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  1. Windstorm | Ask PIA

    My client’s home is insured on a basic peril dwelling policy form  (in the FAIR Plan). While they were away in Florida for three weeks during the March storms, wind came down the flue and blew out the pilot light on the furnace, causing the furnace to become inoperable and...

    No. Take a look at the exact wording of that policy exclusion. The windstorm coverage does not apply to a loss to the inside of a building, or the property contained in the building, caused by rain, snow, sleet, sand or dust unless the direct force of wind or hail damages...

  2. Charging for accident of unlicensed user | Ask PIA

    Our insured’s child, who is 18 and not licensed, took our insured’s car and had an accident. The insurer intends to surcharge for the accident. The child was not a listed driver in the household.

    Since the claim was covered and the loss paid, the insurer will charge points. It would be the same as if an operator lost his license for a DWI conviction.

  3. Discontinued operations—gone out of business | Ask PIA

    When contractors go out of business, we always recommend they buy “discontinued operations liability coverage,” i.e., for products completed operations exposures going forward. My question is, if a contractor is incorporated and dissolves the corporation, how free from liability are they? Can't they still be sued say a deck they built collapses...

    The only way the officers can be held individually responsible would be if the corporate veil were to be pierced; that is, to circumvent the limited liability of the owners and to hold them liable for some underlying corporate obligation. See http://www.expertlaw.com/library/business/corporate_veil.html and http://en.wikipedia.org/wiki/Piercing_the_corporate_veil for factors to be...

  4. Earthquake coverage for the condo or unit owner | Ask PIA

    I am writing a California condominium unit owners policy. The insured is not interested in earthquake coverage on his contents; however, because the association has no earthquake coverage on the building, he would like building coverage in order that he may recoup the $975,000 purchase price on the unit in...

    The first question you must answer is whether the association bylaws hold the condo owner responsible for insuring the building property. If so, this must be insured under adequate Coverage A limits. The peril of earthquake may then be added by endorsement HO 04 54, but it will cover all...

  5. Definition of insured location—vacant property | Ask PIA

    Under the various ISO homeowners policies, there is automatic coverage for an “insured location,” which includes vacant land in its definition. If there is any structure on the land, is it no longer “vacant” land? In my mind, a fence on the property is a structure. If so, do you believe...

    This is a matter of interpretation, since “vacant” is not defined. Most insurance practitioners believe that any man-made structure will remove the land from the vacant category; meaning, it must be in its natural state. However, the following case in New York makes the land’s lack of use the primary...

  6. Loss run data—how many years must be provided? | Ask PIA

    How many years’ worth of loss information must a commercial insurer provide upon request? Can a prospective insurer ask for more information than the current insurer is required to provide?

    According to an OGC opinion regarding how much loss run data the current insurer must provide: “In the absence of a regulation, the insurer must provide loss information covering the period of time that coverage has been provided by the insurer. However, Section 3426(g)(2) does not require an insurer to...

  7. Advertising insurance ’discount’ misleading if refers to ’quasi group’ rate | Ask PIA

    Can a bank in New York advertise that its customers are eligible for a discount on the insurance products sold by the bank’s affiliated insurance agency?

    No. Where a bank-affiliated insurance agency can offer a lower rate than would be available to other similar risks, it is not due to a “discount.” This also is true of other groups of consumers who are targeted by mass-merchandising programs, not just bank customers. Insurers are permitted to file...

  8. Group rate can’t be called a ’discount’ | Ask PIA

    Can a bank in New York state advertise its customers are eligible for a discount on insurance products?

    No. Where a bank can offer customers a lower rate than would be available to other similar risks, it is not due to a “discount.” This also is true for other groups of consumers who are targeted by mass-merchandising programs. Insurers are permitted to file rates for “quasi-groups” which differ...

  9. Class change upon audit | Ask PIA

    Can a carrier add a new class to a workers’ compensation policy upon audit?

    Below are excerpts from the workers’ compensation policy, which give the insurer the right to revise the classifications: B. Classifications Item 4 of the Information Page shows the rate and premium basis for certain business or work classifications. These classifications were assigned based on an...

  10. Out-of-state registration | Ask PIA

    I have a client who will soon be declaring residency in Florida and changing his driver’s license to Florida. He will be living in Florida for six months and New Jersey for six months. The client wants one vehicle to be registered in Florida and one vehicle to remain registered...

    If the client wants to register one vehicle in Florida and the other vehicle in New Jersey, then two policies will be required. Each state’s financial responsibility and compulsory insurance laws will govern the coverage requirements for vehicles registered in that state.

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