There Is a Newer Version of the New York Consolidated Laws
2012 New York Consolidated Laws
ISC - Insurance
Article 21 - (2101 - 2137) AGENTS, BROKERS, ADJUSTERS, CONSULTANTS AND INTERMEDIARIES
2101 - Definitions.
NY Ins L § 2101 (2012) What's This?
§ 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;
(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; or
(9) a person who is not a resident of this state who sells, solicits
or negotiates a contract of property/casualty insurance, as defined in
paragraph six of subsection (x) of this section, of an insurer not
authorized to do business in this state, provided that: (A) the
insured's home state is a state other than this state; and (B) such
person is otherwise licensed to sell, solicit or negotiate excess line
insurance in the insured's home 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 officer, director or regular salaried employee of an
authorized insurer that is licensed to write the kind of insurance to be
adjusted, or any manager thereof, individual or corporate, when the
claim to be adjusted is pursuant to a policy that is issued or
administered by another insurer within the same holding company system
as the authorized insurer adjusting the claim, unless acting as an auto
body repair estimator as defined in subsection (j) of this section;
(E) any officer, director or regular salaried employee of an
authorized life insurance company, or any manager thereof, individual or
corporate, or the manager, agent or general agent of any department
thereof, individual or corporate, when the claim to be adjusted is
submitted under an insurance contract issued by another insurer and the
claim: (i) is within the scope of a contract of reinsurance between the
two insurers for all of the underlying risks and none of the underlying
risks are later reinsured back to the ceding insurer; and (ii) relates
to a kind of insurance that the authorized life insurance company
adjusting the claim is licensed to write;
(F) 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;
(G) 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;
(H) any licensed attorney at law of this state;
(I) any average adjuster or adjuster of maritime losses; or
(J) 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;
(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;
or
(11) a person who is not a resident of this state who sells, solicits
or negotiates a contract of property/casualty insurance, as defined in
paragraph six of subsection (x) of this section, of an insurer not
authorized to do business in this state, provided that: (A) the
insured's home state is a state other than this state; and (B) such
person is otherwise licensed to sell, solicit or negotiate excess line
insurance in the insured's home state.
(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.
(s) In this article, "controlled person" shall have the meaning set
forth in paragraph five of subsection (a) of section one thousand five
hundred one of this chapter.
(t) In this article, "holding company" shall have the meaning set
forth in paragraph three of subsection (a) of section one thousand five
hundred one of this chapter.
(u) In this article, "holding company system" shall have the meaning
set forth in paragraph six of subsection (a) of section one thousand
five hundred one of this chapter.
(v) In this article, "life settlement broker" shall have the meaning
contained in subsection (j) of section seven thousand eight hundred two
of this chapter.
(w) In this article, "state" means the District of Columbia or any
state or territory of the United States.
(x) In this article, with respect to excess line insurance and excess
line brokers:
(1) With respect to an insured's home state, "affiliated group" means
any group of entities that are all affiliated. For the purposes of this
paragraph:
(A) "affiliate" means, with respect to an insured, any entity that
controls, is controlled by, or is under common control with the insured;
and
(B) an entity has control over another entity if the entity:
(i) directly or indirectly or acting through one or more other persons
owns, controls, or has the power to vote twenty-five percent or more of
any class of voting securities of the other entity; or
(ii) controls in any manner the election of a majority of the
directors or trustees of the other entity;
(2) "Exempt commercial purchaser" means any person purchasing
commercial insurance that, at the time of placement, meets the following
requirements:
(A) the person employs or retains a qualified risk manager to
negotiate insurance coverage;
(B) the person has paid aggregate nationwide commercial
property/casualty insurance premiums in excess of one hundred thousand
dollars in the immediately preceding twelve months; and
(C) (i) the person meets at least one of the following criteria:
(I) the person possesses a net worth in excess of twenty million
dollars, as such amount is adjusted pursuant to item (ii) of this
subparagraph;
(II) the person generates annual revenues in excess of fifty million
dollars, as such amount is adjusted pursuant to item (ii) of this
subparagraph;
(III) the person employs more than five hundred full-time or full-time
equivalent employees per individual insured or is a member of an
affiliated group employing more than one thousand employees in the
aggregate;
(IV) the person is a not-for-profit organization or public entity
generating annual budgeted expenditures of at least thirty million
dollars, as such amount is adjusted pursuant to item (ii) of this
subparagraph; or
(V) the person is a municipality with a population in excess of fifty
thousand persons;
(ii) Effective on the fifth January first occurring after July
twenty-first, two thousand ten and each fifth January first occurring
thereafter, the amounts in clauses (I), (II), and (IV) of item (i) of
this subparagraph shall be adjusted to reflect the percentage change for
such five-year period in the Consumer Price Index for All Urban
Consumers published by the Bureau of Labor Statistics of the Unites
States Department of Labor;
(3) "Insured's home state" means:
(A) the state in which an insured maintains its principal place of
business or, in the case of an individual, the individual's principal
residence;
(B) if one hundred percent of the insured risk is located outside of
the state referred to in subparagraph (A) of this paragraph, then the
state to which the greatest percentage of the insured's taxable premium
for that insurance contract is allocated;
(C) if more than one insured from an affiliated group are named
insureds on a single insurance contract, then the insured's home state,
as determined pursuant to subparagraph (A) of this paragraph, of the
member of the affiliated group that has the largest percentage of
premium attributed to it under such insurance contract; or
(D) in the case of a group policy:
(i) when the group policyholder pays one hundred percent of the
premium from its own funds, then the insured's home state, as determined
pursuant to subparagraph (A) of this paragraph, of the group
policyholder; or
(ii) when the group policyholder does not pay one hundred percent of
the premium from its own funds, then the home state, as determined
pursuant to subparagraph (A) of this paragraph, of the group member;
(4) With respect to determining an insured's home state, "principal
place of business" means the state where:
(A) the insured maintains its headquarters and where the insured's
high-level officers direct, control, and coordinate the business
activities; or
(B) if the insured's high-level officers direct, control, and
coordinate the business activities in more than one state, or if the
insured's principal place of business is located outside any state, then
the state to which the greatest percentage of the insured's taxable
premium for that insurance contract is allocated;
(5) With respect to determining an insured's home state, "principal
residence" means the state:
(A) where the individual resides for the greatest number of days
during a calendar year; or
(B) if the insured's principal residence is located outside any state,
the state to which the greatest percentage of the insured's taxable
premium for that insurance contract is allocated;
(6) "Property/casualty insurance" means any kind of insurance as
specified in subsection (a) of section one thousand one hundred thirteen
of this chapter, except insurance issued pursuant to paragraph one, two,
three, fifteen, eighteen or thirty-one of subsection (a) of section one
thousand one hundred thirteen of this chapter or insurance substantially
similar thereto; and
(7) With respect to an exempt commercial purchaser, "qualified risk
manager" means, with respect to a policyholder of commercial insurance,
a person who meets all of the following requirements:
(A) the person is an employee of, or third-party consultant retained
by, the commercial policyholder;
(B) the person provides skilled services in loss prevention, loss
reduction, or risk and insurance coverage analysis, and purchase of
insurance;
(C) the person:
(i)(I) has a bachelor's degree or higher from an accredited college or
university in risk management, business administration, finance,
economics, or any other field determined by the superintendent to
demonstrate minimum competence in risk management; and
(II)(aa) has three years of experience in risk financing, claims
administration, loss prevention, risk and insurance analysis, or
purchasing commercial lines of insurance; or
(bb) has:
(aaa) a designation as a chartered property and casualty underwriter
(in this clause referred to as a "CPCU") issued by the American
Institute for CPCU/Insurance Institute of America;
(bbb) a designation as an associate in risk management (ARM) issued by
the American Institute for CPCU/Insurance Institute of America;
(ccc) a designation as certified risk manager (CRM) issued by the
National Alliance for Insurance Education & Research;
(ddd) a designation as a Risk and Insurance Management Society (RIMS)
fellow (RF) issued by the Global Risk Management Institute; or
(eee) any other designation, certification, or license determined by
the superintendent to demonstrate minimum competency in risk management;
(ii) (I) has at least seven years of experience in risk financing,
claims administration, loss prevention, risk and insurance coverage
analysis, or purchasing commercial lines of insurance; and
(II) has any one of the designations specified in subclauses (aaa)
through (eee) of subitem (bb) of clause (II) of item (i) of this
subparagraph;
(iii) has at least ten years of experience in risk financing, claims
administration, loss prevention, risk and insurance coverage analysis,
or purchasing commercial lines of insurance; or
(iv) has a graduate degree from an accredited college or university in
risk management, business administration, finance, economics, or any
other field determined by the superintendent to demonstrate minimum
competence in risk management.
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