The Office of General Counsel issued the following informal opinion on November 26, 2001, representing the position of the New York State Insurance Department.

Re: Accident and health insurance agent and certificate of appointment

Questions Presented:

1. What, if any, differences would there be in the kind of health insurance sold by an accident and health insurance agent licensed under N.Y. Ins. Law § 2103(a) (McKinney 2000) and by a property/casualty insurance agent licensed under N.Y. Ins. Law § 2103(b) (McKinney 2000)?

2. Does the Insurance Department require an insurer to indicate on its certificates of appointment whether an agent is an independent insurance agent within the meaning of N.Y. Law § 2101(b) (McKinney 2000), or has an exclusive agency with the insurer?

Conclusions:

1. The accident and health insurance agent is licensed under N.Y. Ins. Law § 2103(a) (McKinney 2000) to sell health insurance and may represent only a life or accident and health insurer. A property/casualty insurance agent is licensed under N.Y. Ins. Law § 2103(b) (McKinney 2000) and may represent only a property/casualty insurer. Such agent may only sell health insurance if certain conditions as described below are met. However, the types of health insurance that may be sold does not vary by type of insurer.

2. No. N.Y. Ins. Law § 2112(a) (McKinney 2000) requires insurers to file with the Department a certificate of appointment naming the licensed insurance agent who will represent the insurer to the buying public. The Department does not require the insurer or the agent to indicate whether an appointed agent is independent or has an exclusive agency.

Facts:

No specific fact pattern was presented.

Analysis:

Accident and health insurance agents sell the same type of health insurance as properly credentialed property/casualty insurance agents. To sell health insurance, property/casualty insurance agents must apply for and pass the accident and health insurance examination as indicated under N.Y. Comp. Codes R. & Regs. tit. 11, § 22.2(b) (1995) and § 23.4 (1996) (Regulations 6 and 7, respectively). Since a property/casualty insurance agent may not be an agent for a life or accident and health insurance company, such agent must have an agency relationship with a property/casualty insurer that is also licensed to issue health insurance policies and that wishes the property/casualty insurance agent to sell its health insurance products.

Although the term "independent insurance agent" is defined in N.Y. Ins. § 2101(b) (McKinney 2000), the Department’s licensing procedures do not require that an insurer distinguish or categorize the nature of the appointed agent’s relationship with it as independent or exclusive. Moreover, an "independent insurance agent" is not treated any differently under the Insurance Law.

For further information, you may contact Associate Attorney Jeffrey A. Stonehill at the New York City Office.