The New York Insurance Department’s Office of General Counsel posted 10 new advisory legal opinions on its Web site last week.
- An insurer may send an electronic notice of cancellation to an insured by means of e-mail if the insured has consented to receiving electronic documents. A reliable, accurate and verifiable electronic record that insurer sent the cancellation notice to the e-mail address for the insured on record with the insurer will suffice as proof of delivery.
- A health services provider may not bill a patient and/or the patient’s health insurer for treatment of injuries arising out of the use of a motor vehicle at the provider’s standard rates when the patient’s no-fault insurer has denied the medical provider’s claim because available coverage for basic economic loss has been exhausted. The provider also may not bill a patient and/or the patient’s health insurer treatment of injuries arising out of the use of a motor vehicle at the provider’s standard rates when the patient’s no-fault insurer has denied the medical provider’s claim because of a policy exclusion, such as driving while intoxicated.
- The life insurance guaranty fund protects a New York resident who resides in Florida each winter, and who purchases a variable annuity contract in Florida, from a New York authorized insurer, that has a death benefit rider not available in New York.
- A university would not commit insurance fraud if it were to waive psychiatric office visit fees of more than twenty dollars for which its students are personally responsible, and notify its students’ insurers of the waivers.
- A service fee agreement that details the service to be provided and at what price, and specifies that the agent will keep any commission earned by the agency on the sale of insurance to the client satisfies the requirements of the Insurance Law.
- After acceptance by all necessary parties of a lump-sum waiver agreement under the New York Workers’ Compensation Law, an insured’s health insurance plan is not obligated to pay future medical expenses arising from the insured’s original injury.
- The method for calculating the fire insurance fee for a businessowners policy that has separate, divisible premiums for the property and liability coverages is to multiply 100 percent of the property premium by 1.25 percent. If the property premium is divisible and there are portions that do not include the peril of fire, then the fire insurance fee is not levied on that portion of the property premium. However, if the property premium is not divisible, then the fire insurance fee is levied on the whole property premium. If inland marine coverage is included in a businessowners policy and the premium is divisible, it is not subject to the fire insurance fee.
The OGC declined to express an opinion on a Medicare question; it also posted opinions pertaining to insurance company investments and the legality of a specific discount medical plan. Visit the department’s Web site to download any opinion issued since 2000.
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