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

                                  4458

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 2, 2015
                               ___________

Introduced  by  M.  of  A.  SKOUFIS,  SILVER, TITONE, CUSICK, GOLDFEDER,
  MORELLE, BROOK-KRASNY, CYMBROWITZ, COLTON, NOLAN,  SOLAGES,  SANTABAR-
  BARA,  PERRY, RAMOS, LUPARDO -- Multi-Sponsored by -- M. of A. ABINAN-
  TI, BRENNAN, BUCHWALD, ENGLEBRIGHT,  GALEF,  GLICK,  GUNTHER,  JAFFEE,
  LAVINE,  MARKEY,  McDONOUGH,  PAULIN,  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:
  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
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.
                                                           LBD03167-02-5
              

A. 4458                             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.
  S 2. This act shall take effect immediately.