Bill Text: NY A07097 | 2019-2020 | General Assembly | Introduced

Bill Title: Establishes standards for the prompt investigation and settlement of claims arising out of states of emergency and disasters.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2019-05-30 - advanced to third reading cal.539 [A07097 Detail]

Download: New_York-2019-A07097-Introduced.html

                STATE OF NEW YORK
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                      April 5, 2019
        Introduced  by M. of A. STERN -- 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-
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The insurance law is amended by adding a new  section  2618
     2  to read as follows:
     3    §  2618.  Standards for prompt investigation and settlement of claims.
     4  (a) This section shall apply to every insurer who writes  policies  that
     5  cover  loss  of  or  damage to real property, personal property or other
     6  liabilities for loss of, damage to, or injury  to  persons  or  property
     7  when  a local state of emergency is declared pursuant to section twenty-
     8  four of the executive law, when the governor declares a  disaster  emer-
     9  gency pursuant to section twenty-eight of the executive law, or when the
    10  President  issues  a major disaster or emergency declaration pursuant to
    11  the Robert T. Stafford Disaster  Relief  and  Emergency  Assistance  Act
    12  (P.L. 93-288), for claims arising from such emergency.
    13    (1)  An insurer shall acknowledge the receipt of all claims in writing
    14  to the claimant or the claimant's authorized representative  in  accord-
    15  ance with regulations promulgated by the superintendent;
    16    (2)  If  the insurer wishes its investigation to include an inspection
    17  of damaged or destroyed property, the inspection, whether  performed  by
    18  the  insurer,  an  independent  adjuster, or other representative of the
    19  insurer, shall occur in accordance with regulations promulgated  by  the
    20  superintendent.   Furthermore, where necessary to protect the health and
    21  safety of the claimant, immediate repairs to  windows,  exterior  walls,
    22  exterior  doors,  roofs,  heating  systems, water systems and electrical
    23  systems may be made and alternative proof of loss such  as  photographs,
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        A. 7097                             2
     1  video  recordings,  inventories and all receipts for repairs or replace-
     2  ment property shall satisfy policy requirements;
     3    (3)  A claim filed with an agent of an insurer shall be deemed to have
     4  been filed with the insurer unless, consistent with law or contract, the
     5  agent notifies the person filing the claim that the agent is not author-
     6  ized to receive notices of claim; and
     7    (4) An insurer shall furnish to such claimant, or  claimant's  author-
     8  ized  representative, a notification of all items, statements and forms,
     9  if any, which the insurer reasonably believes will be  required  of  the
    10  claimant  in  order  to  investigate such claim in accordance with regu-
    11  lations promulgated by the superintendent.
    12    (b)(1) An insurer shall, within fifteen business days  of  receipt  of
    13  all  items,  statements  and forms requested under this section from the
    14  claimant, or the claimant's authorized representative, advise the claim-
    15  ant in writing whether the insurer has accepted or rejected the claim.
    16    (2) An insurer shall be granted a one-time extension of fifteen  busi-
    17  ness  days  to determine whether a claim should be accepted or rejected.
    18  If the insurer elects to utilize this extension, it shall so notify  the
    19  claimant, or the claimant's authorized representative, in writing.  Such
    20  notification shall include the reasons additional time is needed for the
    21  investigation.
    22    (3)  Once  the  claim  is  accepted  by the insurer, the insurer shall
    23  advise the claimant, or the  claimant's  authorized  representative,  in
    24  writing  of  the amount the insurer is offering to settle the claim. The
    25  insurer shall also provide to the claimant, or the claimant's authorized
    26  representative, in writing, of all applicable policy provisions  regard-
    27  ing the claimant's right to reject and appeal the offer.
    28    (4) In any case where the claim is rejected by the insurer, the insur-
    29  er  shall  notify  the  claimant, or the claimant's authorized represen-
    30  tative, in writing, of all applicable policy  provisions  regarding  the
    31  claimant's right to appeal the decision.
    32    (c)  An insurer shall pay the claim not later than three business days
    33  from the settlement of the claim.
    34    (d) The superintendent may promulgate any rules or regulations  neces-
    35  sary to implement the provisions of this section.
    36    § 2. This act shall take effect immediately.