N.Y. Comp. Codes R. & Regs. tit. 11 § 215.3

Current through Register Vol. 46, No. 50, December 11, 2024

Section 215.3 - Definitions

(a) An advertisement for the purpose of this Part shall include:

(1) printed and published material, audio-visual material, and descriptive literature of an insurer used in direct mail, newspapers, magazines, radio scripts, TV scripts, billboards and similar displays;

(2) descriptive literature and sales aids of all kinds issued by an insurer, agent or broker for presentation to members of the insurance buying public, including but not limited to circulars, leaflets, booklets, depictions, illustrations and form letters; and

(3) prepared sales talks, presentations and material for use by agents, brokers and solicitors.

(b) Policy for the purpose of this Part shall include any policy, plan, certificate, contract, agreement, statement of coverage, rider or endorsement which provides accident and health insurance, whether on an indemnity, reimbursement, service or prepaid basis.

(c) Insurer for the purpose of this Part shall include any individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds, fraternal benefit society, and any other legal entity which is defined as an insurer in the New York Insurance Law and is engaged in the advertisement of a policy as herein defined.

(d) Exception for the purpose of this Part shall mean any provision in a policy whereby coverage for a specified hazard is entirely eliminated; it is a statement of a risk not assumed under the policy.

(e) Reduction for the purpose of this Part shall mean any provision which reduces the amount of a benefit; a risk of loss is assumed but payment upon the occurrence of such loss is limited to some amount or period less than would be otherwise payable had such reduction not been used.

(f) Limitation for the purpose of this Part shall mean any provision which restricts coverage under the policy other than an exception or a reduction.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 215.3