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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 the...

    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...

  2. Cancellation/nonrenewal—workers’ compensation | Ask PIA

    Are workers’ compensation policies subject to the cancellation/nonrenewal rules of New York State Insurance Law Section 3426?

    No, they are not. New York State Insurance Law 3426 does not apply to policies that provide workers’ compensation coverage because New York State Insurance Law Section 3426(l)(2) (McKinney Supp. 2004) states that Section 3426 “shall not apply to ... policies providing workers’ compensation ... coverage.”

  3. Nonlicensed agency owner | Ask PIA

    Can an unlicensed business entity buy into an insurance agency?

    Yes, unlicensed entities may become owners of an insurance agency that is licensed provided the unlicensed entities do not engage in any activities that would require an insurance license and do not receive any share of the commissions. The unlicensed entities may, however, share in the profits of the corporation...

  4. Referral fees for unlicensed entity | Ask PIA

    A business entity approaches an insurance agency. The business entity has clients that need a particular type of insurance. For each policy written, the business entity would like to be compensated. Can this business entity that does not have an insurance license receive commission as shares after the deduction of...

    No, a licensed insurance agent may not compensate a nonlicensee for referrals contingent upon the placement of insurance. However, the nonlicensee may be compensated for the referral if the compensation is not based upon the placement of insurance and the nonlicensee does not discuss specific insurance policy terms or conditions...

  5. Insurance industry “quality assurance” law | Ask PIA

    I have heard that there is an Insurance Industry Quality Assurance Law in place. How does it affect me, as an insurance producer?

    On Jan. 17, 2010, a bill was signed into law as Chapter 278 of the Laws of 2009, that was described as such. However, the extent of this bill’s reach is quite limited; it requires any producer who has been the subject of discipline by a nongovernmental regulatory agency to...

  6. Surety bond fees | Ask PIA

    Are surety bonds a commercial-lines product, for which a fee can be charged?

    Surety bonds are, indeed, a commercial-lines product. N.J.S.A. 17:29AA-3 defines commercial-lines insurance as: … all insurance policies issued by a licensed insurer pursuant to Title 17 of the Revised Statutes, except:insurance of vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity or other risks commonly insured under...

  7. Replacement cost vs. market value | Ask PIA

    Do you have any resource documents showing why to insure a home for reconstruction replacement cost vs. the market value or the differences between the two? This is a hot topic among our clients lately.

    In today’s economy, many people are looking at ways to reduce their household expenses, including their insurance costs. Insureds are seeing the values of their homes, and of those homes around them, decrease, so if the values are decreasing, why is the home insured for more than it can sell...

  8. HO mold coverage | Ask PIA

    My insured discovered the growth of mold in her kitchen, which was caused by a water leak from the dishwasher. Does the ISO homeowners policy cover mold damage?

    The standard ISO homeowners policy covers mold “that is hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure if such loss results from the accidental discharge or overflow of water or steam from within … a household appliance.” However, there are endorsements...

  9. WYO flood carriers | Ask PIA

    What is the difference between the Write-Your-Own flood program and that offered by the National Flood Insurance Program?

    I think Write-Your-Own flood program is a little bit of a misnomer. The federal government is the insurer for flood coverage. The WYO program began in 1983 and is a cooperative undertaking of the Federal Emergency Management Agency and the private insurance industry. The WYO program operates within the context of the...

  10. Physical damage inspection—insured’s photos | Ask PIA

    A policyholder bought a car from a used-car dealer, but she did not have a physical damage inspection within 14 days. An accident subsequently occurred, and the company denied collision coverage. The policyholder has her own “before” and “after” pictures showing there was no prior damage to the vehicle. Also,...

    No. The waiver provision (11 NYCRR 67.3) allows, but does not require, companies to let the policyholder submit proper documentation on the new vehicle in lieu of an inspection. But note that this optional waiver applies only to new, unused vehicles purchased from a franchised dealer. (For this reason, you...

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