OGC Opinion No. 07-04-11

The Office of General Counsel issued the following opinion on April 13, 2007, representing the position of the New York State Insurance Department.

RE: Insurance Fraud Litigation in the New York Court of Claims

This inquiry raises questions regarding insurance fraud litigation currently pending in the New York Court of Claims. The inquirer reports that he is a claims handler for ABC, Inc., and that he is currently handling a claim that is to proceed to trial in May 2007. He further states, inter alia, that the insured claimant alleges that he cannot return to work because of physical and mental injuries, but that the inquirer’s investigation demonstrates otherwise. The inquirer seeks guidance from the Insurance Department about how to bolster the proof in his company’s case.

The Department is an administrative agency charged with the administration and enforcement of the Insurance Law. It is the Department’s general policy not to render legal opinions on matters that are the subject of litigation. Accordingly, this office must refrain from addressing the merits of the inquiry at this time. However, for further information, the inquirer may wish to consult N.Y. Ins. Law Art. 4 (McKinney 2006 and Supp. 2007), N.Y. Comp. Codes R. & Regs. tit. 11, Part 86 (2003) (Regulation 95), and Circular Letter No. 1 (2007), all of which may be referenced at the Department’s website at http://www.ins.state.ny.us.

For further information you may contact Associate Attorney Pascale Jean-Baptiste at the New York City Office.