S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 1092--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  M.  of  A.  SKOUFIS, SILVER, TITONE, CUSICK, WEISENBERG,
  GOLDFEDER, WEINSTEIN, MORELLE,  BROOK-KRASNY,  CYMBROWITZ,  HENNESSEY,
  COLTON, NOLAN, MAISEL, SOLAGES, SANTABARBARA, PERRY, RAMOS, LUPARDO --
  Multi-Sponsored  by  --  M.  of A. ABINANTI, BRENNAN, BUCHWALD, ENGLE-
  BRIGHT, GALEF, GLICK,  GUNTHER,  JAFFEE,  LAVINE,  MARKEY,  McDONOUGH,
  PAULIN,  RABBITT,  SWEENEY, THIELE, TITUS -- read once and referred to
  the Committee on Insurance  --  committee  discharged,  bill  amended,
  ordered reprinted as amended and recommitted to said committee

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:
  S 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

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

                                                           LBD05809-04-3

A. 1092--A                          2

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
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.
  S 2. This act shall take effect immediately.