Bill Text: NY S05242 | 2023-2024 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Prohibits insurers from reducing disability benefits due to the actual or anticipated receipt of social security disability benefits unless certain conditions are met.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-06-05 - SUBSTITUTED BY A6126A [S05242 Detail]

Download: New_York-2023-S05242-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          5242

                               2023-2024 Regular Sessions

                    IN SENATE

                                    February 28, 2023
                                       ___________

        Introduced  by  Sen. BRESLIN -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance

        AN ACT to amend the insurance law, in relation to  prohibiting  insurers
          from reducing disability benefits unless certain conditions are met

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Section 3216 of the insurance law is amended by adding  two
     2  new subsections (n) and (o) to read as follows:
     3    (n)  No policy or certificate of accident and health insurance provid-
     4  ing disability benefits delivered or issued for delivery to  any  person
     5  in  this  state  shall  contain  any provision authorizing an insurer to
     6  offset or reduce benefits due to the actual or  anticipated  receipt  of
     7  social security disability benefits or other disability benefits, unless
     8  such  policy  or  certificate  notifies the insured that the insured may
     9  qualify for such benefits, and  to  pursue  such  benefits  through  any
    10  required administrative appeals.
    11    (o) No insurer may offset or reduce benefits payable under a policy of
    12  accident  and health insurance providing disability insurance due to the
    13  actual or estimated receipt  of  social  security  disability  insurance
    14  benefits unless:
    15    (1)  the  insurer has a reasonable, good faith belief that the insured
    16  is entitled to such benefits and a means of  reasonably  estimating  the
    17  amount payable;
    18    (2)  the  insurer  makes  a good faith effort to assist the insured in
    19  applying for such benefits; and
    20    (3) the insured fails to apply for,  or  pursue,  such  benefits  with
    21  reasonable  diligence  during  the  application  process or any required
    22  appeals.
    23    § 2.  This act shall take effect immediately.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09886-01-3