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  1. Fraud reporting | Ask PIA

    Do licensees have a duty to report suspected fraudulent insurance acts? 

    Yes. New York Insurance Law Section 405(a) requires that any person licensed under the Insurance Law (“licensee”) ... shall file reports of suspected insurance fraud. These reports are used by the department as the basis for determining if a matter warrants criminal investigation and/or civil penalties. The report is required...

  2. Obligations for bonds | Ask PIA

    One of my clients has asked to have a meeting about his bond requirements. He is not a contractor. What kind of bonds could he need and what do I need to know?

    There are virtually an endless number of types of bonds that could be needed. In essence, though, a bond is a surety, which is another way of saying a type of guarantee where one party (a guarantor) agrees to meet the failed obligation assumed by, or expected of, an obligor...

  3. Rules for accessing the excess-line market | Ask PIA

    For risks that do not automatically qualify for the excess-line market, I continue to hear somewhat conflicting information about the need for and completeness of declinations in the admitted market. Is there some “flexibility” that makes this less onerous?

    In a word, no. The process that is required is not intended to be an exercise in creativity or in how to streamline work. The affidavit, which may be found in QuickSource document No. QS31208, titled ELANY Affidavit Part C—affidavit by producing broker, is detailed, placing the burden and responsibility...

  4. New York law against steering for auto repairs | Ask PIA

    I have been told that our agency can never recommend a specific repair shop when a customer needs repairs to a vehicle following a collision. Is this true?

    Not quite. Agents can recommend one or more repair facilities if your client asks you for a recommendation. If your client does not ask, you cannot make such a recommendation.There is an exception if the damage involves only window glass. For glass-only claims, you can make a recommendation without being asked (although...

  5. Switch to excess-line carrier from New York-authorized carrier at renewal | Ask PIA

    A company has issued a conditional renewal notice on a commercial policy. The purpose of the conditional renewal is to require the renewal to be issued in a nonadmitted (unauthorized) affiliate of the current admitted (authorized) carrier. In addition to changing companies, the insured’s coverage would be subject to exclusions...

    No. The authorized insurer may not condition its renewal upon the policy’s placement with the unauthorized insurer. The condition that the insured accept a renewal in an unauthorized company renders the current carrier’s conditional renewal notice invalid. The proposed transaction would violate Sections 1102(a) and 2117(a) of the Insurance...

  6. Rules for accessing the surplus-lines market | Ask PIA

    For risks that do not automatically qualify for the surplus-lines market, I continue to hear somewhat conflicting information about the need for and completeness of declinations in the admitted market. Is there some “flexibility” that makes this less onerous?

    In a word, no. The process that is required is not intended to be an exercise in creativity or in how to streamline work. The regulation (N.J.A.C. 11:1-33.2) requires a “diligent effort” to place a risk with an authorized insurer, as defined below: "Diligent effort"...

  7. Connecticut homeowners coverage for home heating oil tanks | Ask PIA

    Has Connecticut approved any endorsements affecting limits for insurance that would respond to leaks involving homeowners’ underground heating oil tanks?

    Yes. Check the policy for endorsements that may affect a) cleanups of the homeowners’ own property; and b) liability for damage to others’ property (e.g., groundwater contamination). If the homeowners policy does not contain an endorsement, then oil tank leaks are not expressly addressed by policy provisions. However, the...

  8. Certificates of insurance | Ask PIA

    Many of my clients are subcontractors, and are being requested by the general contractor to have certificates of insurance that sometimes go beyond the policy wording. Is there any way of modifying the certificate to assist our clients?

    No, there is not. On Jan. 11, 2016, then-New Jersey Gov. Chris Christie signed legislation into law (Chapter 195 of the Public Laws of 2015) that prohibits any person from preparing, issuing, requesting or requiring the issuance of a certificate of insurance that contains false or misleading information. The new...

  9. Negotiated claims settlement | Ask PIA

    My client was involved in an automobile accident that was the complete fault of the other party. He has received a letter from the adjuster of the other party’s insurer offering a compromise payment, claiming they had not received a notice of loss, nor could they contact their insured. Can...

    Yes, but your client need not accept it. An insurer is entitled to prompt notification of a claim and the cooperation of their insured. Failure to do either could result in a denial of coverage, hence, a denial of claim. (Your client should check to see if the insurer met...

  10. ’Active duty’ clarification | Ask PIA

    We were told by one company that if a son/daughter is in “boot camp” or basic training that this is not considered active duty, so they will charge until he/she has passed basic training and becomes “active.” Is this correct?

    According to the local Army Recruiting Office, a person in basic training is considered to be in “active duty.”

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