N.Y. Comp. Codes R. & Regs. tit. 11 § 15.3

Current through Register Vol. 46, No. 45, November 2, 2024

Section 15.3 - Requirements for policies other than life insurance

(a) No simplified or comprehensive policy issued pursuant to section 3101 may be sold in this State unless such policy has been approved in writing by the superintendent.

(b) Every insurer filing a policy pursuant to this Part must be authorized to write in this State every kind of insurance set forth in section 1113(a) of the Insurance Law included in such policy.

(c) Every policy shall state that it provides coverage and terms at least as favorable as that required by any provision of law with respect to the kinds of coverage included under such policy, and it shall be so construed. The approved policy need not then contain the language required under any provision of law which specifies the content of insurance policies.

(d) Each policy filed for approval pursuant to this Part shall be accompanied by the following:

(1) A statement describing the insurance coverages included in such policy.

(2) A copy of each replacement policy which must be offered pursuant to the provisions of section 15.5 of this Part, together with the rates and limits of coverage applicable to each replacement policy.

(3) A statement indicating:

(i) the intended market for the approved policy;

(ii) the underwriting standards which the company will apply in accepting applicants;

(iii) the standards of suitability to be used by the insurer, which must include an assertion that no approved policy will be issued in the absence of reasonable grounds to believe that the purchase of such policy is not unsuitable for such applicant, on the basis of information furnished after reasonable inquiry of such applicant concerning the applicant's insurance needs; and

(iv) a copy of the application form which will be used in connection with the approved policy.

(4) Any supplementary documents, such as certificates of coverage, which the insurer will issue to or on behalf of an insured.

(5) A plan, approved where necessary by the appropriate authorities, for identifying and reporting premium or other appropriate exposure bases for purposes of determining:

(i) the participation of the insurer in the New York Automobile Insurance Plan and the New York Property Insurance Underwriting Association;

(ii) assessments for security funds;

(iii) applicable taxes; and

(iv) any other requirement for identification of premium components.

(6) Such other information as the superintendent may request.

(e) Every insurer issuing approved policies shall maintain separate records with respect to the experience of such policies, including exposures, premiums, losses and expenses.

(f) The superintendent may, depending upon the specific circumstances of each filing, suspend such rating and other requirements of the Insurance Law and of this or any other department regulation as he deems appropriate for the implementation of section 3101 of the Insurance Law. In the absence of a specific suspension, every applicable provision of the Insurance Law and department regulation shall remain in effect.

(g) The superintendent shall not approve any policy which is filed pursuant to this Part unless he determines that such policy is readily understandable and the issuance of such policy by the insurer would be neither unjust, unfair, inequitable, misleading, deceptive, contrary to the public policy of this State nor prejudicial to the policyholders of the company.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 15.3