New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter IV - Financial Condition Of Insurer and Reports to Superintendent › Subchapter C - Fire, Marine, Casualty And Surety Insurers › Part 105 - Operating Expense Classification For Annual Statement Purposes › Section 105.2 - Claim adjustment services

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
				  Direct. Include the following expenses when in connection with the
				  investigation and adjustment of policy claims:
Independent adjusters: fees and expenses of independent
					 adjusters or settling agents.
Legal: fees and expenses of lawyers for legal services in
					 the defense, trial or appeal of suits, or for other legal services.
Bonds: premium costs of bonds.
Appeal costs and expenses: appeal bond premiums; charges
					 for printing records; charges for printing briefs; court fees incidental to
					 appeals.
General court costs and fees: entry fees and other court
					 costs, and other fees not includible in losses.
Note: Interest and costs assessed as part of or subsequent
					 to judgment are includible in losses.
Medical testimony: fees and expenses of medical witnesses
					 for attendance or testimony at trials or hearings.
(Medical includes physicians, surgeons, chiropractors,
					 chiropodists, dentists, osteopaths, veterinarians, and hospital
					 representatives.)
Expert witnesses: fees and expenses of expert witnesses for
					 attendance or testimony at trials or hearings.
Lay witnesses: fees and expenses of lay witnesses for
					 attendance or testimony at trials or hearings.
Service of process: constables' sheriffs' and other fees
					 and expenses for service of process, including subpoenas.
Transcripts of testimony: stenographers' fees and fees for
					 transcripts of testimony.
Medical examinations: fees for medical examinations, fees
					 for performing autopsies, fees for impartial examination, X-rays, etc., for the
					 purpose of trial and determining questions of liability. This does not include
					 fees for medical examinations, X-rays, etc., made to determine necessary
					 treatment, or made solely to determine the extent or continuation of
					 disability, or first aid charges, as such fees and charges are includible in
					 losses.
Miscellaneous: costs of appraisals, expert examinations,
					 surveys, plans, estimates, photographs, maps, weather reports, detective
					 reports, audits, credit or character reports, watchman. Charges for hospital
					 records and records of other kinds, notary fees, certified copies of
					 certificates and legal documents. Charges for claim adjustment services by
					 underwriting syndicates, pools and associations.
Exclude:
Compensation to employees (see salaries).
Expenses of salaried employees (see travel and travel
					 items) Items includible in allowances to managers and agents.
Payments to State industrial commissions (see taxes,
					 licenses and fees).
Payments to claim adjusting organizations except where the
					 expense is billed specifically to individual companies (see boards, bureaus and
					 associations).
Cost of services of medical examiners for underwriting
					 purposes
Salvage and subrogation recovery expense, rewards, lost and
					 found advertising, expenses for disposal of salvage. Such expenses shall be
					 deducted from salvage.
Any expenses which by these instructions are includible
					 elsewhere.
(b) Separation
				  of claim adjustment services. The statistical plans filed by certain rating
				  bureaus contain definitions of "allocated loss adjustment expenses" which
				  exclude for rating purposes certain types of claim adjustment services as
				  defined herein. For the lines of business thus affected, companies which are
				  members of such rating bureaus shall maintain records necessary to the
				  reporting of claim adjustment services--direct, as follows:
(1) as defined in statistical plans;
				  and
(2) other than as defined in
				  statistical plans.