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ABC Insurance Services, Inc.

Based upon the letter and materials the inquirer submitted to the Department, the contracts issued by ABC do not come within the definition of an insurance contract as defined by the Insurance Law. The customer enters into a contract with ABC for home care services for a specified number of hours at a pre-determined total cost. The cost is pre-determined through the approval of a Plan of Service by ABC. Therefore, all services contemplated by ABC and the customer are not dependent upon the occurrence of a fortuitous event. Any and all services are provided solely for conditions that have resulted from events that have previously occurred.
As a result, ABC’s Home Service Contract does not constitute an insurance contract and, therefore, this Department does not require ABC to be licensed for issuing its Home Service Contract.
The inquirer’s client, ABC Home Care Services, Inc. contracts with consumers to provide them, or their relatives, with non medical, in home, personal care. The care is provided for individuals who are homebound due to some physical or medical condition. As stated in ABC’s Home Service Contract, the services provided involve assistance with everyday activities and chores.
ABC arranges for appropriately trained and supervised service providers to provide services up to the number of hours purchased in a given stated period of time. In consideration for the services, the customer pays a pre-determined amount. In the event that the customer exhausts the contracted number of hours, the customer may contract for additional hours at an hourly rate. In the event the customer dies during the stated period of time, ABC will make no refund of payments.
As a condition of service, the customer must have an approved plan of service determined by ABC. As defined in ABC’s Glossary of Important Terms, a Plan of Service is a statement of the goals and objectives of the services provided for the customer, and the objectives and activities or tasks required to accomplish the schedule written for the customer and signed by the company.
As stated in the inquirer’s letter, the home care service is provided without the need for a claim or the occurrence of any type of loss or event. The inquirer’s customers may only obtain services as provided through the company, by way of its subcontractors and may not engage a service provider and be reimbursed by ABC.

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