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Insurance Law
SUNY Buffalo Law School
Kohane, Dan D.

INSURANCE LAW
I.       Insurance Concepts and the “Business of Insurance”
A.   Selected Readings
1.                 York & Whalen, “Insurance Law: In General”
Definitions of basic Insurance Terms
2.                 NY Insurance Law § 1101: Definitions; doing an insurance business
3.                 NY Insurance Law § 1102: Insurer’s license required; issuance
4.                 NY Insurance Law § 1113: Kinds of insurance authorized
5.                 Danzeisen Realty v. Continental (1994)
a)                Overview
Π, in 1982, sought reimbursement for his roof sliding under an “all risk” insurance policy it had with Δ. Π had hired a roofing company to make repairs following a 1980 fire, which repairs Δ paid for.   Subsequently, the roof began sliding. An “all risk” policy covers all losses which are fortuitous. Since there was no rational process upon which the jury could base a finding in favor of Δ, judgment as a matter of law in favor of the Π as to liability was warranted
b)                RULES
A fortuitous event is “any occurrence or failure to occur which is, or is assumed by the parties to be, to a substantial extent beyond the control of either party”
 
Mere negligence of an insured is not a defense to coverage under an “all risk” policy 
 
Losses caused by inherent or latent defects fall under the “all risk” policy’s exclusions (at least here)
6.                 State v. Blue Crest Plans (1979)
a)                Overview
Δ was engaging in the business of insurance without a license from the Dept. of Insurance of NY and Π sued for an injunction. The independent organization, not the union, was held to be doing business
b)                RULES
“Insurance K” includes any agreement or other transaction whereby one party, herein called the insurer, is obligated to confer benefit of pecuniary value upon another party, herein called the insured or the beneficiary, dependent upon the happening of a fortuitous event in which the insured or beneficiary has, or is expected to have at the time of such happening, a material interest which will be adversely affected by the happening of such event
 
Indications that the agreement at issue constitutes insurance: distribution of loss among a large group; an insurable interest, a legally binding promise; a premium paid; a profit motive fo

es to regulate and tax the business of insurance, but this was not intended as an expansion of the state’s power prior to this enactment, nor was it an attempt to make the states supreme in regulating all activities of insurance companies. Insurance companies may do many things which are subject to paramount federal regulation; only when they are engaged in ‘the business of insurance’ does the statute apply.
 
“The business of insurance” concerns the relationship between insurer and insured, the type of policy which could be issued, its reliability, interpretation, and enforcement. Statutes aimed at protecting the relationship between the insurance company and the policyholder, directly or indirectly, are laws regulating ‘the business of insurance.’
 
Key distinction between AZ statute and M-F Act is that AZ statute is geared toward protecting shareholders, which is a securities interest of paramount federal interest, as