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 88.06 - Administrative Resolution of Appeals Prior to an Appeal Hearing

(1) Administrative Review. The Board at its discretion may conduct an administrative review to determine whether the information on an Appeal Form and any documents submitted with it provide persuasive evidence that the At-fault Accident Determination should be vacated, and, based upon such a review, the Board may vacate an At-fault Accident Determination when an Accident results from a Special Hazardous Driving Condition. Appeals of At-fault Accident Determinations that are not vacated based on an Administrative Review will be scheduled for an Appeal Hearing.

(2) Documentary Review. The Board at its discretion may conduct an administrative review to resolve those Appeals of At-fault Accident Determinations that can be vacated based upon document submissions. The Board will notify Insurers of the Appeals pending for their companies and will request copies of the documents or other information that resulted in their At-fault Accident Determinations. The insurer may choose not to submit the documents and request a hearing be scheduled. The Board will review these Appeals based upon the documents submitted by an Insurer, the Appeal Form, and information filed by the Appellant. The Board will vacate the At-fault Accident Determination if the record provides sufficient information to determine that the Appellant is not more than 50% at fault for the Accident at issue. Appeals of At-fault Accident Determinations that are not vacated will be scheduled for an Appeal Hearing.

(3) Findings and Order. The Board shall notify the Merit Rating Board of its decision to vacate an At-fault Accident Determination based on an Administrative Review or Documentary Review, and shall provide a copy of its Findings and Order to the Parties.

(4) Insurer Obligations. If the Board vacates an At-fault Accident Determination based on an Administrative Review or Documentary Review, the Board shall notify the Merit Rating Board, and the Insurer promptly shall notify any other data collection agency to which the Insurer reported the At-fault Accident Determination. If the Insurer, based on the claim underlying the Appeal, has imposed a Surcharge for an At-fault Accident on the policy insuring the Involved Operator, it shall promptly rescind the Surcharge and return any premium paid as a result of the Surcharge. No Insurer shall thereafter include such Accident for the purpose of calculating a Surcharge for a Private Passenger Motor Vehicle insurance policy covering the Involved Operator unless the Board's Findings and Order are reversed by a court of competent jurisdiction.