PIA Search

Results 1591 - 1600 of 3226

  1. ’Steering’ to repair shops | Ask PIA

    We have an insurance company that is telling people where to go for their glass repairs. Is this legal?

    No. It is not legal for the insurer to require claimants to go to any specific repair facility. Insurers can recommend or suggest a specific repair facility. If the claim involves solely window glass, the insurer has always been permitted to recommend or suggest a facility without the insured requesting...

  2. Fire legal liability coverage | Ask PIA

    Could you provide a definition of “fire legal liability” with respect to a commercial general liability policy? Our insureds are asking what it means.

    Fire is a common cause of loss for property, and the exposure can be quite severe; so tenants need a means of protecting themselves when they are responsible for damage to their landlords’ buildings. This is where fire legal liability coverage comes into play. The fire legal liability coverage in...

  3. Audit premium for ‘inadequate’ subcontractor limits | Ask PIA

    We wrote a commercial general liability policy for a contractor with a $500,000 liability limit. He engaged a subcontractor with only $300,000 in liability coverage. Our company is saying that the subcontractor’s limits must match our CGL limits or, upon audit, they will charge for the subcontractor as if he...

    Yes, the company can do this. Check the general liability classification table in the ISO manual, showing the various classifications for contractors. In the notes for contractor classes that contemplate the use of subcontractors, it clarifies that “determination of adequacy of (subcontractors’) insurance shall be made in accordance with criteria established by...

  4. Comprehensive coverage applies to contact with deer | Ask PIA

    Would a collision with a deer be considered a “collision” under the personal auto policy and, therefore, covered under the collision coverage portion of the policy?

    No. The language of the personal automobile policy excludes “contact with bird or animal” from its definition of “collision,” so that “other than collision” (i.e., comprehensive) is the applicable coverage in these cases.

  5. Repair shop as payee | Ask PIA

    We have a client with a collision claim. The company wrote out the check to the insured and the auto repair shop. They told us they do this for all collision claims now. Is this legal?

    This practice is legal with the consent of the claimant. There is no contractual or regulatory basis for naming the repair shop as payee. The insured claimant is a party to the auto insurance contract and the repair shop is not. Further, there is no condition in the policy...

  6. Extended rental period | Ask PIA

    My client has two cars insured on a personal automobile policy. His son is away at college, so the two vehicles have been adequate for him and his wife. His son is coming home for the summer, and my client wants to rent a third car for two-and-a-half months. He...

    The duration of this contemplated rental leads me to believe that the insurer would exclude coverage. This arrangement (two-and-a-half months) is likely to be construed as making the rental car “furnished or available for [your insured’s] regular use.” This would trigger the “regular use” exclusion (B.2) of liability coverage for...

  7. Acceptance of claims check | Ask PIA

    Our insured’s car was hit when another driver ran a stop sign. The police report and a witness’ statement confirmed this, although the other driver was not ticketed. The other driver’s carrier offered only 80 percent of the damages. Our insured cashed the claim check, endorsing it “partial payment,” so...

    New Jersey, Connecticut and New HampshireYes. Acceptance of the company’ check, which was negotiated as a final settlement, is full accord and satisfaction for the claim, regardless of what the claimant inserted in endorsing it.New YorkWhen a payment is received by check with a notation on the front or the...

  8. Caddies defined | Ask PIA

    How do we handle caddies for purposes of workers’ compensation? The caddies are compensated by the players they caddy for.

    For purposes of workers’ compensation, caddies are employees of the golf course, whether they are compensated by the golf course or not, and their compensation is included in rating the golf course policy. However, “services of golf caddies” are explicitly excluded from the definition of “employment” for purposes of statutory...

  9. Mandatory medical malpractice | Ask PIA

    What are the details on the mandatory medical malpractice requirements in Connecticut?

    The law requires a number of specific types of health-care providers to maintain professional liability insurance or other indemnity against liability for professional malpractice. The minimum requirement is $500,000 per person, per occurrence; with an aggregate of $1.5 million (Section 20-11b). The law authorizes medical licensing boards to restrict, suspend...

  10. Audit time frames | Ask PIA

    According to the company, the wrong rates were used to rate workers’ compensation coverage for a construction business back in 2018-2019. In 2021, after a third audit, the company discovered the rate discrepancy. They are just now suing the business for the difference. Can they do this?

    According to the workers’ compensation policy terms, the company is within its rights. The policy states [Part Five—Premium, E. Final Premium] that “the final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply...

Search
Filter Clear