Md. Code Regs. 31.15.10.03

Current through Register Vol. 51, No. 21, October 18, 2024

Section 31.15.10.03 - Private Passenger Motor Vehicle Insurance

A. Scope. This regulation applies to private passenger motor vehicle insurance.

B. Determining Number of Claims.

(1) For the purpose of determining the number of not-at-fault claims under Insurance Article, § 27-501(k), Annotated Code of Maryland, claims under the following types of coverage shall be presumed to be not-at-fault:

(a) Uninsured motorist coverage; and

(b) Comprehensive coverage.

(2) The presumption in §B(1) of this regulation may be overcome if the carrier demonstrates that the claim was an at-fault claim.

C. Complaint Proceeding Based on Accident-Determination of Fault.

(1) In a consumer complaint proceeding for cancellation or refusal to renew coverage under Insurance Article, § 27-501(k) or (l)(iv), Annotated Code of Maryland, based wholly or partly on an accident, the Insurance Administration may:

(a) Review the insurer's determination of fault for the accident; and

(b) Decide whether the insurer's determination of fault was arbitrary or capricious.

(2) Payment of a settlement by an insurer for an accident is evidence of the insured's fault for the accident, but is not conclusive proof of fault.

D. Material Misrepresentation.

(1) For purposes of Insurance Article, § 27-501(l)(1)(i), Annotated Code of Maryland, a material misrepresentation is a misrepresentation:

(a) About an insured's driving record made on an initial or underwriting renewal application; or

(b) But for which an insurer would:

(i) Not have provided coverage; or

(ii) Have denied a claim or any part of a claim.

(2) For purposes of Insurance Article, § 27-501(l)(1)(i), Annotated Code of Maryland, a material misrepresentation does not include a good faith representation of the value of a claim or any part of a claim.

E. Action Based on Criminal Conduct.

(1) In the case of private passenger motor vehicle insurance, standards that meet the business purposes standard and do not require statistical validation include a standard that allows cancellation or nonrenewal of coverage if the named insured or a covered driver under the policy is convicted of:

(a) Operating the motor vehicle while intoxicated, or impaired by drugs;

(b) Committing homicide, reckless endangerment, or criminal negligence arising out of the operation of the motor vehicle; or

(c) Using the motor vehicle to participate in a felony.

(2) If a named insured or covered driver is found guilty of a crime listed in §E(1) of this regulation, and the guilty finding subsequently is struck, and the final disposition of the matter is probation before judgment, the guilty finding:

(a) May be used as evidence that the named insured or covered driver committed the conduct listed in §E(1) of this regulation; but

(b) Is not conclusive proof that the named insured or covered driver committed the conduct listed in §E(1) of this regulation and may be rebutted by evidence showing that the insured or covered driver did not commit the conduct.

Md. Code Regs. 31.15.10.03

Regulations .03 adopted as an emergency provision effective February 4, 1999 (26:5 Md. R. 389); emergency status expired August 4, 1999; emergency status reinstated effective August 26, 1999 (26:19 Md. R. 1446); emergency status expired December 29, 1999
Regulations .03 adopted effective March 6, 2000 (27:4 Md. R. 455)