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  1. Guaranty fund for Health Maintenance Organizations | Ask PIA

    Is there a guaranty fund in New York state that would back Health Maintenance Organizations and nonprofit medical and dental indemnity or health and hospital service corporations?

    New York state does not have a guaranty fund that would back insolvent group health plans provided by entities authorized to issue plans based on Insurance Law Article 43 and New York Public Health Law Article 44 Health Maintenance Organizations. However, New York’s Insurance Law Article 77, “The Life...

  2. Dwelling owned by an LLC | Ask PIA

    My limited liability company client owns a three-family rental dwelling that is insured on a dwelling policy with personal liability coverage. If the owner member is sued along with the LLC, where does he obtain coverage?

    According to an article by Stephen Fishman, J.D. (see https://www.nolo.com/legal-encyclopedia/limited-liability-protection-llcs-a-50-state-guide.html), “There is one extremely significant exception to the limited liability provided by LLCs. This exception exists in all states. If you form an LLC, you will remain personally liable for any wrongdoing you commit during the course of your LLC...

  3. Ensuring protection for leased employees | Ask PIA

    My client has leased employees from a labor contractor. The labor contractor has purchased the workers’ compensation policy for the leased employees. How can my client be certain the labor contractor is maintaining this protection?

    The New York Compensation Insurance Rating Board offers two methods for insuring leased employees (see Rule II, H. Employee Leasing—pages R-7 through R-10 of the manual). This rule also applies to professional employer organizations who become co-employers with the client employer. The first option permits the client, who has leased...

  4. Permanent storm shutters | Ask PIA

    Is there a law prohibiting homeowners insurers from refusing to issue or renew a policy solely due to lack of permanent storm shutters?

    There used to be, however that has changed. Public Act No. 14-175 amends C.G.S.A. 38a-316a(a) effective Oct. 1, 2014, by prohibiting insurers from declining to write, renew, amend or endorse a homeowners insurance policy solely on the basis that the insured or prospective insured has failed to install storm shutters...

  5. Termination rights under Section 3425(j) extend to brokers | Ask PIA

    As an insurance wholesaler, our firm accepts business from licensed insurance brokers. If we terminate a broker’s agreement, is the broker entitled to certain protections under Section 3425(j) of the Insurance Law for the personal lines policies placed pursuant to the agreement?

    Unless the termination was “for cause,” the broker is protected by the termination provisions of New York Insurance Law Section 3425(j). For nonauto personal-lines policies, that would require the policy remain in place and be renewed for at least one year following the termination of the broker. For auto policies,...

  6. Definition of ’employee’—real-estate exception | Ask PIA

    Could you fill us in on a law that was passed a while back exempting real-estate brokers from workers’ compensation? We don’t want to make a mistake in this area.

    You’re thinking of Connecticut General Statute 20-312b, which took effect Oct. 1, 1991. This law was amended as of Jan. 1, 2017. The act provides that a licensed real-estate broker or real-estate salesperson shall not be considered an employee under Connecticut’s Workers’ Compensation Law if substantially all of...

  7. Limits on claims-made forms | Ask PIA

    What types of risks may be written on a claims-made basis in Connecticut?

    Licensed insurers may not provide claims-made coverage except for the following: directors and officers liability; employee benefits liability; errors-and-omissions liability; excess liability (defined as commercial liability written over at least $1 million in underlying insurance or over at least $15 million in self-insured retention); fiduciary liability; pollution & environmental...

  8. Coverage while preparing for work | Ask PIA

    When does workers’ compensation coverage begin to apply to workers during the typical workday?

    Connecticut added clarifying amendments to its workers’ compensation regulations in 1996 to address the whole area of injuries that occur while preparing to come to work. Section 31-275 of the Connecticut Workers’ Compensation Act concerns itself with the act’s definitions. In defining the term (1) “arising out of and...

  9. Equipment for apartment building breakdown | Ask PIA

    Should a standard six-story apartment building in New York have a need to purchase comprehensive equipment breakdown boiler insurance? We understand the basic coverage covers boiler and machinery and that the comprehensive covers the electrical system, however, we are not sure if this is a necessary coverage. Should a...

    I don’t know the exposures your client has, but there are many possibilities. Example An apartment complex’s aluminum electrical supply bus burned out, severely damaging electrical wires and cables. Angry residents had to be relocated. Equipment repair cost: $118,681Relocation cost: $72,152Total loss: $190,833 Other possibilities are building controls,...

  10. Insurance penalty points | Ask PIA

    According to New Jersey Insurance Law, a person whose license has been suspended for failure to comply with a time-payment order or for failure to respond to or pay a parking judgment is not subject to the same penalties as a person whose license has been suspended for a driving-related...

    You ask a good question. This law, which went into effect Jan. 1, 2008, does not address the insurance regulations that classify a violation of N.J.S.A. 39:3-40 (operating a vehicle with a suspended license) as a nine-point penalty violation. The law, which is an amendment to N.J.S.A. 39:3-40 (the operating...

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