New York State Seal
STATE OF NEW YORK
INSURANCE DEPARTMENT
25 BEAVER STREET
NEW YORK, NEW YORK 10004

George E. Pataki
Governor

Gregory V. Serio
Superintendent

The Office of General Counsel issued the following opinion on May 7, 2004, representing the position of the New York State Insurance Department.

Re: Triggers for Compliance with Regulation 95

QUESTIONS PRESENTED

1. Does the phrase "automobile insurance", when used in New York Insurance Law § 409 (McKinney’s Supp. 2004) and 11 NYCRR § 86.6 (2002), Regulation 95, include insurance for motorcycles, all-terrain vehicles (both on and off road), and/or snowmobiles?

2. How does the Department determine if the number of insurance polices written by an insurer triggers compliance with 11 NYCRR § 86.6 (2002), Regulation 95?

CONCLUSIONS

1. The phrase "automobile insurance", when used in New York Insurance Law § 409 (McKinney’s Supp. 2004) and 11 NYCRR § Part 86.6 (2002), Regulation 95, does not include insurance for all terrain-vehicles (either on or off road), snowmobiles, or motorcycles.

2. The Department aggregates the total number of insurance polices written by an insurer to determine if compliance with 11 NYCRR § 86.6 (2002), Regulation 95 is required.

FACTS

No facts were provided.

ANALYSIS

New York Insurance Law § 409(a) (McKinney’s Supp. 2004) states in relevant part:

Every insurer writing private or commercial automobile insurance, workers’ compensation insurance, or individual, or group or blanket accident and health insurance policies issued for delivery in this state, except for insurers that write less than three thousand of such policies, issued or issued for delivery in this state annually… shall… file with the superintendent a plan for the detection, investigation and prevention of fraudulent insurance activities in this state and those fraudulent insurance activities affecting policies issued or issued for delivery in this state…

In accordance with New York Insurance Law § 409 (McKinney’s Supp. 2004), 11 NYCRR § 86.6 (2002), Regulation 95 states in relevant part:

(a) Every insurer writing private or commercial automobile insurance, workers’ compensation insurance or individual, group or blanket accident and health insurance policies issued or issued for delivery in this State, which writes 3,000 or more of such policies in any given year… shall develop and file with the superintendent a plan for the detection, investigation and prevention of fraudulent insurance activities in this State and those fraudulent insurance activities affecting policies issued or issued for delivery in this State.

The Department does not interpret the phrase "automobile insurance", as used in New York Insurance Law § 409(a) (McKinney’s Supp. 2004) and § 86.6 of Regulation 95, as including insurance for motorcycles, all-terrain vehicles (either on or off road), or snowmobiles.

When calculating the number of insurance policies written by an insurer, the Department aggregates all the types of insurance written by the insurer that are specified in § 86.6. That means that if an insurer writes 500 private1 automobile insurance policies; 500 commercial automobile insurance polices; 500 workers’ compensation insurance policies; and 1500 group or blanket accident and health insurance policies, such insurer would be subject to Regulation 95 because the aggregate of all the insurance policies specified in § 86.6 is 3,000.

For further information you may contact Senior Attorney Susan A. Dess at the New York City Office.


1 That is, non-commercial automobile insurance.