Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				211 CMR 88.00, the following
				words and phrases shall mean:
Accident
. An unexpected, unintended
				event arising out of the ownership, maintenance or use of a private passenger
				motor vehicle, that causes damage to the Operator's vehicle, another vehicle,
				or other property.
Administrative Review
. A review
				process pursuant to which the Board may resolve the merits of an Appeal without
				holding an Appeal Hearing.
Appeal
. A procedure by which an
				Involved Operator may obtain review of the Insurer's determination that he or
				she was more than 50% at fault for an Accident.
Appeal Form
. The form approved by the
				Board that an Insurer must send to an Operator with a Notice of At-fault
				Accident Determination that the Operator must complete and file with the Board
				to initiate an Appeal in accordance with
				211 CMR 88.00.
Appeal Hearing
. A hearing conducted by
				the Board.
Appeal Record
. The Insurer's Claim
				Record, Appeal Form, audio recordings of the Appeal Hearing, records, accident
				reports, citations, photographs or other documents submitted to the Board by
				either Party, motions, and rulings made in an Appeal.
Appellant
. An Involved Operator who
				files an Appeal in accordance with
				211 CMR 88.00.
At-fault Accident
. An Accident
				involving a Private Passenger Motor Vehicle in which its Operator is found to
				be more than 50% at fault.
At-fault Accident Determination
. An
				Insurer's determination pursuant to the Standards of Fault set forth in
				211 CMR 74.00:
Standards of Fault to Be Used by the Board of Appeal on Motor Vehicle
				Liability Policies and Bonds and Insurers in Presuming Fault When Making at
				Fault Determinations
that an Involved Operator was more than 50% at
				fault for an Accident.
Authorized Representative
. An
				individual authorized in writing by a Party to represent that Party in an
				Appeal.
Board
. The Board of Appeal on Motor
				Vehicle Liability Policies and Bonds established pursuant to M.G.L. c. 26,
				§ 8A.
Commissioner
. The Commissioner of
				Insurance appointed pursuant to M.G.L. c. 26, § 6.
Competitive Market
. A market in which
				Private Passenger Motor Vehicle insurance rates are not fixed and established
				pursuant to M.G.L. c. 175, § 113B but rather are determined pursuant to
				M.G.L. c. 175A and M.G.L. c. 175E.
Findings and Order
. The Board's
				written decision that vacates or upholds the Insurer's At-fault Accident
				Determination. The Findings and Order shall state the Board's reasons for its
				decision.
Fixed-and-established Market
. A market
				in which premiums for Private Passenger Motor Vehicle insurance are based on
				rates fixed-and-established by the Commissioner pursuant to M.G.L. c. 175,
				§ 113B.
Hearing Officer
. The Board's designee
				to review Appeals, conduct Appeal Hearings, and render Findings and
				Orders.
Insurer
. Any corporation, association,
				partnership, group or individual authorized to write motor vehicle insurance in
				the Commonwealth of Massachusetts.
Insurer's Claim Record
. Any and all
				documents including, but not limited to, accident reports, police reports,
				citations, photographs, witness statements or other materials upon which the
				Insurer based its At-fault Accident Determination.
Involved Operator
. The Operator of a
				Private Passenger Motor Vehicle who receives an Insurer's Notice of At-fault
				Accident Determination.
Merit Rating Board
. The Motor Vehicle
				Insurance Merit Rating Board established pursuant to M.G.L. c. 6C, §
				57A.
Merit Rating Plan
. A rating procedure
				Insurers use in a Competitive Market to adjust a prospective Private Passenger
				Motor Vehicle insurance premium based on the Operator's past motor vehicle
				insurance claims and traffic law violation experience.
Notice of At-fault Accident
				Determination
. A notice issued by an Insurer to an Involved
				Operator.
Operator
. A person who operates a
				private passenger motor vehicle in the Commonwealth.
Party
. The Insurer and the Appellant
				whose legal rights, duties or privileges are being determined in an
				Appeal.
Special Hazardous Driving Condition
. A
				general driving condition, including but not limited to a condition such as an
				ice storm, that the Board, in light of all the relevant facts, determines
				renders an Involved Operator less than 50% at fault for an Accident.
Standards of Fault
. The standards
				referred to in M.G.L. c. 175E, § 7A and M.G.L. c. 175, § 113P; which
				are contained in
				211
				CMR 74.04:
Standards of Fault:
				Circumstances in Which an Operator's Fault Is Presumed to Be More than
				50%
.
Statement in
Lieu
of a Personal
				Appearance
. A written statement submitted byan Appellant who
				chooses to waive appearing in person at an Appeal Hearing.
Surcharge
. An amount added to the
				Involved Operator's premium.