PIA Search

Results 1471 - 1480 of 3226

  1. Liquidated damage agreement; commercial property waiver of subrogation | Ask PIA

    I just ran into a new term. Could you tell me what a “liquidated damage clause” is? This involves an alarm company contract. The alarm company wants our client to waive subrogation in excess of liquidated damages. What is this about?

    Liquidated damage is a fixed sum agreed upon between two parties to a contract, to be paid as damages by the party that breaches the terms of the contract. Such provisions generally are allowed by the courts only when actual damages would be difficult to determine. When courts find an...

  2. Reformation of policy language | Ask PIA

    In a settlement agreement we saw recently, the company consented to a “reformation” of its policy. Specifically, the company stated that its renewal policy was improperly issued, and that its intent was to cover the loss in question. What does the term “reformation” mean in this context?

    “Reformation” has a common meaning of “doing over to bring about a better result, correction or rectification.” From this has developed a legal term, meaning a correction of a written instrument to cause it to reflect the true intentions of the parties. As in the case you witnessed, this...

  3. COBRA basics | Ask PIA

    Which employers are subject to COBRA rules? How long does COBRA entitlement last?

    The federal COBRA program applies to all employer group health plans that provide medical, dental, vision or prescription drug coverages. COBRA affects employers with 20 or more employees (counting part-time as well as full-time, and counting people whether or not they participate in the health plan). “Employees” can include self-employed...

  4. ERISA pre-emption | Ask PIA

    We are trying to help a client with a health claim. The family is insured under a self-insured health trust based in Pennsylvania, even though they reside in New York state. Do New York’s minimum benefit standards apply?

    They do not. Self-insured health plans are exempt from state Insurance Law under the Employee Retirement Income Security Act pre-emption. The only factors that could determine minimum benefits for an ERISA plan would be any relevant prior case law in federal courts for the district in which the plan is...

  5. HIPAA ’eligible individual’ rule | Ask PIA

    One of our insureds has a New Jersey individual health insurance policy. He has a pre-existing condition. He is considering moving to another state. Does the federal law offer him portability protection?

    It appears that your client may have some protection under H.R.3103, the Health Insurance Portability and Accountability Act of 1996. Provisions of this act affecting individual policies took effect July 1, 1997. These provisions state that a carrier offering coverage in the individual market may not decline to offer coverage...

  6. Debit cards | Ask PIA

    Is a debit card treated the same as a credit card with respect to the homeowners policy “Additional coverages,” Item 6, “Credit card, electronic fund transfer card or access device, forgery and counterfeit money”?

    A debit card also is called a “fund transfer card.” The 2011 HO policy agrees to pay up to $500 for legal liability due to theft or unauthorized use of a debit card. The additional coverage titled Credit Card, Electronic Fund Transfer Card or Access Device, Forgery and Counterfeit Money...

  7. Parents own young couple’s house | Ask PIA

    We insure a young couple who are living in a home purchased for them by their parents. The home is titled in the parents’ names, but only the couple lives there. We could write a dwelling policy for the parents and an HO-4 for the occupants, but we feel...

    The problem with writing an HO-3 policy is that this situation does not meet the ISO “eligibility” standards of owner/occupancy. However, if an underwriter will write the policy anyway, there should be no coverage problems as long as the named insured(s) reside in the home. Be sure to add Endorsement...

  8. Business activities exclusion—’other structure’ | Ask PIA

    We have an insured who has set up an office in her detached garage (she is a Mary Kay salesperson). Mary Kay is providing insurance that covers replacement of the company products she stores there. However, we are concerned about our insured’s business activity, and whether this business activity affects...

    The HO-3 2011 states coverage is not provided for any other structures from which any business is conducted. This means property coverage for the garage is excluded and business personal property at the residence premises, though not excluded, is normally limited to $2,500 ($1,500 away from the premises). In addition,...

  9. Reinstatement after premium-finance agency cancels | Ask PIA

    My insured received a notice of nonpayment cancellation from a premium-finance agency. If the insured pays the premium-finance agency, must the policy be reinstated by the insurer?

    A premium-finance agreement typically contains a power of attorney or other authority enabling the premium-finance agency to cancel for nonpayment any insurance contract listed in the agreement. The PFA must give the insured at least 10 days to cure the default as provided in the following instructions from Banking Law Section...

  10. Fundraising event | Ask PIA

    We have an insured with an HO-3 policy. He is planning to have a “carnival” for kids in his large side yard. He plans to invite selected friends and expects an attendance of 50 to 100 people. The purpose is to raise money for Cystic Fibrosis. He plans to ask...

    In my view, the “carnival” you describe is not a “business” engaged in by the insured. In the ISO 2011 HO policy, “business” is defined as follows: 3. “Business” means: a. A trade, profession or occupation engaged in on a full-time, part-time or...

Search
Filter Clear