S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8004
 
                             I N  S E N A T E
 
                              January 5, 2024
                                ___________
 
 Introduced  by  Sen. SKOUFIS -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law, in relation to standards  for  prompt
   investigation  and settlement of claims; and to amend a chapter of the
   laws of 2023 amending the insurance  law  relating  to  standards  for
   prompt  investigation  and settlement of claims arising from states of
   emergency, as proposed in legislative bills numbers  S.  5201  and  A.
   2078, in relation to the effectiveness thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 2618 of the insurance law, as added by a chapter of
 the laws of 2023 amending the insurance law relating  to  standards  for
 prompt  investigation  and  settlement  of claims arising from states of
 emergency, as proposed in legislative bills numbers S. 5201 and A. 2078,
 is amended to read as follows:
   § 2618. Standards for prompt investigation and settlement  of  claims.
 (a)  (1)  FOR  THE PURPOSE OF THIS SECTION, "NATURAL DISASTER" MEANS THE
 OCCURRENCE OF WIDESPREAD CATASTROPHIC OR SEVERE DAMAGE, INJURY, OR  LOSS
 OF  LIFE  OR  PROPERTY RESULTING FROM ANY NATURAL CAUSE, INCLUDING FIRE,
 FLOOD, EARTHQUAKE, HURRICANE, TORNADO, HIGH WATER, LANDSLIDE,  MUDSLIDE,
 WIND, STORM, WAVE ACTION, AND ICE STORM.
   (2) 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)  a  local state of emergency is declared pursuant to section twen-
 ty-four of the executive law, when  the  governor  declares  a  disaster
 emergency 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];
   (B)  THE DISASTER IS A NATURAL DISASTER OR A DISASTER CAUSED BY AN ACT
 OF TERRORISM; AND
   (C) THE CLAIMS ARE A RESULT OF SUCH DISASTER.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD02303-02-4
 S. 8004                             2
 
   [(1)](3) An insurer shall acknowledge the receipt  of  all  claims  in
 writing  to  the claimant or the claimant's authorized representative in
 accordance with regulations promulgated by the superintendent;
   [(2)]  (4)  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 represen-
 tative of the  insurer,  shall  occur  in  accordance  with  regulations
 promulgated  by  the  superintendent.    Furthermore, where necessary to
 protect [the] health and 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 replacement property shall satisfy policy requirements;
   [(3)](5)  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 authorized to receive notices of claim; and
   [(4)](6) An insurer shall furnish to such claimant, or THE  claimant's
 authorized  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  A
 PROPERLY EXECUTED PROOF OF LOSS AND RECEIPT OF all items, statements and
 forms  requested under this section from the claimant, or the claimant's
 authorized representative, advise the claimant in  writing  whether  the
 insurer  has  accepted  or  rejected  the NON-COMMERCIAL claim. WHEN THE
 INSURER SUSPECTS THAT THE NON-COMMERCIAL CLAIM INVOLVES ARSON, THE FORE-
 GOING FIFTEEN BUSINESS DAYS SHALL BE READ AS THIRTY BUSINESS DAYS.
   (2) An insurer shall be granted a one-time extension of fifteen  busi-
 ness days to determine whether a NON-COMMERCIAL 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)  (I)  IF THE INSURER NEEDS MORE TIME TO DETERMINE WHETHER THE NON-
 COMMERCIAL CLAIM SHOULD BE ACCEPTED OR REJECTED BECAUSE THE  INSURER  IS
 PROHIBITED  FROM  ACCESSING  THE  PROPERTY TO INVESTIGATE THE CLAIM, THE
 INSURER SHALL BE GRANTED ONE ADDITIONAL EXTENSION  OF  FIFTEEN  BUSINESS
 DAYS. IF THE INSURER ELECTS TO UTILIZE THIS EXTENSION, IT SHALL SO NOTI-
 FY  THE  CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, IN WRIT-
 ING, SETTING FORTH THE REASONS ADDITIONAL TIME IS NEEDED FOR THE  INVES-
 TIGATION.
   (II)  IF  THE  INSURER NEEDS MORE TIME TO BE ABLE TO PHYSICALLY ACCESS
 THE PROPERTY BECAUSE THE INSURER IS PROHIBITED FROM  ACCESSING  IT,  THE
 INSURER  SHALL  SO  NOTIFY  THE  CLAIMANT,  OR THE CLAIMANT'S AUTHORIZED
 REPRESENTATIVE, EVERY FIFTEEN BUSINESS DAYS, IN WRITING,  SETTING  FORTH
 THE  REASONS  ADDITIONAL  TIME IS NEEDED FOR THE INVESTIGATION. WHEN THE
 INSURER IS NO LONGER PROHIBITED FROM ACCESSING  THE  PROPERTY,  AND  THE
 PROPERTY  CAN  BE  ACCESSED, THE INSURER SHALL HAVE NO MORE THAN FIFTEEN
 DAYS TO ADJUDICATE THE CLAIM.
   (C) (1) AN INSURER SHALL, WITHIN FIFTEEN BUSINESS DAYS OF RECEIPT OF A
 PROPERLY EXECUTED PROOF OF LOSS AND RECEIPT OF ALL ITEMS, STATEMENTS AND
 FORMS REQUESTED UNDER THIS SECTION FROM THE CLAIMANT, OR THE  CLAIMANT'S
 AUTHORIZED  REPRESENTATIVE,  ADVISE  THE CLAIMANT IN WRITING WHETHER THE
 INSURER HAS ACCEPTED OR REJECTED THE COMMERCIAL CLAIM.
 S. 8004                             3
 
   (2) AN INSURER SHALL BE GRANTED A ONE-TIME EXTENSION OF  THIRTY  BUSI-
 NESS  DAYS TO DETERMINE WHETHER A COMMERCIAL 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,  SETTING  FORTH  THE  REASONS ADDITIONAL TIME IS NEEDED FOR THE
 INVESTIGATION.
   (3) IF SUCCEEDING THE ONE-TIME EXTENSION OF THIRTY BUSINESS  DAYS  THE
 INSURER NEEDS MORE TIME TO DETERMINE WHETHER THE COMMERCIAL CLAIM SHOULD
 BE  ACCEPTED  OR  REJECTED, THE INSURER SHALL SO NOTIFY THE CLAIMANT, OR
 THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, EVERY THIRTY BUSINESS DAYS, IN
 WRITING, SETTING FORTH THE REASONS ADDITIONAL TIME  IS  NEEDED  FOR  THE
 INVESTIGATION.
   (4)  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 AND REQUEST AN
 APPRAISAL.
   [(4)](5)  In  any case where the claim is rejected by the insurer, the
 insurer shall notify the claimant, or the claimant's  authorized  repre-
 sentative,  in  writing,  of all applicable policy provisions [regarding
 the claimant's right to appeal the decision] AND DEADLINES  BY  WHICH  A
 CLAIMANT  MAY  SUE  THE  INSURER.  ANY NOTICE REJECTING ANY ELEMENT OF A
 CLAIM INVOLVING PERSONAL PROPERTY INSURANCE SHALL CONTAIN  THE  IDENTITY
 AND  THE  CLAIMS PROCESSING ADDRESS OF THE INSURER, THE INSURED'S POLICY
 NUMBER, THE CLAIM NUMBER,  AND  INFORMATION  REGARDING  HOW  TO  FILE  A
 COMPLAINT WITH THE DEPARTMENT IN ACCORDANCE WITH REGULATIONS PROMULGATED
 BY THE SUPERINTENDENT.
   [(c)  An]  (D) EVERY insurer shall pay [the] ANY AMOUNT FINALLY AGREED
 UPON IN SETTLEMENT OF ALL OR PART OF ANY claim not  later  than  [three]
 FOUR  business  days  from the [settlement of the claim] RECEIPT OF SUCH
 AGREEMENT BY THE INSURER, OR FROM THE DATE OF  THE  PERFORMANCE  BY  THE
 CLAIMANT  OF  ANY  CONDITION  SET BY SUCH AGREEMENT, WHICHEVER IS LATER,
 EXCEPT AS PROVIDED IN SECTION THREE HUNDRED THIRTY-ONE OF  THIS  CHAPTER
 WITH RESPECT TO LIENS BY TAX DISTRICTS ON FIRE INSURANCE PROCEEDS.
   [(d)](E)  The  superintendent  may promulgate any rules or regulations
 necessary to implement the provisions of this section.
   § 2. Section 2 of a chapter of the laws of 2023 amending the insurance
 law relating to standards for prompt  investigation  and  settlement  of
 claims  arising  from  states  of  emergency, as proposed in legislative
 bills numbers S. 5201 and A. 2078, is amended to read as follows:
   § 2. This act shall take effect [immediately]  ON  THE  THIRTIETH  DAY
 AFTER IT SHALL HAVE BECOME A LAW.
   §  3.  This  act  shall  take  effect  immediately; provided, however,
 section one of this act shall take effect on the same date  and  in  the
 same  manner as a chapter of the laws of 2023 amending the insurance law
 relating to standards for prompt investigation and settlement of  claims
 arising  from  states  of  emergency,  as  proposed in legislative bills
 numbers S. 5201 and A. 2078, takes effect.