2006 New York Code - Definitions.



 
    § 2101. Definitions.  (a) In this article, "insurance agent" means any
  authorized  or  acknowledged  agent  of  an  insurer,  fraternal benefit
  society or health  maintenance  organization  issued  a  certificate  of
  authority  pursuant  to article forty-four of the public health law, and
  any sub-agent or other representative of such an agent, who acts as such
  in the solicitation of, negotiation  for,  or  sale  of,  an  insurance,
  health  maintenance  organization  or  annuity contract, other than as a
  licensed insurance broker, except that such term shall not include:
    (1) any regular salaried officer or employee of  a  licensed  insurer,
  fraternal  benefit  society  or  health maintenance organization or of a
  licensed insurance agent, who  does  not  solicit  or  accept  from  the
  public,  outside  of  an  office  of  such  insurer,  health maintenance
  organization or agent, applications or orders for any such contract,  if
  such  officer  or  employee  does  not  receive  a  commission  or other
  compensation for his services which commission or other compensation  is
  directly dependent upon the amount of business done;
    (2)  employees  of  insurers,  fraternal  benefit  societies or health
  maintenance  organizations  or  organizations  employed   by   insurers,
  fraternal  benefit societies or health maintenance organizations who are
  engaging in the inspection, rating or classification of risks, or in the
  supervision of the training of licensed insurance producers and who  are
  not  individually  engaged  in  the sale, solicitation or negotiation of
  insurance;
    (3) any agent or representative of a fraternal benefit society,  other
  than  agents  representing  societies  governed by section four thousand
  five hundred twenty-seven of this chapter, who devotes,  or  intends  to
  devote, less than fifty percent of the person's time to the solicitation
  and  negotiation  or  sale  of insurance contracts for fraternal benefit
  societies and who receives or intends to receive any commission or other
  compensation directly dependent on the  amount  of  insurance,  provided
  that  any  person  who  in  the  preceding  calendar year has solicited,
  negotiated or sold any of the following contracts of insurance on behalf
  of a fraternal benefit society is presumed to have devoted, or  intended
  to  devote,  fifty  percent  of  the  person's time to the solicitation,
  negotiation and sale of insurance contracts;
    (A) life insurance  contracts  that,  in  the  aggregate,  exceed  two
  hundred  thousand  dollars  of  coverage  for  all lives insured for the
  preceding calendar year;
    (B) a  permanent  life  insurance  contract  offering  more  than  ten
  thousand dollars of coverage on an individual life;
    (C)  a  term life insurance contract offering more than fifty thousand
  dollars of coverage on an individual life;
    (D) any insurance contracts other than life that the fraternal benefit
  society may  write  that  insure  the  individual  lives  of  more  than
  twenty-five persons;
    (E) any variable life insurance or variable annuity contract;
    (4) any agent or other representative of any title insurance company;
    (5)  any  service  contract  provider  or  any administrator or person
  designated by a service contract provider who  in  this  state  markets,
  sells,  offers  for  sale, issues, makes, proposes to make or administer
  service contracts pursuant to article seventy-nine of this chapter;
    (6) a person who secures and furnishes information for the purpose  of
  group   life   insurance,   group   property/casualty  insurance,  group
  annuities, group or blanket accident and health insurance;  or  for  the
  purpose of enrolling individuals under plans, issuing certificates under
  plans  or  otherwise  assisting  in  administering  plans; or performing
  administrative  services  related  to  mass  marketed  property/casualty
  insurance,  provided  that  no  commission is paid to the person for the
  service;
    (7)  an employer or association or its officers, directors, employees,
  or the trustees of an employee  trust  plan,  to  the  extent  that  the
  employers, officers, employees, directors or trustees are engaged in the
  administration  or  operation  of a program of employee benefits for the
  employer's or association's  own  employees  or  the  employees  of  its
  subsidiaries  or affiliates, which program involves the use of insurance
  issued by an insurer, fraternal benefit society  or  health  maintenance
  organization,   as   long  as  the  employers,  associations,  officers,
  directors, employees or trustees are  not  in  any  manner  compensated,
  directly or indirectly, by the company issuing the contracts;
    (8) a person whose activities in this state are limited to advertising
  without   the   intent  to  solicit  insurance  in  this  state  through
  communications in printed publications or other forms of electronic mass
  media whose distribution is not  limited  to  residents  of  the  state,
  provided  that  the person does not sell, solicit or negotiate insurance
  that would insure risks residing, located or to  be  performed  in  this
  state;
    (9)  a  person who is not a resident of this state who sells, solicits
  or negotiates a contract of insurance for  commercial  property/casualty
  risks  to  an  insured with risks located in more than one state insured
  under that contract, provided that such person is otherwise licensed  as
  an  insurance  producer  to sell, solicit or negotiate that insurance in
  the state where the insured maintains its principal  place  of  business
  and the contract of insurance insures risks located in that state; or
    (10)  any  salaried  full-time employee who counsels or advises his or
  her employer relative to the insurance interests of the employer  or  of
  the  subsidiaries  or  business affiliates of the employer provided that
  the employee does not sell or solicit insurance or receive a commission.
    (b) In this article, "independent insurance agent" means an "insurance
  agent" who is not owned or controlled by any insurer, fraternal  benefit
  society or health maintenance organization or group of such insurers and
  whose  agency  agreement  does  not prohibit the representation of other
  insurers or groups of insurers and which provides that upon  termination
  of  the agreement the agent's records and use and control of expirations
  remain the property of the agent. Only an "independent insurance  agent"
  shall  be represented to the public as an independent insurance agent or
  agency.
    (c) In this  article,  "insurance  broker"  means  any  person,  firm,
  association or corporation who or which for any compensation, commission
  or  other  thing  of  value  acts  or  aids in any manner in soliciting,
  negotiating or selling, any insurance or annuity contract or in  placing
  risks  or  taking  out  insurance,  on  behalf  of an insured other than
  himself, herself or itself  or  on  behalf  of  any  licensed  insurance
  broker, except that such term shall not include:
    (1) any salaried full-time employee who counsels or advises his or her
  employer  relative  to the insurance interests of the employer or of the
  subsidiaries or business affiliates of the employer  provided  that  the
  employee does not sell or solicit insurance or receive a commission;
    (2) an officer, director or employee of a licensed insurance producer,
  provided  that  the  officer,  director or employee does not receive any
  commission on policies written or sold to insure risks residing, located
  or to be performed in this state and:
    (A) the officer, director  or  employee's  activities  are  executive,
  administrative,  managerial, clerical or a combination of these, and are
  only indirectly related to the  sale,  solicitation  or  negotiation  of
  insurance; or
    (B)   the   officer,   director  or  employee's  function  relates  to
  underwriting, loss control, inspection  or  the  processing,  adjusting,
  investigating or settling of a claim on a contract of insurance; or
    (C)  the  officer, director or employee is acting in the capacity of a
  special  agent  or  agency  supervisor  assisting   licensed   insurance
  producers  where  the  person's  activities  are  limited  to  providing
  technical advice and assistance to licensed insurance producers  and  do
  not include the sale, solicitation or negotiation of insurance;
    (3) any foreign freight forwarder registered with the federal maritime
  commission  or  any  custom  house  broker licensed by the United States
  treasury department, when such forwarder or broker negotiates, issues or
  delivers a certificate or other evidence  of  a  contract  of  insurance
  under  an  open  marine  policy  naming  the  forwarder or broker as the
  insured and covering exports or imports serviced by  such  forwarder  or
  broker on behalf of others, provided that such forwarder or broker takes
  or  receives no money or other thing of value when acting as hereinafter
  specified, from  any  insurer  or  representative  thereof,  unless  the
  receipt of money or thing of value is authorized under this chapter;
    (4)  any  service  contract  provider  or  any administrator or person
  designated by a service contract provider who  in  this  state  markets,
  sells,  offers  for sale, issues, makes, proposes to make or administers
  service contracts pursuant to article seventy-nine of this chapter;
    (5) a person who secures and furnishes information for the purpose  of
  group   life   insurance,   group   property/casualty  insurance,  group
  annuities, group or blanket accident and health insurance;  or  for  the
  purpose of enrolling individuals under plans, issuing certificates under
  plans  or  otherwise  assisting  in  administering  plans;  or  performs
  administrative  services  related  to  mass  marketed  property/casualty
  insurance, where no commission is paid to the person for the service;
    (6)  an employer or association or its officers, directors, employees,
  or the trustees of an employee  trust  plan,  to  the  extent  that  the
  employers,  officers, employees, director or trustees are engaged in the
  administration or operation of a program of employee  benefits  for  the
  employer's  or  association's  own  employees  or  the  employees of its
  subsidiaries or affiliates, which program involves the use of  insurance
  issued  by  an  insurer, fraternal benefit society or health maintenance
  organization,  as  long  as  the  employers,   associations,   officers,
  directors,  employees  or  trustees  are  not in any manner compensated,
  directly or indirectly, by the company issuing the contracts;
    (7) a person whose activities in this state are limited to advertising
  without  the  intent  to  solicit  insurance  in  this   state   through
  communications in printed publications or other forms of electronic mass
  media  whose  distribution  is  not  limited  to residents of the state,
  provided that the person does not sell, solicit or  negotiate  insurance
  that  would  insure  risks  residing, located or to be performed in this
  state; or
    (8) a person who is not a resident of this state who  sells,  solicits
  or  negotiates  a  contract for commercial property/casualty risks to an
  insured with risks located in more than one  state  insured  under  that
  contract,  provided  that  such  person  is  otherwise  licensed  as  an
  insurance producer to sell, solicit or negotiate that insurance  in  the
  state  where  the  insured maintains its principal place of business and
  the contract of insurance insures risks located in that state.
    (d)  In  this  article,  "non-resident  insurance  agent"   means   an
  individual  who  is  a non-resident of this state and who is licensed or
  authorized to act as an  insurance  agent  in  the  state  in  which  he
  resides,  or  in  which  he  or the firm or association of which he is a
  member or employee, or the  corporation  of  which  he  is  an  officer,
  director, or employee maintains an office as an insurance agent.
    (e)  In  this  article,  "non-resident  insurance  broker",  means  an
  individual who is a non-resident of this state and who  is  licensed  or
  authorized  to  act  as  an  insurance  broker  in the state in which he
  resides, or in which he, or the firm or association of  which  he  is  a
  member  or  employee,  or  the  corporation  of  which he is an officer,
  director or employee, maintains an office as an insurance broker.
    (f) In this article,  "reinsurance  intermediary"  means  any  person,
  firm,  association  or  corporation  who  acts  as broker in soliciting,
  negotiating or selling any reinsurance contract or binder, or acts as an
  agent in accepting any reinsurance contract or binder on  behalf  of  an
  insurer, except that such term shall not include:
    (1)   licensed  attorneys  at  law  of  this  state  acting  in  their
  professional capacity as such;
    (2) regular salaried officers, employees or attorneys in  fact  of  an
  authorized  insurer  or  of an underwriting office of such insurer while
  acting in their capacity as such in  discharging  the  duties  of  their
  employment or appointment;
    (3)  licensed insurance agents acting within the scope of their agency
  authority in  the  placement  or  acceptance  of  reinsurance  on  risks
  produced or managed by such agents; or
    (4)  licensed  insurance  brokers,  in the placement of reinsurance on
  risks produced by such brokers.
    (g) In this article, "adjuster" means any  "independent  adjuster"  or
  "public adjuster" as defined below:
    (1)   The   term   "independent  adjuster"  means  any  person,  firm,
  association or corporation who, or which, for money, commission  or  any
  other  thing of value, acts in this state on behalf of an insurer in the
  work of investigating  and  adjusting  claims  arising  under  insurance
  contracts  issued  by such insurer and who performs such duties required
  by such insurer as are incidental to such claims and also  includes  any
  person  who  for  compensation  or  anything  of  value investigates and
  adjusts claims on behalf of any independent adjuster, except  that  such
  term shall not include:
    (A)   any  officer,  director  or  regular  salaried  employee  of  an
  authorized insurer or entity licensed pursuant to article forty-four  of
  the  public  health law providing comprehensive health service plans (as
  used in this paragraph, a "health  maintenance  organization"),  or  any
  manager  thereof,  individual  or  corporate,  or  the manager, agent or
  general agent of any department thereof,  individual  or  corporate,  or
  attorney  in  fact  of  any reciprocal insurer or Lloyds underwriter, or
  marine underwriting  office,  unless  acting  as  an  auto  body  repair
  estimator as defined in subsection (j) of this section;
    (B)  any  officer, director or regular salaried employee of an insurer
  authorized  to  write  accident  and  health  insurance,  a  corporation
  licensed  under  article  forty-three  of this chapter (collectively, as
  used in this paragraph, a "health  insurer")  or  a  health  maintenance
  organization,  or any manager thereof, individual or corporate, when the
  claim to be adjusted is issued or administered by another health insurer
  or health maintenance  organization  within  the  same  holding  company
  system   as  the  health  insurer  or  health  maintenance  organization
  adjusting the claim;
    (C) any officer, director or regular salaried employee of  an  article
  fifteen  holding  company  or  a  controlled  person within such holding
  company system providing administrative  services  within  that  holding
  company, or any manager thereof, individual or corporate, when the claim
  to be adjusted is submitted for payment under a health benefit plan that
  is  issued  or  administered  by  a health insurer or health maintenance
  organization within that same holding company system;
    (D)  any  adjustment  bureau  or  association  owned and maintained by
  insurers to adjust  or  investigate  losses,  or  any  regular  salaried
  employee or manager thereof who devotes substantially all of his time to
  the  business  of  such  bureau or association, unless acting as an auto
  body repair estimator as defined in subsection (j) of this section;
    (E) any licensed agent of an authorized insurer who adjusts losses for
  such insurer solely under policies issued through  his  or  its  agency,
  provided  the agent receives no compensation for such services in excess
  of fifty dollars per loss adjusted;
    (F) any licensed attorney at law of this state;
    (G) any average adjuster or adjuster of maritime losses;
    (H) any agent or other representative  of  an  insurer  authorized  to
  issue  life  and annuity contracts, provided he receives no compensation
  for such services.
    (2)  "Public  adjuster"  means  any  person,  firm,   association   or
  corporation  who,  or which, for money, commission or any other thing of
  value, acts or aids in any manner on behalf of an insured in negotiating
  for, or effecting, the settlement of a  claim  or  claims  for  loss  or
  damage  to property of the insured in this state caused by, or resulting
  from, any of the risks as enumerated  in  paragraphs  four,  five,  six,
  seven,  eight,  nine  and ten and subparagraphs (B) and (C) of paragraph
  twenty of subsection (a) of section one thousand one hundred thirteen of
  this chapter, not including loss or damage to persons under subparagraph
  (B) of paragraph twenty of subsection (a) of such  section  or  who,  or
  which,  advertises  for,  or  solicits employment as an adjuster of such
  claims, and shall also include any person who, for money, commission  or
  any other thing of value, solicits, investigates, or adjusts such claims
  on  behalf  of any such public adjuster, except that such term shall not
  include:
    (A) any employee, agent or  other  representative  of  any  authorized
  insurer  who acts as such in the adjustment of any claim or any licensed
  insurance broker who acts as an adjuster for a client  of  such  broker,
  without any compensation for such services as adjuster if such insurer's
  representative  or  such licensed insurance broker does not advertise or
  publicly solicit the adjustment of claims in such a way as is likely  to
  mislead  the public into believing that he is offering his services as a
  public adjuster;
    (B) any licensed attorney at law of this state who  acts  or  aids  in
  adjusting  insurance  claims  as  an  incident  to  the  practice of his
  profession and who does not advertise himself as a public adjuster;
    (C) any licensed insurance broker who acts as an adjuster with respect
  to any loss involving insurance contracts under which he was the  broker
  of record in placing the insurance, whether or not designated in writing
  to act for the insured; or
    (D) any other licensed insurance broker who has been designated to act
  for the insured in writing before a loss occurs.
    (h)  In  this chapter, "licensed insurance broker," means an insurance
  broker who is the licensee or a sub-licensee named in a  license  issued
  or  renewed  pursuant  to  the  provisions  of  section two thousand one
  hundred four of this article and in full force and effect.
    (i) In this chapter, "limited licensee" shall mean a person authorized
  to sell certain coverages relating  to  the  rental  of  motor  vehicles
  pursuant   to  the  provisions  of  section  two  thousand  one  hundred
  thirty-one of this article.
    (j) In this article, "auto body repair estimator" means  any  officer,
  director or regular salaried employee of an authorized insurer or of any
  adjustment  bureau  or association owned and maintained by insurers, who
  writes, or who directly supervises the writing  of,  any  motor  vehicle
  body  repair  estimate  in  this state, on behalf of such insurer in the
  work   of  diagnosing  or  estimating  motor  vehicle  repair  costs  or
  procedures relative to appraising, investigating or adjusting claims for
  motor vehicle body repair work pursuant to an insurance contract.
    (k) In this article, "insurance producer" means  an  insurance  agent,
  insurance  broker, reinsurance intermediary, excess lines broker, or any
  other person required to be licensed under the laws  of  this  state  to
  sell, solicit or negotiate insurance. Such term shall not include:
    (1)  an officer, director or employee of a licensed insurer, fraternal
  benefit society or health maintenance  organization  or  of  a  licensed
  insurance producer, provided that the officer, director or employee does
  not  receive  any commission on policies written or sold to insure risks
  residing, located or to be performed in this state and:
    (A) the officer, director  or  employee's  activities  are  executive,
  administrative,  managerial, clerical or a combination of these, and are
  only indirectly related to the  sale,  solicitation  or  negotiation  of
  insurance; or
    (B)   the   officer,   director  or  employee's  function  relates  to
  underwriting, loss control, inspection  or  the  processing,  adjusting,
  investigating or settling of a claim on a contract of insurance; or
    (C)  the  officer, director or employee is acting in the capacity of a
  special  agent  or  agency  supervisor  assisting   licensed   insurance
  producers  where  the  person's  activities  are  limited  to  providing
  technical advice and assistance to licensed insurance producers  and  do
  not include the sale, solicitation or negotiation of insurance;
    (2)  employees  of  insurers,  fraternal  benefit  societies or health
  maintenance  organizations  or  organizations  employed   by   insurers,
  fraternal  benefit societies or health maintenance organizations who are
  engaging in the inspection, rating or classification of risks, or in the
  supervision of the training of licensed insurance producers and who  are
  not  individually  engaged  in  the sale, solicitation or negotiation of
  insurance;
    (3) any agent or representative of a fraternal benefit society,  other
  than  agents  representing  societies  governed by section four thousand
  five hundred twenty-seven of this chapter, who devotes,  or  intends  to
  devote,   less   than   fifty  percent  of  the  person's  time  to  the
  solicitation, negotiation or sale of insurance contracts  for  fraternal
  benefit  societies and who receives or intends to receive any commission
  or other compensation directly dependent on  the  amount  of  insurance,
  provided  that  any  person  who  in  the  preceding  calendar  year has
  solicited,  negotiated  or  sold  any  of  the  following  contracts  of
  insurance  on  behalf of a fraternal benefit society is presumed to have
  devoted, or intended to devote, fifty percent of the  person's  time  to
  the solicitation, negotiation or sale of insurance contracts:
    (A)  life  insurance  contracts  that,  in  the  aggregate, exceed two
  hundred thousand dollars of coverage  for  all  lives  insured  for  the
  preceding calendar year;
    (B)  a  permanent  life  insurance  contract  offering  more  than ten
  thousand dollars of coverage on an individual life;
    (C) a term life insurance contract offering more than  fifty  thousand
  dollars of coverage on an individual life;
    (D) any insurance contracts other than life that the fraternal benefit
  society  may  write  that  insure  the  individual  lives  of  more than
  twenty-five persons;
    (E) any variable life insurance or variable annuity contract; or
    (4) any agent or other representative of any title insurance company;
    (5) any service contract  provider  or  any  administrator  or  person
  designated  by  a  service  contract provider who in this state markets,
  sells, offers for sale, issues, makes, proposes to  make  or  administer
  service contracts pursuant to article seventy-nine of this chapter;
    (6)  a person who secures and furnishes information for the purpose of
  group  life  insurance,   group   property/casualty   insurance,   group
  annuities,  group  or  blanket accident and health insurance; or for the
  purpose of enrolling individuals under plans, issuing certificates under
  plans  or  otherwise  assisting  in  administering  plans;  or  performs
  administrative  services  related  to  mass  marketed  property/casualty
  insurance, where no commission is paid to the person for the service;
    (7) an employer or association or its officers, directors,  employees,
  or  the  trustees  of  an  employee  trust  plan, to the extent that the
  employers, officers, employees, directors or trustees are engaged in the
  administration or operation of a program of employee  benefits  for  the
  employer's  or  association's  own  employees  or  the  employees of its
  subsidiaries or affiliates, which program involves the use of  insurance
  issued  by  an  insurer, fraternal benefit society or health maintenance
  organization,  as  long  as  the  employers,   associations,   officers,
  directors,  employees  or  trustees  are  not in any manner compensated,
  directly or indirectly, by the company issuing the contracts;
    (8) a person whose activities in this state are limited to advertising
  without  the  intent  to  solicit  insurance  in  this   state   through
  communications in printed publications or other forms of electronic mass
  media  whose  distribution  is  not  limited  to residents of the state,
  provided that the person does not sell, solicit or  negotiate  insurance
  that  would  insure  risks  residing, located or to be performed in this
  state;
    (9) a person who is not a resident of this state who  sells,  solicits
  or  negotiates  a contract of insurance for commercial property/casualty
  risks to an insured with risks located in more than  one  state  insured
  under  that contract, provided that such person is otherwise licensed as
  an insurance producer to sell, solicit or negotiate  that  insurance  in
  the  state  where  the insured maintains its principal place of business
  and the contract of insurance insures risks located in that state; or
    (10) any salaried full-time employee who counsels or  advises  his  or
  her  employer  relative to the insurance interests of the employer or of
  the subsidiaries or business affiliates of the employer,  provided  that
  the employee does not sell or solicit insurance or receive a commission.
    (l)  In  this  article, "home state" means the District of Columbia or
  any state or territory of  the  United  States  in  which  an  insurance
  producer  maintains  his,  her  or  its  principal place of residence or
  principal place of business and is  licensed  to  act  as  an  insurance
  producer.
    (m)  In  this  article,  "negotiate" or "negotiation" means the act of
  conferring directly with or offering advice directly to a  purchaser  or
  prospective  purchaser  of a particular contract of insurance concerning
  any of the substantive benefits, terms or conditions  of  the  contract,
  provided  that  the person engaged in that act either sells insurance or
  obtains insurance from licensed insurers, fraternal benefit societies or
  health maintenance organizations for purchasers.
    (n) In this article, "sell" or "sale" means to exchange a contract  of
  insurance  by  any  means,  for  money or its equivalent, on behalf of a
  licensed  insurer,  fraternal  benefit  society  or  health  maintenance
  organization.
    (o)  In  this article, "solicit" or "solicitation" means attempting to
  sell insurance or asking or urging a person to apply  for  a  particular
  kind  of insurance from a particular licensed insurer, fraternal benefit
  society or health maintenance organization.
    (p)   In   this   article,  "business  entity"  means  a  corporation,
  association, partnership, limited liability company,  limited  liability
  partnership or other legal entity.
    (q)  In  this  article,  "person"  means  an  individual or a business
  entity.
    (r) In this article, "line of authority" means any of the following:
    (1) life: insurance coverage on  human  lives  including  benefits  of
  endowment  and annuities, and may include benefits in the event of death
  or dismemberment by accident and benefits for disability income;
    (2) accident and health or sickness: insurance coverage for  sickness,
  bodily   injury  or  accidental  death  and  may  include  benefits  for
  disability income;
    (3) property: insurance coverage for the direct or consequential  loss
  or damage to property of every kind;
    (4)  casualty:  insurance  coverage against legal liability, including
  that for death, injury or disability  or  damage  to  real  or  personal
  property;
    (5)  variable  life  and variable annuity products: insurance coverage
  provided under variable life insurance contracts and variable annuities;
    (6) personal  lines:  property/casualty  insurance  coverage  sold  to
  individuals and families for primarily noncommercial purposes; and
    (7) any other line of insurance permitted pursuant to this chapter.

Disclaimer: These codes may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.