OGC Opinion No. 04-02-27
The Office of General Counsel issued the following opinion on February 27, 2004, representing the position of the New York State Insurance Department.
Re: Certificates of Insurance
Question Presented:
May a Certificate of Insurance provide obligations, conditions, or coverages not contained within the underlying insurance policy?
Conclusion:
No. See "Analysis" below.
Facts:
An agency has come across examples of improper Certificates of Insurance that do not accurately reflect the actual coverages provided within the insurance policies in issue.
Analysis:
A Certificate of Insurance is often used as proof that a policy of insurance is in effect. It is merely a document used in business to summarize information about the insurance coverage. It is usually a brief summary of the essential terms, conditions, and duration of the contract of insurance that is in effect between the insured and the insurer. The Certificate of Insurance is not a contract and is not required by statute or regulation. However, the Certificate of Insurance must contain the same information as the insurance policy. It is not intended to confer on a certificate holder new or additional rights beyond what the insurance policy provides. Thus, if any provision in the Certificate of Insurance is not contained in the policy and it imposes an obligation or liability not presently existing upon an insurer, such difference would alter, expand, or modify the rights between an insured and the insurer and would constitute a policy form that must be filed with the Superintendent pursuant to N.Y. Ins. Law § 2307(b) (McKinney Supp. 2004).
N. Y. Ins. Law § 2307(b) provides in relevant part:
Except as otherwise provided herein, no policy form shall be delivered or issued for delivery unless it has been filed with the superintendent and either he has approved it, or thirty days have elapsed and he has not disapproved it as misleading or violative of public policy.
A producer is in violation of the Insurance Law if he amends, expands, or alters the terms of the policy without authorization from the insurer and, where required, approval from this Department. As stated in Circular Letter No. 15 (1997), the Department may seek disciplinary measures against producers who act in this manner. It is always prudent to review the entire policy in order to ensure that the Certificate of Insurance prepared by the producer actually reflects the terms of the policy.
Circular Letters No. 8 (1995) and No. 15 (1997) as well as the Departments General Counsel opinions are available at the Departments website: www.ins.state.ny.us.
For further information you may contact Associate Attorney Jeffrey A. Stonehill at the New York City Office.