New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter IX - Unfair Trade Practices › Part 216 - Unfair Claims Settlement Practices And Claim Cost Control Measures › Section 216.8 - Verification and reporting requirements applicable to losses arising under automobile physical damage policies and reporting of third-party property damage losses

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
Preamble.
The purpose of this section is to implement the provisions of
				  section 3412  of the Insurance Law, which provides
				  for measures to be applied by insurers and a central organization engaged in
				  loss prevention in order to prevent payment of fraudulent claims arising under
				  automobile physical damage policies. Such measures shall include: reporting of
				  data on private passenger automobiles involved in total losses to a central
				  organization engaged in loss prevention, as designated by the superintendent;
				  verification procedures to be applied by insurers prior to the payment of total
				  theft losses; restrictions on the insured's retention of salvage; restrictions
				  and procedures for insurer's disposition of salvage; the insurer's right to
				  retrieve located stolen or abandoned vehicles; and notification by insurers to
				  law enforcement agencies, when the insurer or the central organization suspects
				  improper or fraudulent action on the part of the insured, or others involved in
				  the loss settlement process.
(b)
Applicability.
This section shall apply to all losses involving private
				  passenger automobiles of the current model year and the preceding six model
				  years and older private passenger automobiles with an actual cash value of
				  $5,000 or more, prior to the loss. A
private passenger
				  automobile
shall mean a four-wheel private passenger vehicle, station
				  wagon, van, jeep-type vehicle, sport utility vehicle or pickup
				  truck.
(c)
Central
				organization.
The central organization shall be designated by the
				  superintendent. For purposes of this Part,
central
				  organization
shall also include any entity that is acceptable to the
				  superintendent with which the central organization contracts to assist in
				  executing its responsibilities pursuant to this Part. All insurers licensed to
				  write automobile physical damage insurance in this State are hereby required to
				  become members of the central organization, for the purpose of compliance with
				  this section.
(d)
Reporting and follow-up requirements.
Insurers shall report all private passenger automobiles
				  involved in losses to the central organization, as follows:
(1) All total theft losses shall be reported
				immediately, but no more than two business days following notice of claim, as
				defined in section
				216.1(d) 
				of this Part. If the insurer has not received any acknowledgment or
				communication from the central organization within 10 calendar days following
				its submission of the total theft report to the central organization, the
				insurer shall immediately communicate with the central organization to
				determine the status of its report.
(2) All other first and third-party losses,
				however sustained, where damage to the claimant's vehicle exceeds $2,500 shall
				be reported to the central organization no later than five calendar days after
				the sale of salvage or, if the insured or claimant is permitted to retain the
				vehicle, no later than five calendar days after the date of loss
				payment.
(3) The central
				organization shall be responsible for recording any special vehicle
				identification number (VIN) issued by the Commissioner of Motor Vehicles, which
				data will be forwarded to the central organization pursuant to section 431 (2)  of the Vehicle and
				Traffic Law.