S T A T E O F N E W Y O R K
________________________________________________________________________
1568
2017-2018 Regular Sessions
I N A S S E M B L Y
January 12, 2017
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Introduced by M. of A. SKOUFIS, TITONE, CUSICK, MORELLE, CYMBROWITZ,
COLTON, NOLAN, SOLAGES, SANTABARBARA, PERRY, RAMOS, LUPARDO, ARROYO,
HOOPER, STIRPE, STECK, OTIS, MALLIOTAKIS -- Multi-Sponsored by -- M.
of A. ABINANTI, BUCHWALD, ENGLEBRIGHT, GALEF, GLICK, GUNTHER, HIKIND,
JAFFEE, LAVINE, McDONOUGH, PAULIN, RIVERA, SIMON, THIELE, TITUS --
read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to standards for prompt
investigation and settlement of claims arising from states of emergen-
cy
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The insurance law is amended by adding a new section 2616
to read as follows:
§ 2616. STANDARDS FOR PROMPT INVESTIGATION AND SETTLEMENT OF CLAIMS.
(A) THIS SECTION SHALL APPLY TO EVERY INSURER WHO WRITES POLICIES THAT
COVER LOSS OF OR DAMAGE TO REAL PROPERTY, PERSONAL PROPERTY OR OTHER
LIABILITIES FOR LOSS OF, DAMAGE TO, OR INJURY TO PERSONS OR PROPERTY
WHEN A LOCAL STATE OF EMERGENCY IS DECLARED PURSUANT TO SECTION TWENTY-
FOUR OF THE EXECUTIVE LAW, WHEN THE GOVERNOR DECLARES A DISASTER EMER-
GENCY PURSUANT TO SECTION TWENTY-EIGHT OF THE EXECUTIVE LAW, OR WHEN THE
PRESIDENT ISSUES A MAJOR DISASTER OR EMERGENCY DECLARATION PURSUANT TO
THE ROBERT T. STAFFORD DISASTER RELIEF AND EMERGENCY ASSISTANCE ACT
(P.L. 93-288), FOR CLAIMS ARISING FROM SUCH EMERGENCY.
(1) AN INSURER SHALL ACKNOWLEDGE THE RECEIPT OF ALL CLAIMS IN WRITING
TO THE CLAIMANT OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE IN ACCORD-
ANCE WITH REGULATIONS PROMULGATED BY THE SUPERINTENDENT;
(2) IF THE INSURER WISHES ITS INVESTIGATION TO INCLUDE AN INSPECTION
OF DAMAGED OR DESTROYED PROPERTY, THE INSPECTION, WHETHER PERFORMED BY
THE INSURER, AN INDEPENDENT ADJUSTER, OR OTHER REPRESENTATIVE OF THE
INSURER, SHALL OCCUR IN ACCORDANCE WITH REGULATIONS PROMULGATED BY THE
SUPERINTENDENT. FURTHERMORE, WHERE NECESSARY TO PROTECT THE HEALTH AND
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01815-01-7
A. 1568 2
SAFETY OF THE CLAIMANT, IMMEDIATE REPAIRS TO WINDOWS, EXTERIOR WALLS,
EXTERIOR DOORS, ROOFS, HEATING SYSTEMS, WATER SYSTEMS AND ELECTRICAL
SYSTEMS MAY BE MADE AND ALTERNATIVE PROOF OF LOSS SUCH AS PHOTOGRAPHS,
VIDEO RECORDINGS, INVENTORIES AND ALL RECEIPTS FOR REPAIRS OR REPLACE-
MENT PROPERTY SHALL SATISFY POLICY REQUIREMENTS;
(3) A CLAIM FILED WITH AN AGENT OF AN INSURER SHALL BE DEEMED TO HAVE
BEEN FILED WITH THE INSURER UNLESS, CONSISTENT WITH LAW OR CONTRACT, THE
AGENT NOTIFIES THE PERSON FILING THE CLAIM THAT THE AGENT IS NOT AUTHOR-
IZED TO RECEIVE NOTICES OF CLAIM; AND
(4) AN INSURER SHALL FURNISH TO SUCH CLAIMANT, OR CLAIMANT'S AUTHOR-
IZED REPRESENTATIVE, A NOTIFICATION OF ALL ITEMS, STATEMENTS AND FORMS,
IF ANY, WHICH THE INSURER REASONABLY BELIEVES WILL BE REQUIRED OF THE
CLAIMANT IN ORDER TO INVESTIGATE SUCH CLAIM IN ACCORDANCE WITH REGU-
LATIONS PROMULGATED BY THE SUPERINTENDENT.
(B)(1) AN INSURER SHALL, WITHIN FIFTEEN BUSINESS DAYS OF RECEIPT OF
ALL ITEMS, STATEMENTS AND FORMS REQUESTED UNDER THIS SECTION FROM THE
CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, ADVISE THE CLAIM-
ANT IN WRITING WHETHER THE INSURER HAS ACCEPTED OR REJECTED THE CLAIM.
(2) AN INSURER SHALL BE GRANTED A ONE-TIME EXTENSION OF FIFTEEN BUSI-
NESS DAYS TO DETERMINE WHETHER A CLAIM SHOULD BE ACCEPTED OR REJECTED.
IF THE INSURER ELECTS TO UTILIZE THIS EXTENSION, IT SHALL SO NOTIFY THE
CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, IN WRITING. SUCH
NOTIFICATION SHALL INCLUDE THE REASONS ADDITIONAL TIME IS NEEDED FOR THE
INVESTIGATION.
(3) ONCE THE CLAIM IS ACCEPTED BY THE INSURER, THE INSURER SHALL
ADVISE THE CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, IN
WRITING OF THE AMOUNT THE INSURER IS OFFERING TO SETTLE THE CLAIM. THE
INSURER SHALL ALSO PROVIDE TO THE CLAIMANT, OR THE CLAIMANT'S AUTHORIZED
REPRESENTATIVE, IN WRITING, OF ALL APPLICABLE POLICY PROVISIONS REGARD-
ING THE CLAIMANT'S RIGHT TO REJECT AND APPEAL THE OFFER.
(4) IN ANY CASE WHERE THE CLAIM IS REJECTED BY THE INSURER, THE INSUR-
ER SHALL NOTIFY THE CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESEN-
TATIVE, IN WRITING, OF ALL APPLICABLE POLICY PROVISIONS REGARDING THE
CLAIMANT'S RIGHT TO APPEAL THE DECISION.
(C) AN INSURER SHALL PAY THE CLAIM NOT LATER THAN THREE BUSINESS DAYS
FROM THE SETTLEMENT OF THE CLAIM.
(D) THE SUPERINTENDENT MAY PROMULGATE ANY RULES OR REGULATIONS NECES-
SARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
§ 2. This act shall take effect immediately.