OGC Op. No. 04-02-12

The Office of General Counsel issued the following opinion on February 18, 2004 representing the position of the New York State Insurance Department.

RE: Written notice to the No-Fault insurer in the event of an accident applicable to the Regulation 68-A mandatory personal injury protection endorsement

Question Presented

Does Regulation 68-A specify whether the written notice that shall be given by or on behalf of each eligible injured person must be mailed to or received by the No-Fault insurer to effect the notice to the No-Fault insurer?

Conclusion

Pursuant to Regulation 68-A, notice to the No-Fault insurer by or on behalf of each eligible injured person is effective upon mailing.

Facts

The inquirer requested that the Office of General Counsel confirm whether it is a correct interpretation of Regulation 68-A that if a notice to the No-Fault insurer in the event of an accident "is placed in the care of the United States Post Office, within 30 days for mailing to the carrier, that would satisfy the thirty day requirement of [Regulation 68-A]."

Analysis

N.Y. Comp. Codes R. & Regs. tit. 11, § 65-1.1(d) (2001) (Regulation 68-A) contains the MANDATORY PERSONAL INJURY PROTECTION ENDORSEMENT and the relevant provision states:

Notice. In the event of an accident, written notice setting forth details sufficient to identify the eligible injured person, along with reasonably obtainable information regarding the time, place and circumstances of the accident, shall be given by, or on behalf of, each eligible injured person, to the Company, or any of the Company's authorized agents, as soon as reasonably practicable, but in no event more than 30 days after the date of the accident, unless the eligible injured person submits written proof providing clear and reasonable justification for the failure to comply with such time limitation.

The Department's website-- www.ins.state.ny.us --provides guidance regarding the start date of the notice and whether the notice is effected by mailing to or by the No-Fault insurer's receipt, within the component of "Consumer Frequently Asked Questions" that focuses on "Regulation 68". The relevant question and answer is:

Do the new time requirements run from the date that notice or submission of claims are made to the insurer or from the date that notice or submission of claims are received by the insurer?

The new time requirements apply as of the date that notice or submission of claims are made to the insurer. For example, if the accident occurs on January 1, notice of the claim must be mailed or submitted to the insurer no later than January 31 to comply with the notice requirement, which begins the day after the accident.

Therefore, the inquirer’s interpretation of Regulation 68-A regarding how notice to the No-Fault insurer shall be given in the event of an accident is correct.

For further information one may contact Senior Attorney Robert Freedman at the New York City Office.