver’s insurance company.

    You must be careful to walk a fine line in these situations. You may help facilitate your client in pursuing a claim; but you may not negotiate a settlement on the client’s behalf, which would be acting as an attorney without a license. Examples of permissible facilitation would be helping...

  7. Who is an insured? | Ask PIA

    The Who Is An Insured (A.1) provision of Section II—Liability Coverage in the Business Auto Coverage form (CA 00 01) states that an insured is anyone “... using with your permission a covered auto....” If a policyholder supplies the majority of its fleet to its sales personnel for their business...

    Section 388 of the New York Vehicle and Traffic Law makes a vehicle’s owner vicariously liable for losses resulting from the negligent use of an auto “by any person using or operating the same with the permission, express or implied, of such owner.” The Business Auto Policy insures anyone "while...

  8. Pickups used for business | Ask PIA

    We insure a pickup truck on a New York personal auto policy. The pickup is used to deliver appliances and do servicing work. This truck is scheduled on the declarations page. If the client replaces this pickup, will the new truck be covered for this business-related use?

    The Insurance Services Office Inc. personal auto policy states that “your covered auto” includes any vehicle shown in the declarations. So there is no question that the current pickup is covered for business use, unless otherwise excluded in the policy when used as a public or livery conveyance or in a garage...

  9. Public adjusters and brokers | Ask PIA

    What are the rules governing referral fees paid by public adjusters? Are they required to pay brokers for referring clients to them?

    Public adjusters are regulated by Regulation 10 (Part 25). This regulation [Section 25.3(b)] prohibits public adjusters from paying anything to any person or firm for referring business to them unless the person or firm is:licensed as a public adjuster; licensed as a broker and was the broker of record in...

  10. Uninsured operation—nonowned vehicles | Ask PIA

    An employee of a trucking firm was arrested because he was driving a truck on which the coverage had lapsed. Can the employee be held responsible for the company not keeping insurance in force?

    Section 319 of the Vehicle and Traffic Law places the obligation on the operator of a nonowned vehicle to produce evidence of insurance. (That is why people should always check for an insurance I.D. card before turning the ignition key in someone else’s car, even though the law does not...

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