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  1. Insurance scenarios—rule | Ask PIA

    If we complete the suggested Department of Banking and Insurance scenario using one of our voluntary company’s rates and pass it on to all of our customers, regardless of their specific circumstance and territory, then have we fulfilled the requirements of the scenario rule?

    Yes.

  2. Insurance scenarios—requirements | Ask PIA

    I would like to clarify my understanding of the insurance scenarios requirements: An agent would be satisfying the requirement by using the DOBI “Cost Saving Options for Auto Insurance” form complete with premiums from any of our carriers.

    Yes, that’s correct.

  3. Voluntary Rating Tier vs. voluntary carrier | Ask PIA

    Voluntary Company A declines an auto applicant using alternate underwriting rules. Voluntary Company B offers coverage at a higher cost than Voluntary Rating Tier (VRT). May customer decline Company B in favor of VRT?

    No. The customer may not obtain coverage from the VRT if they have an offer from a voluntary market company.

  4. Insurance scenarios—choosing scenario options | Ask PIA

    Can an agency pick which bodily injury, PIP and physical damage coverages to do for each insurance scenario (i.e., can Scenario 1 be only the comparison of savings for the different liability limits from $35,000 CSL to $500,000) or do we also have to discuss the thresholds?

    If you opt to produce your own scenarios, and not use the DOBI form, you can pick and choose which coverages to do for each scenario. As you have suggested for Scenario 1, you could show just the different liability limits for bodily injury coverage and not discuss the thresholds....

  5. Employee vs. independent contractor—statutory definition | Ask PIA

    What are the conditions that must exist before the presumption that a worker is an employee can be overcome?

    There are seven conditions listed in Section 281-A of the New Hampshire Workers’ Compensation Law (as amended by Chapter 362 of the Laws of 2007; effective Jan. 1, 2008). A person who performs services for pay for an employer is presumed to be an employee. This presumption may be rebutted by...

  6. Requiring certain coverages/endorsements be reflected on certificates | Ask PIA

    Does the New York certificates law prohibit someone from requiring certain insurance coverages or endorsements, and that those coverages/endorsements be reflected on the certificate?

    No. The New York certificates law prohibits the issuance of a certificate of insurance that attempts to amend, extend or alter the coverage provided by the insurance policy to which the certificate of insurance makes reference or confers to any person any rights beyond those expressly provided by the policy...

  7. Notice of cancellation on wholesale business | Ask PIA

    What are the notice obligations of an insurer to the retail producer when canceling or nonrenewing a policy that has been placed through a wholesale broker? Should I expect to receive a copy of the notice?

    In most cases, if the policyholder has authorized you to be their producer, then you should receive a copy of the notice. However, the complete answer on the insurer’s obligations is different depending on whether the policy is personal insurance (subject to Insurance Law Section 3425) or commercial insurance (subject...

  8. Certificates—principals excluded | Ask PIA

    Should certificates of insurance indicate whether a principal (that is a sole proprietor, partner or member) has not elected coverage on the workers’ compensation policy?

    The current edition of the ACORD 25 Certificate Of Liability Insurance form includes a question in the workers’ compensation box. It asks, “Any proprietor/partner/executive officer/member excluded? If yes, describe under DESCRIPTION OF OPERATIONS below.” Since the certificate asks the question, the certificate holder will be expecting an answer. If you...

  9. Employee vs. independent contractor | Ask PIA

    All of our producers are incorporated and their corporation has an independent contractor relationship with our agency. We believe these producers should not be rated on our policy because they are not employees of our corporation, but employees of their own corporations; unless, of course, they are not insured by...

    I agree. These producers would look to their own corporation for protection (in New Jersey, all executive officers are protected by the Workers’ Compensation Law and cannot be excluded). I assume you will require proof of insurance from these corporate producers.

  10. Employee vs. independent contractor—audit | Ask PIA

    Is there any way to dispute an audit if the policyholder does not believe certain workers should be classified as employees?

    The National Council on Compensation Insurance Basic Manual for Workers’ Compensation and Employers’ Liability Insurance provides the guidance in Dispute Resolution Process Rule ID: BM-DISP-D5B64. The Dispute Resolution Process has three steps. Policyholder attempts to resolve dispute with the carrierFirst, a policyholder must attempt to resolve the dispute directly with...

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