N.Y. Comp. Codes R. & Regs. tit. 11 § 224.3

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

Section 224.3 - Definitions

For purposes of this Part:

(a) Consumer means the owner or prospective purchaser of a policy.

(b) Insurer means a life insurance company as defined in Insurance Law section 107(a)(28) or a fraternal benefit society as defined in Insurance Law section 4501(a).

(c) Insurance producer or producer means an insurance agent or insurance broker.

(d) Policy means a life insurance policy, an annuity contract, a certificate issued by a fraternal benefit society, or a certificate issued under a group life insurance policy or group annuity contract.

(e) Recommendation means one or more statements or acts by a producer, or by an insurer where no producer is involved, to a consumer that:

(1) reasonably may be interpreted by a consumer to be advice and that results in a consumer entering into or refraining from entering into a transaction in accordance with that advice; or

(2) is intended by the producer, or an insurer where no producer is involved, to result in a consumer entering into or refraining from entering into a transaction. A recommendation does not include general factual information to consumers, such as advertisements, marketing materials, general education information regarding insurance or other financial products and general administrative services to the consumer. A recommendation also does not include use of an interactive tool that solely provides a prospective consumer with the means to estimate insurance, future income, or other financial needs or compare different types of products or refer the consumer to a producer, provided that the interactive tool is not used by a producer, or an insurer where no producer is involved, to satisfy any requirement imposed by this Part.

(f) Replace or replacement means a transaction subject to Part 51 of this Title (Insurance Regulation 60) and involving a policy.

(g) Suitability information means :

(1) For a policy solely providing term life insurance with no cash value, information that is reasonably appropriate to determine the suitability of a recommendation commensurate with the materiality of the transaction to a consumer's financial situation at the time of the recommendation and the complexity of the transaction recommended, including some or all of the following, as relevant to the consumer:

(i) age;

(ii) annual income;

(iii) financial situation and needs, including the financial resources used for the funding of the policy;

(iv) financial objectives;

(v) intended use of the policy, including any riders attached thereto;

(vi) financial time horizon, including the duration of existing liabilities and obligations;

(vii) existing assets, including investment and insurance holdings;

(viii) willingness to accept non-guaranteed elements in the policy, including variability in premium, death benefit, or fees; and

(ix) any other information provided by the consumer which in the reasonable judgment of the producer, or the insurer where no producer is involved, is relevant to the suitability of the transaction.

(2) For any policy other than a policy solely providing term life insurance with no cash value, information that is reasonably appropriate to determine the suitability of a recommendation commensurate with the materiality of the transaction to a consumer's financial situation at the time of the recommendation and the complexity of the transaction recommended, including some or all of the following, as relevant to the consumer:

(i) age;

(ii) annual income;

(iii) financial situation and needs, including the financial resources used for the funding of the policy;

(iv) financial experience;

(v) financial objectives;

(vi) intended use of the policy, including any riders attached thereto;

(vii) financial time horizon, including the duration of existing liabilities and obligations;

(viii) existing assets, including investment and insurance holdings;

(ix) liquidity needs;

(x) liquid net worth;

(xi) risk tolerance;

(xii) willingness to accept non-guaranteed elements in the policy, including variability in premium, cash value, death benefit, or fees;

(xiii) tax status; and

(xiv) any other information provided by the consumer which in the reasonable judgment of the producer, or the insurer where no producer is involved, is relevant to the suitability of the transaction.

(h) Suitable means in furtherance of a consumer's needs and objectives under the circumstances then prevailing, based upon the suitability information provided by the consumer and all products, services, and transactions available to the producer.

(i) Transaction means any sales transaction or in-force transaction.

(j) Sales transaction means the purchase or issuance of a policy, any replacement as defined by section 51.2(a) of Part 51 (Insurance Regulation 60), conversion, or any modification or election of a contractual provision with respect to an in-force policy that generates new sales compensation. New sales compensation does not include compensation provided to a producer when, after the initial premium or deposit under a policy, the consumer pays further premiums or deposits pursuant to the policy.

(k) In-force transaction means any modification or election of a contractual provision with respect to an in-force policy that does not generate new sales compensation. New sales compensation does not include compensation provided to a producer when, after the initial premium or deposit under a policy, the consumer pays further premiums or deposits pursuant to the policy.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 224.3

Amended New York State Register August 1, 2018/Volume XL, Issue 31, eff. 8/1/2018