Insurers: What to do When an Insured Fights for Their Right to an At-Fault Determination Reversal

On November 16, 2010, Joseph G. Murphy, Commissioner of Insurance, posted a bulletin explaining the necessary steps insurers must take if their at-fault determination gets reversed by the Board of Appeals (BOA), a clerk magistrate or judge.

If a reversal is issued and the operator is not a policyholder, or no longer a policyholder, of the insurer that made the at-fault determination, the operator bears the responsibility of informing his current insurer of such reversal if the operator seeks a premium adjustment.  The BOA will inform the operator of this obligation in the notice of reversal it sends to the operator.  The operator must send this notice of reversal to the insurer within 45 days of its issuance.  An operator is not entitled to a premium adjustment if the insurer did not factor the at-fault determination into its premium calculation.

An insurer shall adjust the premium associated with an at-fault determination within 30 days after receiving notice of a reversal of that determination.  The premium shall be calculated in accordance with the insurer’s rates and rules in effect when the at-fault determination was made.  If the operator is a policyholder of the insurer at the time of the reversal and at the time of the request for an adjustment, the insurer shall refund or credit any difference in premium associated with the at-fault determination to the operator.  Any premium owed to an operator that is no longer insured by the insurer when it receives such reversal notification shall be sent to the address identified by the operator in connection with his request for a premium adjustment.

An insurer must also report to the Merit Rating Board, as well as all collection agencies previously notified of an original at-fault determination, within 15 days of the reversal notification from the BOA, judge, etc.

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Published in: on November 20, 2010 at 10:37 pm  Leave a Comment  

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