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 216.7 - Standards for prompt, fair and equitable settlement of motor vehicle physical damage claims

Current through Register Vol. 46, No. 28, July 10, 2024
This section is applicable to claims arising under motor
				  vehicle collision and comprehensive coverages. The provisions of this Part
				  shall continue to be applicable to these claims, except to the extent that such
				  provisions are inconsistent with the specific provisions of this section. The
				  sections of this Part that do not apply at all to motor vehicle physical damage
				  claims are sections
				  216.2(b)-(d),
				  216.6(c),
				  (h), and
				  216.9 
				  of this Part.
(a) The following shall
				govern the construction of the terms used in this section:
(1) Agreed price shall mean the amount agreed
				to by the insurer and the insured, or their representatives, as the reasonable
				cost to repair damages to the motor vehicle resulting from the loss, without
				considering any deductible or other deductions.
(2) Designated representative (DR) shall mean
				an insured's broker of record or an insured's intended repair shop designated
				by the insured to represent the insured shop in negotiations with the insurer
				in an attempt to settle the claim. Such designated representative may legally
				act on the insured's behalf. If the designated representative is the insured's
				intended repair shop, such repair shop, if located within New York State, must
				be registered pursuant to the provisions of the Motor Vehicle Repair Shop
				Registration Act (article 12-A, Vehicle and Traffic Law), and may only
				represent the insured in negotiation of the amount necessary to repair the
				insured's damaged vehicle. The designation form must contain the repairer's
				registration number.
(3) Motor
				vehicle shall have the meaning ascribed in section 311  of the Vehicle and Traffic
				Law.
(4) Substantially similar
				vehicle shall mean a vehicle of the same make, model, year and condition,
				including all major options of the insured vehicle. Mileage must not exceed
				that of the insured vehicle by more than 4,000 miles or 10 percent of the
				mileage on the vehicle at the date of loss, whichever is greater.
(5) Business day shall mean a day other than
				Saturday, Sunday or a New York State legal holiday.
(6) Crash part means a part of a motor
				vehicle, which:
(i) is made of sheet metal,
				plastic, fiberglass or similar material, including a door, fender, panel,
				bumper, hood, floor or trunk lid, but not including windows or hubcaps;
				and
(ii) constitutes or provides
				support for the motor vehicle's exterior.
(7) Original equipment manufacturer or OEM
				means a motor vehicle manufacturer or distributor that produces or markets,
				under its own name, crash parts for use in motor vehicles that it manufactures
				or distributes under its own name.
(8) Nonoriginal equipment manufacturer or
				non-OEM means a manufacturer or distributor (including any entity supplying the
				required warranty other than a manufacturer), that produces or markets, under
				its own name, crash parts for use in motor vehicles that it does not
				manufacture or distribute.
(9)
				Waste material means material defined as a liquid toxic waste or liquid
				hazardous waste material under Federal or New York State environmental laws or
				regulations.
(10) Local market area
				shall mean a 100-mile radius, limited to within the United States, of the place
				of principal garagement of the insured's motor vehicle.