The New York Insurance Department’s Office of General Counsel issued the following advisory legal opinions in June:
· A No-Fault insurer may not deny a claim for failure to submit the Application for motor vehicle no-fault benefits form.
· New York law does not require physicians to carry professional liability insurance. Physician groups may not purchase group liability insurance in New York, but they may obtain it through a purchasing group.
· New York law does not govern the reimbursement of physicians by a health insurer.
· When an employer terminates a group health policy and replaces it with a new insurer, the new insurer’s smaller network of participating healthcare providers does not violate a terminated employee’s right to continuation of coverage. There is also no violation of the continuation right if the employee relocates to an area where the new insurer has a smaller provider network.
· A New York licensed property/casualty insurance agent may not lawfully offer a ten-dollar gift card for purchasing gas to currently insured clients who refer non-clients to an insurance company for an insurance quote on personal lines property/casualty insurance.
· The Insurance Department does not have authority to permit an insurer in the latter stages of a run-off to implement a phased non-renewal of its remaining New York personal auto policies in excess of the annual two percent limit.
· New York law does not require a life insurance agent to hold any other insurance license to broker a life settlement or to offer the policy for sale in an auction.
· A small group health insurer that offers domestic partner coverage must provide the same coverage to all of the small groups that it insures. An employer may choose to offer some plans (or even none) that provide for domestic partner coverage. Domestic partners are ineligible for coverage under COBRA but are eligible for benefits under New York law.
· A firm may market and sell a plan that provides paintless dent removal services to its members for a membership fee, plus a discounted fee for each service that covers the cost and overhead associated with the repair, without obtaining an insurance license. This is provided that the additional discounted fee for each service it charges covers the cost and overhead associated with the repair, or the cost of rendition.
The Department posted these and other opinions in June. Visit the Department’s Web site to find any opinion issued since 2000.