New York State seal

September 26, 1979

SUBJECT: INSURANCE

WITHDRAWN

Circular Letter No. 26 (1979)

(Addendum to Circular Letters 21 and 22 (1979))

TO: ALL INSURERS AUTHORIZED TO WRITE PRODUCT LIABILITY INSURANCE IN NEW YORK STATE

SUBJECT: AMENDED REPORTING REQUIREMENTS-PRODUCT LIABILITY INSURANCE

Circular Letter No. 21 (1979) and Circular Letter No. 22 (1979), dated August 2, 1979, advised insurers of the requirement to submit semi-annual reports to the Superintendent of Insurance with respect to cancellations and nonrenewals of product liability insurance in addition to reports of product liability claims for the preceding six month period ending June 30, 1979.

Information received by the Department has indicated that the requirement of developing data retroactive to January 1, 1979 for the six month period ending June 30, 1979 would be an extreme hardship and involve tremendous cost. Furthermore, we have been informed that insurers need additional time to complete their reports for the six month reporting periods.

After due reconsideration of this matter, we are making the requirement for reporting information for the six month period ending June 30, 1979 optional on the part of the companies. The filing dates for the submission of such reports is hereby extended to October 15, 1979. In addition, the filing date for transmitting reports to this Department for subsequent six month periods shall be sixty (60) days after the end of the preceding six month reporting period.

The forms for the reporting of claims, cancellations and nonrenewals which were attached to Circular Letters 21 and 22 have been revised in order to provide greater clarity and detail. Attached are copies of the amended forms which are to be completed for the six month period ending December 31, 1979.

The completed forms, signed by a responsible officer of the insurer, should be mailed to:

Mr. Harold I. Baida, Principal Insurance Examiner

Property and Casualty Insurance Bureau

State of New York Insurance Department

Two World Trade Center

New York, N.Y. 10047

You will be advised concerning the form of reports to be submitted for periods subsequent to December 31, 1979.

Very truly yours,

[SIGNATURE]

ALBERT B. LEWIS

Superintendent of Insurance

ATTACHMENT

Product Liability Claim Report Form

Period ending_______________________________

1a. Name of insurer_______________ NAIC Company Code__________

1b. Claim file identification_______________________________________

2a. Date of occurrence. Month_____ Day_____Year______

2b. Date claim reported to insurer. Month_____ Day_____ Year________.

3a. Insured's Address_________________________________________.

3b. Insured's City___________State___________Zip Code_________.

3c. Insured's policy number____________Effective date__________.

4. Type of product involved in claim (description)_________________

____________________________________________________________.

5. ISO statistical class (CSP Code) of product*__________________.

6. Date of manufacture of product. Month______Day_____ Year_____.

7. Date of sale of product. Month______Day______Year_____.

8. Claim was for BI only______PD only________BI and PD

                                                                             (both)_________________.

9. Severity (code) *__________________________________________________.

10. Injured person's status in the occurrence (code) *___________________.

11. State in which incident occurred_________________________________.

12a. Amount of reserve for indemnity *

        BI $ _______________________PD$ ________________________.

12b. Amount of indemnity paid by you, if closed* BI $ __________________

        PD $ _______________Combined (if not separable) $ _________________.

12c. Other indemnity paid by or on behalf of insured, if closed*BI $ ______

        PD $ __________________Combined (if not separable) $ ____________.

13a. Amount of reserve for allocated expenses *

        BI $ _________________PD $ ________________Check here [] if not kept separately but is included in item 12a.

13b. Amount of allocated expenses paid, if closed *BI $ ______________

        PD $ _____________Combined (if not separable) $ _____________________.

* See Instructions

_____________________________________________

Contact person's name & Telephone No.

_____________________________________________

Address

_____________________________________________

Person responsible for report

Reason for nonrenewal

1

2

3

4

5

6

7

8

Total

B. Policies

 a. Product Liability

 b. CGL (incl. Product Liability)

 c. Comm'l Package(incl. Product

  Liability)

 d. Others(Incl. Product Liability)

Total

Footnote

Each policy included in the summary is to be assigned only one of

the following major reasons for nonrenewal:

1. Poor loss experience of insured - Product Liability

2. Poor loss experience of insured - Coverage other than

Product Liability

3. Poor safety engineering

4. Increase in hazard of product

5. Termination of producer

6. Non-payment of premium

7. Insured's request

8. All others

_____________________________________________

Contact person's name & Telephone No.

_____________________________________________

Person responsible for report

Product Liability Claim Report Form - Instructions

Complete all items on the form. Indicate "NA" when an item is not applicable or not available. When an item calls for a dollar amount and no amount is involved enter -0- in the space after the dollar sign. Record all amounts in whole dollars only and all States by the two letter Post Office abbreviation.

All fields are self explanatory except as follows:

5. If CSP Code is not known, enter classification code shown on policy.

9. Enter the two digit code describing the degree of injury and/or property damage:

First digit

Second Digit

Bodily Injury

Property Damage

0 - No injury (or legal issue)

0 - No property damage

1 - Emotional only (fright)

1 - Little or no interruption

2 - Temporary (bruise, strain,

2 - Interrupted use

 sprain or fracture)

3 - Permanent (loss of motion,

3 - Total replacement

 disfigurement or

 amputation)

4 - Death

10. Enter appropriate code:

1 - Employee injured in the course of employment, regardless of employer

2 - Purchaser of product

3 - User or consumer (non-purchaser)

4 - Other - specify

12a. Enter reserves on a gross basis (before deductions for reinsurance) as of the end of the report period.

12b, 12c & 13b. If claim is opened and closed during the report period, enter amount paid.

13a. Enter reserves on a gross basis (before deductions for reinsurance) as of the end of the report period. If company does not set up a separate reserve for allocated expenses but includes such reserves with the indemnity reserve figure, check box.

Summary of Cancellations of Product Liability Insurance

Period ending________________

Insurer________________________NAIC Company Code___________________

Number of policies cancelled _________________

Reason for cancellation

Type of:

1

2

3

4

5

6

7

8

Total

A. Product *

 a. Air conditioning equipment

 b. Alcoholic beverages

 c. Automobiles, supplies or equipment

 d. Building materials

 e. Chemical

 f. Coal, wood or fuel (not gas or

  petroleum)

 g. Drugs

 h. Electrical

 i. Food or Food Products(excl.

 Alcohol)

 j. Gas or Petroleum

 k. Heating equipment

 l. Medical equipment or supplies

 m. Optical goods

 n. Plumbing

 o. Tools and machinery

 p. Others (attach separate sheet)

Total

B. Policies

 a. Product Liability

 b. CGL (incl. Product Liability)

 c. Comm'l Package(incl. Product

  Liability)

 d. Others(Incl. Product Liability)

Total

* If policy covers two or more products enter major product, except in those

cases where basis for cancellation is other than the major product.

Footnote

Each policy included in the summary is to be assigned only one of the

following major reasons for cancellation:

1. Poor loss experience of insured - Product Liability

2. Poor loss experience of insured - Coverage other than Product Liability

3. Poor safety engineering

4. Increase in hazard of product

5. Termination of producer

6. Non-payment of premium

7. Insured's request

8. All others

_____________________________________________

Contact person's name & Telephone No.

_____________________________________________

Person responsible for report

Summary of Nonrenewals of Product Liability Insurance

Period ending_______________

Insurer______________________NAIC Company Code_________________

Number of policies nonrenewed ______________

Reason for nonrenewal

Type of:

1

2

3

4

5

6

7

8

TOtal

A. Product *

 a. Air conditioning equipment

 b. Alcoholic beverages

 c. Automobiles, supplies or equipment

 d. Building materials

 e. Chemical

 f. Coal, wood or fuel (not gas or

  petroleum)

 g. Drugs

 h. Electrical

 i. Food or Food Products(excl.

  Alcohol)

 j. Gas or Petroleum

 k. Heating equipment

 l. Medical equipment or supplies

 m. Optical goods

 n. Plumbing

 o. Tools and machinery

 p. Others (attach separate sheet)

Total

* If policy covers two or more products enter major product, except in those

cases where basis for nonrenewal is other than the major product.