N.Y. Comp. Codes R. & Regs. Tit. 11 §§ 60-4.7

Current through Register Vol. 46, No. 51, December 18, 2024

Section 60-4.7 - Additional Requirement

(a) The insurer shall be responsible for mailing or delivery of a certificate of insurance to each group member in accordance with Insurance Law section 3458(h).

(b) Pursuant to General Business Law section 902(2), a group policy shall provide that the group policy is primary over a policy issued in satisfaction of Vehicle and Traffic Law article 6 and in accordance with section 60-4.3(h) of this Subpart.

(c) Pursuant to General Business Law section 902(1), if insurance maintained by a peer-to-peer car sharing program administrator pursuant to General Business Law section 901(2) has lapsed, then the peer-to-peer car sharing program administrator shall retain liability during such lapse. If the group policy lapses, then the peer-to-peer car sharing program administrator shall be subject to Subparts 65-3 and 65-4 of this Title.

(d) No group policy or certificate shall contain any deductible or self-insured retention with respect to liability, no-fault or supplementary uninsured/underinsured motorist coverage, provided, however, a group policy may set forth a liability insurance deductible for which the insurer is responsible to pay for damages to third-party claimants and the peer-to-peer car sharing program administrator is solely responsible for reimbursing the insurer up to the amount of the liability insurance deductible. A group member shall not be held responsible for reimbursing the insurer or the peer-to-peer car sharing program administrator for the amount of the deductible.

(e) No group policy or certificate shall be subject to a group or sub-group aggregate liability limit of any kind at any time, and any liability limit applicable to a group member shall:

(1) be separate and apart from any liability limit to which any other group member insured under the group policy may be subject; and

(2) operate unaffected by the experience of any other group member or the overall experience of the group itself.

(f) Group policy forms and rates of an authorized insurer shall comply with Insurance Law article 23 standards, and no such rates shall be excessive, inadequate, unfairly discriminatory, destructive of competition, detrimental to solvency, or otherwise unreasonable, subject to the following factors:

(1) advantages may be considered, based on actual or reasonably anticipated loss and expense experience of the group or its members, where such advantages and experience can be fairly demonstrated; and

(2) rates, rating plans or rating rules recognizing loss differences on a group basis, in comparison to like risks not in the group, shall be deemed rating classifications subject to the superintendent's approval pursuant to Insurance Law section 2307.

(g) Except with respect to requiring a shared vehicle driver or shared vehicle owner to be insured under the group policy required by General Business Law article 40, no insurer shall provide coverage in regard to a group program that:

(1) requires the purchase of insurance as a condition of group membership; or

(2) imposes any penalty upon a group member if insurance is not purchased.

(h) No insurer shall provide coverage in regard to a group if:

(1) the purchase of any good or service from the group or sponsoring entity is a condition of purchasing insurance by a group member; or

(2) the purchase of insurance by a group member is a condition of purchasing any good or service from the group or sponsoring entity.

N.Y. Comp. Codes R. & Regs. Tit. 11 §§ 60-4.7

Adopted New York State Register February 8, 2023/Volume XLV, Issue 06, eff. 2/8/2023