Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations
Section 88.02 - Definitions

As used in 211 CMR 88.00, the following words and phrases shall mean:

Accident. An unexpected, unintended event arising out of the ownership, maintenance or use of a private passenger motor vehicle, that causes damage to the Operator's vehicle, another vehicle, or other property.

Administrative Review. A review process pursuant to which the Board may resolve the merits of an Appeal without holding an Appeal Hearing.

Appeal. A procedure by which an Involved Operator may obtain review of the Insurer's determination that he or she was more than 50% at fault for an Accident.

Appeal Form. The form approved by the Board that an Insurer must send to an Operator with a Notice of At-fault Accident Determination that the Operator must complete and file with the Board to initiate an Appeal in accordance with 211 CMR 88.00.

Appeal Hearing. A hearing conducted by the Board.

Appeal Record. The Insurer's Claim Record, Appeal Form, audio recordings of the Appeal Hearing, records, accident reports, citations, photographs or other documents submitted to the Board by either Party, motions, and rulings made in an Appeal.

Appellant. An Involved Operator who files an Appeal in accordance with 211 CMR 88.00.

At-fault Accident. An Accident involving a Private Passenger Motor Vehicle in which its Operator is found to be more than 50% at fault.

At-fault Accident Determination. An Insurer's determination pursuant to the Standards of Fault set forth in 211 CMR 74.00: Standards of Fault to Be Used by the Board of Appeal on Motor Vehicle Liability Policies and Bonds and Insurers in Presuming Fault When Making at Fault Determinations that an Involved Operator was more than 50% at fault for an Accident.

Authorized Representative. An individual authorized in writing by a Party to represent that Party in an Appeal.

Board. The Board of Appeal on Motor Vehicle Liability Policies and Bonds established pursuant to M.G.L. c. 26, § 8A.

Commissioner. The Commissioner of Insurance appointed pursuant to M.G.L. c. 26, § 6.

Competitive Market. A market in which Private Passenger Motor Vehicle insurance rates are not fixed and established pursuant to M.G.L. c. 175, § 113B but rather are determined pursuant to M.G.L. c. 175A and M.G.L. c. 175E.

Findings and Order. The Board's written decision that vacates or upholds the Insurer's At-fault Accident Determination. The Findings and Order shall state the Board's reasons for its decision.

Fixed-and-established Market. A market in which premiums for Private Passenger Motor Vehicle insurance are based on rates fixed-and-established by the Commissioner pursuant to M.G.L. c. 175, § 113B.

Hearing Officer. The Board's designee to review Appeals, conduct Appeal Hearings, and render Findings and Orders.

Insurer. Any corporation, association, partnership, group or individual authorized to write motor vehicle insurance in the Commonwealth of Massachusetts.

Insurer's Claim Record. Any and all documents including, but not limited to, accident reports, police reports, citations, photographs, witness statements or other materials upon which the Insurer based its At-fault Accident Determination.

Involved Operator. The Operator of a Private Passenger Motor Vehicle who receives an Insurer's Notice of At-fault Accident Determination.

Merit Rating Board. The Motor Vehicle Insurance Merit Rating Board established pursuant to M.G.L. c. 6C, § 57A.

Merit Rating Plan. A rating procedure Insurers use in a Competitive Market to adjust a prospective Private Passenger Motor Vehicle insurance premium based on the Operator's past motor vehicle insurance claims and traffic law violation experience.

Notice of At-fault Accident Determination. A notice issued by an Insurer to an Involved Operator.

Operator. A person who operates a private passenger motor vehicle in the Commonwealth.

Party. The Insurer and the Appellant whose legal rights, duties or privileges are being determined in an Appeal.

Special Hazardous Driving Condition. A general driving condition, including but not limited to a condition such as an ice storm, that the Board, in light of all the relevant facts, determines renders an Involved Operator less than 50% at fault for an Accident.

Standards of Fault. The standards referred to in M.G.L. c. 175E, § 7A and M.G.L. c. 175, § 113P; which are contained in 211 CMR 74.04: Standards of Fault: Circumstances in Which an Operator's Fault Is Presumed to Be More than 50%.

Statement in Lieu of a Personal Appearance. A written statement submitted byan Appellant who chooses to waive appearing in person at an Appeal Hearing.

Surcharge. An amount added to the Involved Operator's premium.