New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter XI - Prepaid Legal Services Plans And Legal Services Insurance › Part 261 - Prepaid Legal Services Plans › Section 261.1 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
For purposes of this Part, the following definitions shall
				  apply:
(a) Access plan means an
				arrangement for the providing of legal services on a prepaid fee basis, where
				such services are not dependent upon the happening of a fortuitous event in
				which the recipient of the services has, or is expected to have at the time of
				such happening, a material interest which will be adversely affected by the
				happening of such event; except that an access plan may agree to provide such
				services in the event a separate fee for each such service is charged, and the
				fee for the service fully covers the cost of rendition, including reasonable
				overhead.
(b) Attorney retainer
				agreement means an agreement by an individual, corporation, or other business
				entity to pay in advance a fee to an attorney, admitted to practice in the
				jurisdiction where the services are to be rendered, in order to retain or
				secure the right of access to the services of an attorney and for such services
				as may be provided in the future and disbursements related thereto, provided
				there is a provision for an accounting of the value of such retainer and any
				services provided.
(c) Certificate
				means any evidence of insurance coverage, or rider or endorsement thereto,
				issued to a group member under a group policy.
(d) Family member means a person, related to
				the insured by blood, marriage, adoption, dependency or operation of law, who
				resides in the same household (including a ward or foster child) or who is a
				dependent child away at school.
(e)
				Fortuitous event has the meaning ascribed in section 1101 (a)(2)  of the
				Insurance Law.
(f) Group member
				means a person or entity to whom a policy or certificate has been issued in
				connection with a group policy.
(g)
				Group master policy means a group policy issued to a group master policyholder
				and under which certificates are issued to group members, but does not include
				such certificates.
(h) Group master
				policyholder means the person or entity to whom a group master policy is
				issued.
(i) Insured means the
				person or entity covered under an individual policy, a group member under a
				group policy, or a family member, if family coverage is provided under the
				policy or certificate.
(j) Issue
				includes issue for delivery.
(k)
				Mass merchandising plan means a method of marketing individually issued
				policies to persons through an employer, association, organization, or other
				entity, with reasonably anticipated economies of acquisition or
				administration.
(l) Policy means a
				contract issued in connection with a prepaid legal services plan, including
				legal services insurance issued pursuant to such a plan.
(m) Prepaid legal services plan means an
				access plan as defined in subdivision (a) of this section, provided by an
				authorized insurer, and may also include legal services insurance.