September 14, 1993

SUBJECT: INSURANCE

Circular Letter No. 11 (1993)

TO: ALL LICENSED PROPERTY/CASUALTY INSURERS & REINSURERS; ALL P/C INSURER, REINSURER & PRODUCER ORGANIZATIONS.

RE: GUIDELINES FOR HOMEOWNERS INSURANCE ALONG NEW YORK COASTAL AREAS AND SPECIAL REPORT PURSUANT TO SECTION 308 OF THE INSURANCE LAW

In the wake of recent natural disasters, all insurers should assess what might happen if a great hurricane ever strikes New York's coastal areas, particularly Long Island, in the future. Without denying that possibility, insurers need to appreciate not only New York's considerably lower hurricane risk relative to other areas, but, as recognized by the Federal Emergency Management Agency, the quality of construction and code enforcement that characterizes New York. Windstorm fears notwithstanding, it is vital that the insurance industry continue to provide proper protection for sound structures, including the many homes that make up New York's shore communities, especially Long Island.

This Circular Letter sets forth the Insurance Department's windstorm recommendations and guidelines, designed to enable homeowners insurers in New York to protect consumers as well as industry solvency. These guidelines have been developed in light of a wide range of Department communications and meetings with concerned public officials, consumers, producers and insurers, plus special Department surveys. For example, the Insurance Department participated in an August 25, 1993 community meeting at the Long Beach City Hall, where, on September 30, 1993, a public hearing by the New York State Assembly Insurance Committee and Long Island Barrier Beaches Subcommittee is scheduled to be held. Supplements to this Circular Letter may be issued to provide further guidance or refinements on this subject.

Our objectives are to maximize consumer protection, to encourage risk management, to emphasize responsible underwriting, and to facilitate voluntary insurance market coverage, through the following approaches to homeowners insurance for shore communities that insurers should apply and follow:

A. NO CANCELLATIONS -- No insurer, because Insurance Law § 3425 prohibits it, can cancel any homeowners insurance policy mid-term due to windstorm exposure, anywhere in New York, including Long Island.

B. 3-YR. GUARANTEE -- Every insurer must honor the 3-year. period of homeowners policyholder protection, guaranteed by Insurance Law § 3425, everywhere in New York, including Long Island.

C. LONG-TERM PROTECTION -- Virtually every insurer is renewing its Long Island homeowners policies now in force, even beyond the 3-year guaranteed period. Moreover, a homeowners policy should not be non-renewed due to a few minor claims in the past.

D. WINDSTORM DEDUCTIBLES -- Insurers can forthwith make windstorm deductible filings, which will receive expeditious review and approval if they meet Attachment I criteria.

E. WRAP-AROUND PROTECTION -- Where appropriate for a specific risk, fire and extended (including windstorm) coverage for dwelling and structures up to actual cash value (ACV) can be placed with NYPIUA, while covering any difference between replacement cost and ACV as well as liability, contents, theft, and vandalism and malicious mischief (V&MM) on a voluntary market basis, by using a special Windstorm Wrap-Around HO Endorsement, consistent with Attachment II criteria.

F. COASTAL MAP -- Special § 308 survey results reflected in Attachment III show that, even before facilitation through D, E or F and even within 1000 feet of shore, a significant number of insurers are actively writing new homeowners business for New York's shore communities, including Long Island, subject to their underwriting guidelines. However, consumers and producers may not know how, or might not be in a position, to identify or access these insurers.

Therefore, a Coastal Market Assistance Program (C-MAP) is created under Insurance Department auspices, to be administered with the assistance of the Professional Insurance Agents of New York (PIANY) and Independent Insurance Agents of New York (II ANY), to serve as a clearinghouse and referral mechanism, in order to assist homeowners living in shore communities and to match those seeking coverage with voluntary market homeowners insurers, in accordance with a C-MAP Plan of Operations now being designed.

In order to consider placements, subject to appropriate underwriting guidelines, insurers open to new business are asked to join C-MAP Consumers and producers seeking coverage for homes in shore communities can call the Insurance Department, using the following special C-MAP numbers:

In view of New York's strong insurance market and consumer safeguards embodied in A, B and C, most homeowners throughout Long Island should not encounter homeowners insurance problems.

Equally important, D, E and F should facilitate underwriting by insurers and effectively address those problems, principally with new business, that do arise for consumers.

Appropriate policy form filings should be submitted as soon as possible. In addition, homeowners insurers can and should insist (and then assist) that a consumer whose home is situated in a flood plain carry federal flood insurance, whenever mandated by federal law or required by the mortgage lender.

Given the competitive and resilient nature of New York's homeowners insurance market, aided by these facilitating approaches, almost every insurer should be able to underwrite new applicants seeking to buy and thus insure homes situated close to shore and, second, those homeowners previously insured with the relatively few insurers confronting capacity constraints and over-concentration of Long Island business.

As a result, we expect that insurers will be able not only to retain business already in force, but to write new business, even on homes within 1000 feet of shore, in New York. Indeed, with the ability of insurers to utilize the above approaches, any insurer that fails in material respects to do so will be subject to investigation for possible unfair trade practices and appropriate sanctions under the Insurance Law.

Pursuant to § 308 of the Insurance Law, the chief underwriting officer of each licensed insurer is hereby directed to:

(a) describe in detail the extent to which, and manner in which, the insurer adheres to, or departs from, each of A through E, since 1/1/93 to 9/14/93, and then how it plans to do so from this point forward;

(b) indicate, in connection with F, whether it will participate in the Coastal MAP, if so, designating a C-MAP contact for the insurer and, if not, explaining the reasons for declining to participate;

(c) identify with particularity the ways in which insurer management communicates its underwriting and marketing intentions about homeowners insurance in New York's shore communities, using each of the above approaches, to its relevant personnel, sales offices or agents, and to the public, attaching copies of these communiques; and

(d) specify telephone numbers and addresses of the insurer's sales offices or agents that consumers seeking coverage for homes in New York's shore communities (for each of the areas specified in Attachment A) can use to access the insurer for coverage.

This § 308 Report must be received by Insurance Examiner John Owens (T:212-602-0371 & F:212-602-8825), in the Property & Casualty Insurance Bureau, at the above address, no later than Thursday, September 23, 1993.

Failure to respond fully and in a timely manner to this § 308 required report, or to the preceding August 9, 1993 § 308 required report, will subject the insurer and its representative to penalties under the Insurance Law.

On September 23, 1993, the Insurance Department will hold a follow-up industry session, for the purposes of further discussing relevant issues and determining industry progress and performance. Representatives of concerned insurers, reinsurers and producers are invited to attend this September 23rd session, to commence at 10 A.M. in the 22nd Floor Hearing Room, at our New York City offices.

Insurers are urged, in the best interests of both the public and the insurance industry, to do everything they can to maximize homeowners insurance policy writings in the voluntary market for homeowners who live in New York's shore communities, including Long Island.

Time is of the essence, and immediate action is imperative. If insurers do not take advantage of the opportunity to respond voluntarily, it can be anticipated that the Insurance Department will recommend measures to the Governor and Legislature to insist, by whatever means necessary, that the insurance industry act responsibly.

Very truly yours,

[SIGNATURE]

SALVATORE R. CURIALE

SUPERINTENDENT OF INSURANCE

 

ATTACHMENTS I, II & III

NEW YORK STATE INSURANCE DEPARTMENT GUIDELINES FOR WINDSTORM DEDUCTIBLES

Windstorm deductibles represent a partnership between insurer and insured, protecting the policyholder from catastrophic loss while creating incentives for the policyholder to apply risk management measures to mitigate the windstorm peril. Subject to review and prior approval of specific applications, the Insurance Department will expeditiously approve for use, in specified areas only, windstorm deductibles meeting the following criteria:

1. The risk must be located in one of the following counties: Kings, Queens, Nassau and Suffolk (Long Island), Richmond County (Staten Island), Westchester, and the Bronx.

2. The insurer must commit to underwrite homeowners insurance policies (and, where appropriate, dwelling fire) for new and renewal business on a voluntary market basis.

3. An approved windstorm deductible can be applied, on a per incident basis, to homeowners insurance policies newly issued or upon renewal after the three-year period of policyholder protection required by § 3425 of the New York Insurance Law, as follows:

a. A non-catastrophic windstorm deductible (see Point 4) applied whenever winds do not attain Force 2 (sustained winds of 96 miles per hour or more) status, as determined by the National Weather Service (NWS), at landfall anywhere in New York State.

b. A catastrophic windstorm deductible (see Point 5) activated only in the event that Force 2 status, or higher, as determined by NWS, is experienced at landfall anywhere in New York State.

4. For non-catastrophic situations, involving any distance from shore in the specified areas, insurers may require a windstorm deductible of no more than $ 500 on a mandatory basis, with an accompanying premium reduction of up to 3% and, on a purely optional basis, may offer a windstorm deductible of no more than $ 1,000, with an accompanying premium reduction of up to 5%.

5. The catastrophic windstorm deductible should be graduated on a percentage basis, so that it is highest nearest the shore, fades with distance from shore, and disappears beyond a mile from shore. The maximum catastrophic windstorm deductible that an insurer can require on a mandatory basis is:

a. For Long Island's South Shore and areas along the shore of Brooklyn, Queens, Staten Island, and Long Island's Forks:

b. For Long Island's North Shore, the Bronx and Westchester along the Long Island Sound:

c. Beyond one mile from shore, a maximum dollar deductible, not to exceed $ 500, with an accompanying premium reduction of up to 1%, may be required on a mandatory basis.

d. The term "shore" refers only to salt-water ocean, sound or bay, with distance measured from normal high-tide mark. A data base technology to determine distance from shore is available via the Geographic Underwriting System (GUS), developed by the Insurance Services Office (ISO).

e. Windstorm deductibles should not be imposed indiscriminately or across-the-board. An insurer need not impose any windstorm deductible at all, or may require a windstorm deductible lower than these maxima.

f. Insurers may also offer homeowners policyholders, whether living within or beyond 1 mile from shore, an optional catastrophic windstorm deductible of no more than 5%, with an accompanying premium reduction of up to 10%, where the choice is entirely the policyholder's.

g. If selected by the policyholder, an optional windstorm deductible can attach upon annual renewal (rather than only after the 3-year guaranteed policyholder protection period).

h. For homes whose replacement cost value is at least $ 500,000, insurers may offer, on an optional basis, higher windstorm deductibles not to exceed- 10% of that replacement cost value, with an accompanying premium reduction of no more than 15%.

6. The non-catastrophic and catastrophic windstorm deductible premium reductions are added, with the summed reduction percentage applied to the total homeowners insurance policy premium.

7. No windstorm deductible of any kind or level will be permitted at this time elsewhere in New York State, even on an optional basis, outside of the areas specified above.

8. Buy-back of a windstorm deductible will not be required, except where the insured, at his or her expense, can demonstrate that the insured home is built or reinforced with special risk management measures, such as wind-resistant architectural or construction techniques. In that event, the insured should have the opportunity to buy back all or at least part of the windstorm deductible.

9. The basis for application of the percentage windstorm deductible is the dwelling's insured value (replacement cost or actual cash value, depending on type of policy) at the beginning of the policy period covering the loss.

10. All losses (coverages A+B+C) caused by the windstorm peril should be counted in determining whether the windstorm deductible has been reached.

11. Loss adjustment costs should be borne by the insurer, even if the loss does not exceed the windstorm deductible.

12. The windstorm deductible does not apply to loss-of-use coverage (D).

13. The insurer remains responsible for all expenses of underwriting normally performed by insurers. Thus inspection and engineering costs that the insurer normally incurs to underwrite a homeowners risk (e.g., type of construction, occupancy, protection and exposure) should continue to be borne by the insurer.

14. Upon filing for approval of a windstorm deductible, the insurer should submit supporting documentation regarding the level and location, by ZIP Code and with maps, of its past and present books of business within the affected areas.

15. In the event of loss due to windstorm, the windstorm deductible is not to be combined with any other deductible to which the homeowners insurance policy is subject. In the rare instance where the general deductible exceeds the windstorm deductible, the general deductible would be applied before the insurer would cover the loss.

16. Insurers should submit for approval disclosure forms, clearly and conspicuously describing and explaining what is and is not covered by the particular homeowners policy in terms of windstorm and flood perils, including the steps the policyholder can take to secure protection for these perils to the extent not covered by the policy.

17. No hail deductible will be approved at this time.

18. An insurer may, with sufficient support, submit for Insurance Department consideration a windstorm deductible filing that differs from the articulated criteria.

Proximity to shore and type of construction may combine to make a particular property, after considered underwriting, truly a residual risk in regard to windstorm peril. Thus, even were windstorm deductibles to be applied, a comprehensive homeowners insurance policy would be inappropriate for such a risk. Under these circumstances, insurers and producers should assist the homeowner in obtaining modified homeowners coverage issued on a voluntary market basis wrapped around New York Property Insurance Underwriting Association (NYPIUA) or FAIR Plan coverage, using the special Windstorm Wrap-Around HO Endorsement, annexed to this Attachment II as an Exhibit and approved for use effective immediately, subject to the following criteria:

1. Any kind of HO policy (as selected by the policyholder) can be so endorsed, thereby eliminating coverage gaps as well as redundancies, with liability, contents, theft, and V&MM, as any difference between replacement cost and ACV covered on a voluntary market basis, while fire and extended (including windstorm) coverage on the dwelling and structures, to the extent of ACV, are provided through the FAIR Plan.

2. This special endorsement in conjunction with FAIR Plan coverage can be used only in the specified areas (see Attachment I), and should be applied only to a truly residual risk situated within 2500 feet of shore.

3. If this special endorsement is used in conjunction with FAIR Plan coverage, then, no windstorm deductible can attach to the HO policy.

4. As a result of this special endorsement, the appropriate HO premium discount is 65%, subject to the insurer's approved minimum premium rules.

5. Appropriate disclosure and explanation should be provided to the insured, including specific risk management and loss control measures (such as renovations- conforming to post-FIRM [FEMA Flood Insurance Rate Map] standards) that the insured could apply in order to become able to obtain a comprehensive homeowners insurance policy, without the need for FAIR Plan coverage, on a voluntary market basis.

6. The insurer should inform its underwriters, sales offices or agents that this partnership approach between the voluntary and residual markets should be used, if practicable, in lieu of non-renewing or denying coverage to a risk.

7. The FAIR Plan will revise its policy application to advise consumers of the availability of a Windstorm Wrap-Around HO Endorsement from a voluntary market homeowners insurer.

8. Even though this special endorsement has been approved for use, insurers should make a policy form filing as soon as possible; any variations from this endorsement require prior approval.

WINDSTORM WRAP-AROUND HO ENDORSEMENT

Coverage for Dwelling and Additional Structures will be provided by the New York Property Insurance Underwriting Association (NYPIUA) or FAIR Plan under its DP-1 Policy with Extended Coverage Endorsement up to Actual Cash Value (ACV), and this Homeowners Policy will apply in excess of ACV, up to the Replacement Cost or Homeowners Policy limit. In consideration of a premium reduction and in view of the FAIR Plan coverage which must be maintained in force, we do not cover direct loss up to ACV to property, whether described in Coverage A -- Dwelling or Coverage B -- Other Structures, if caused by the following perils as defined by the DP-1 Policy: 1A. Fire or Lightning; 1B. Internal Explosion; 2. Windstorm or Hail; 3. Explosion; 4. Riot or Civil Commotion; 5. Aircraft; 6. Vehicles; 7. Smoke; or 8. Volcanic Eruption.

The "Other Insurance" Condition of the Homeowners Policy is amended by adding the following:

1. If a loss is not covered under the DP-1 Policy with Extended Coverage Endorsement, coverage will be provided under this Homeowners Policy in accordance with the Homeowners Policy conditions.

2. If a loss is covered under the DP-1 Policy with Extended Coverage Endorsement and is also covered under the Homeowners Policy, and the loss is more than ACV under the DP-1 Policy with Extended Coverage Endorsement, then the Homeowners Policy will be excess over the DP-1 Policy with Extended Coverage Endorsement in accordance with the Homeowners Policy conditions.

The following Conditions are added to the Homeowners Policy:

1. Any ambiguity in the language of the DP-1 Policy with Extended Coverage Endorsement as to which policy will provide coverage is resolved by this Homeowners Policy providing the disputed coverage.

2. If you fail to maintain the DP-1 Policy with Extended Coverage Endorsement, this Homeowners Policy is still valid. However, we will pay only the amount we would have paid if you had maintained the DP-1 Policy with Extended Coverage Endorsement.

3. In the event of a loss, the insured must notify both NYPIUA and us.

4. All applicable deductibles apply in accordance with their terms.

5. If there is a loss in excess of ACV and ACV cannot be agreed upon or determined, either NYPIUA or we may demand an appraisal, of the loss to determine the amount of loss, ACV and replacement cost.

All other provisions of the Homeowners Policy apply.

(distance from shore in feet)

(subject to the insurer's underwriting guidelines)

HOMEOWNERS INSURERS WRITING NEW BUSINESS FOR LONG ISLAND HOMES