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  1. Conditional renewal—increase in deductible | Ask PIA

    My insured’s policy was recently renewed, but with a new exclusion, an increase in the deductible and lowered coverage. Can the company do this? Don’t they have to give us advance notice?

    This action is typically known as a “conditional renewal” and is addressed in part “D” of Connecticut Insurance Department Bulletin PC-66. A company can, indeed, conditionally renew a policy, but must give advance notice to the policyholder. Generally, the insurer must give 60 days’ notice whenever offering a conditional...

  2. Denial of homeowners claim for lack of building permits | Ask PIA

    Could an insurer deny a homeowners policy claim for damage caused by a condition in improvements made to the home for which the homeowner neglected to get the proper building permits?

    The typical homeowners insurance policy does not exclude coverage for dwellings, or their upgrades or improvements, that have not been built according to current building code. However, recovery is limited to the value of the damaged property, not the value of property as it should have been built according to...

  3. Umbrella policy—notice of claim requirements | Ask PIA

    My client had someone get injured on his property that initially resulted in a $1,500 reserve being placed on his commercial general liability policy. Since it was such a small amount, my client chose not to report it to his umbrella insurer. However, when the reserve subsequently was increased to...

    First of all, in most jurisdictions, the insurer would be required to show prejudice in its ability to adequately defend the claim before such denial could be enforced. If there is no prejudice, it will not matter that the insured’s notice was late. For example, a bill was signed into...

  4. Fire after lengthy unoccupancy due to storm aftermath | Ask PIA

    What if my house is unoccupied due to the storm and a fire or any other type of loss happens? Will I still have coverage for the subsequent loss?

    Yes, if the loss is a result of a covered peril. However, with that being said, the adjusters will have to review the loss and see what would be considered new damage and what would be attributable to the prior loss. Unoccupancy does not impact the validity of the subsequent...

  5. Credit-card fraud | Ask PIA

    Is there some way to insure a business owner when a stolen credit card is used to purchase merchandise, typically, over the phone or internet? The business owner runs the transaction on a card and it initially clears. Then the business owner ships the product in good faith. Later the...

    The standard crime policy has several exclusions applicable to this scenario that will preclude coverage. Unfortunately, PIA is not aware of any coverage available for this business risk. There are, however, loss-control measures that can be taken with little or no cost. In addition, the latest fraud-detection technologies can be...

  6. Cancellation at policyholder’s request—effective date | Ask PIA

    Is a company required to cancel flat when the policyholder presents evidence that another policy was obtained for the same risk, and became effective on the date the policyholder wants to cancel?

    No—not unless there is a policy provision that states so. When an insurance policy is canceled at the behest of the policyholder, the provisions of the policy regarding cancellation govern the transaction. Normally, an insurance contract provides that the policyholder may cancel by providing advance written notice or returning the...

  7. New DWI—notification to department | Ask PIA

    One of my producers was arrested for Driving While Intoxicated. How soon must he/she notify the New Jersey Department of Banking and Insurance of the arrest?

    The producer does not have to notify the department upon arrest; however, N.J.S.A. 17:22-A-47 requires all producers to, within 30 days of the initial pre-trial hearing date, notify the commissioner of any criminal prosecution taken in any jurisdiction. The report is to include a copy of the initial complaint...

  8. Tenant performing building maintenance | Ask PIA

    If a tenant provides all of the maintenance and upkeep on a home he is renting and, in return, the owner of the home provides a discounted rent, is there an employee-employer relationship and should the tenant be covered by a workers’ compensation policy?

    Yes. A landlord is considered a “for-profit” business; therefore, if a tenant provides any work for remuneration (this could be in the form of a “discount” or money taken off the rent or lease extension for example) he would need to be covered by a workers’ compensation policy. Basically, all...

  9. New York rental car—credit-card coverages | Ask PIA

    I recently received a flyer from a credit-card company touting their new Rental Car Protection service for a flat fee every time you rent a car. It provides a set limit for coverage for damage and theft of the rental car, excess coverage protection for personal property in the car...

    In New York, every private-passenger auto policy is endorsed with the PP 03 46 Rental Vehicle Coverage Endorsement—New York. This endorsement affords coverage to any insured. “Insured” means named insured or any “relative.” “Relative” means a spouse, child or other person related to the named insured by blood, marriage or...

  10. Paid Sick Leave—part-time employees | Ask PIA

    I have part-time employees in my office. Does the Paid Sick Leave Law apply to them?

    Yes. Under the law, “employee” is defined as an individual engaged in service to an employer in the business of the employer for compensation. So that definition would include full and part-time employees. Part-time employees would accrue paid sick leave time at the same rate as full-time employees as well,...

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