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  1. Who owns the engagement ring? | Ask PIA

    When a man gives a woman an engagement ring, who has an insurable interest in that ring and how should it be insured?

    We know that two conditions must be met in order for a property insurance policy to pay for a loss. Condition 1. Insurable interest in the property is a necessary condition for payment under a contract of indemnity. You can make someone whole again only if that person has...

  2. New Jersey Certificates of Insurance Law | Ask PIA

    I have a client whose business is located in New Jersey, but will be doing a job in another state. Does the New Jersey Certificate of Insurance Law apply if the insured is located in New Jersey even though the operations are being performed in a state other than New...

    No, the Certificates of Insurance Law would not apply where the operations are outside of the State of New Jersey. Section 7 of Chapter 195 of the Public Laws of 2015, also known as the Certificates of Insurance Act, states that “[t]he provisions of this act shall apply to all...

  3. Electronic delivery of policies | Ask PIA

    Must an insurer that implements an online insurance policy delivery system obtain the consent of each insured before it can place the insured’s insurance policies online, in lieu of issuing paper copies of the policies?

    Yes. The New York State Department of Financial Services has previously opined that an insurer who seeks to transmit insurance policy forms to insureds by electronic means (specifically by email) must obtain the consent of each insured to carry out the transaction electronically. See Office of General Counsel Opinion No....

  4. Supplementary payments—attorney fees | Ask PIA

    I was doing a little research and I see that the 2007 edition of the ISO Commercial General Liability Coverage Form (CG 00 01) will not pay for attorney fees taxed against an insured. Supplementary Payments, item 1.e., has a limitation in the 2007 edition not found in the 2004...

    The Supplementary Payments provision was revised by ISO in its business automobile policy, commercial general liability policy and umbrella policy. The insurer does not want to pay the plaintiff’s attorney fees, only the insured’s defense costs and court costs. Despite this amendment, insurers typically will not pay them anyway because...

  5. Out-of-state medical treatment | Ask PIA

    Our client has a New Jersey personal automobile policy and is seeking medical treatment for an accident. If he chooses to see a doctor located in New York, we understand that out-of-state services are subject to the fee schedule. Is this correct? Also, we know that in New Jersey, doctors...

    Since treatment for your insured does not appear to be “emergency” treatment, it would fall under item 2. of the regulation shown below. The payment of medical services is limited to the fee schedule where the insured resides. Section 11:3-29.4 Application of medical fee schedules (d) The...

  6. Swimming pool—water delivery | Ask PIA

    An insured suffered a covered swimming pool loss where the liner had to be replaced. Of course, to get to the liner, the water had to be drained. There is an agreed price between the carrier and the pool contractor for the replacement liner. Our insured is out the cost...

    You are correct, the current ISO homeowners policy does not cover water or steam. The Exception to c.(6) “tear out” provision you mentioned is a specific grant of coverage that will not translate to other scenarios. While your argument for covering labor costs shows creativity, I wouldn’t expect it to...

  7. Cyber security regulation—third-party service providers | Ask PIA

    What are “third-party service providers”?

    “Third-party service providers” are defined by the regulation as a person that provides service to you (the covered entity) AND maintains, processes or otherwise is permitted access to nonpublic information. The New York State Department of Financial Services has said that covered entities can be third parties of one another,...

  8. Electronic privacy notices | Ask PIA

    Sending out the GLBA privacy notices is expensive and time consuming. Can I deliver the GLBA privacy notices by email?

    Yes, you may use electronic means to deliver this information, subject to limitations. 16 CFR 313, the section of federal regulation which deals with this issue states:“How to provide notices. You must provide any privacy notices and opt-out notices, including short-form initial notices, that this part requires so that each...

  9. Forgery of an insurance certificate | Ask PIA

    Recently, we were shown a certificate of insurance that we issued which the insured photocopied, whited out and re-typed to indicate the presence of a coverage not on the policy, after we refused to issue such a certificate. Is this against the law?

    Yes. This would violate not only New York state’s Certificate of Insurance Law but the state’s forgery law as well. In 2015, New York State Insurance Law was amended to add Article 5, titled “Certificates of Insurance.” This section made it illegal to issue a certificate of insurance that attempts...

  10. PIP coverage—persons afforded extended medical expense benefits | Ask PIA

    Who is insured by Extended Medical Expense Benefits Coverage?

    The family is covered anywhere in the world while occupying or using a “highway vehicle,” or when struck as a pedestrian. Nonfamily persons are covered in New Jersey while occupying a “highway vehicle” (other than a motorcycle or livery vehicle) operated by someone in the family or using a...

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