September 26, 1979
SUBJECT: INSURANCE
Circular Letter No. 26 (1979)
(Addendum to Circular Letters 21 and 22 (1979))
WITHDRAWN
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
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Reason for nonrenewal |
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1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Total |
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B. Policies |
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a. Product Liability |
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b. CGL (incl. Product Liability) |
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c. Comm'l Package(incl. Product |
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Liability) |
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d. Others(Incl. Product Liability) |
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Total |
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Footnote |
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Each policy included in the summary is to be assigned only one of |
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the following major reasons for nonrenewal: |
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1. Poor loss experience of insured - Product Liability |
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2. Poor loss experience of insured - Coverage other than |
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Product Liability |
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3. Poor safety engineering |
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4. Increase in hazard of product |
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5. Termination of producer |
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6. Non-payment of premium |
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7. Insured's request |
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8. All others |
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_____________________________________________
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:
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First digit |
Second Digit |
|---|---|
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Bodily Injury |
Property Damage |
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0 - No injury (or legal issue) |
0 - No property damage |
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1 - Emotional only (fright) |
1 - Little or no interruption |
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2 - Temporary (bruise, strain, |
2 - Interrupted use |
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sprain or fracture) |
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3 - Permanent (loss of motion, |
3 - Total replacement |
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disfigurement or |
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amputation) |
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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 _________________
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Reason for cancellation |
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Type of: |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Total |
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A. Product * |
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a. Air conditioning equipment |
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b. Alcoholic beverages |
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c. Automobiles, supplies or equipment |
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d. Building materials |
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e. Chemical |
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f. Coal, wood or fuel (not gas or |
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petroleum) |
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g. Drugs |
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h. Electrical |
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i. Food or Food Products(excl. |
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Alcohol) |
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j. Gas or Petroleum |
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k. Heating equipment |
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l. Medical equipment or supplies |
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m. Optical goods |
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n. Plumbing |
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o. Tools and machinery |
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p. Others (attach separate sheet) |
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Total |
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B. Policies |
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a. Product Liability |
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b. CGL (incl. Product Liability) |
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c. Comm'l Package(incl. Product |
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Liability) |
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d. Others(Incl. Product Liability) |
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Total |
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* If policy covers two or more products enter major product, except in those |
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cases where basis for cancellation is other than the major product. |
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Footnote |
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Each policy included in the summary is to be assigned only one of the |
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following major reasons for cancellation: |
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1. Poor loss experience of insured - Product Liability |
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|
2. Poor loss experience of insured - Coverage other than Product Liability |
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|
3. Poor safety engineering |
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4. Increase in hazard of product |
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5. Termination of producer |
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6. Non-payment of premium |
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7. Insured's request |
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8. All others |
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_____________________________________________
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 |
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Type of: |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Total |
|
A. Product * |
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a. Air conditioning equipment |
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b. Alcoholic beverages |
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c. Automobiles, supplies or equipment |
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d. Building materials |
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e. Chemical |
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f. Coal, wood or fuel (not gas or |
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petroleum) |
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g. Drugs |
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h. Electrical |
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i. Food or Food Products(excl. |
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Alcohol) |
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j. Gas or Petroleum |
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k. Heating equipment |
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l. Medical equipment or supplies |
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m. Optical goods |
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n. Plumbing |
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o. Tools and machinery |
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p. Others (attach separate sheet) |
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Total |
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* If policy covers two or more products enter major product, except in those |
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cases where basis for nonrenewal is other than the major product. |
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