A01092 Summary:

BILL NO    A01092A

SAME AS    SAME AS S03413-A

SPONSOR    Skoufis

COSPNSR    Silver, Titone, Cusick, Weisenberg, Goldfeder, Weinstein, Morelle,
           Brook-Krasny, Cymbrowitz, Hennessey, Colton, Nolan, Solages,
           Santabarbara, Perry, Ramos, Lupardo, Weprin, Moya, Titus, Saladino

MLTSPNSR   Abinanti, Brennan, Buchwald, Englebright, Farrell, Galef, Glick,
           Gunther, Jacobs, Jaffee, Lavine, Markey, McDonough, Paulin, Sweeney,
           Thiele

Add S2616, Ins L

Establishes standards for the prompt investigation and settlement of claims
arising out of states of emergency and disasters.
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A01092 Actions:

BILL NO    A01092A

01/09/2013 referred to insurance
05/20/2013 amend and recommit to insurance
05/20/2013 print number 1092a
05/23/2013 reported 
05/23/2013 advanced to third reading cal.376
06/04/2013 passed assembly
06/04/2013 delivered to senate
06/04/2013 REFERRED TO INSURANCE
01/08/2014 DIED IN SENATE
01/08/2014 RETURNED TO ASSEMBLY
01/08/2014 ordered to third reading cal.65
01/22/2014 committed to insurance
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A01092 Votes:

A01092A06/04/2013 121/23
AbbateYColtonYGarbariYKearnsYMillmanYRiveraYStevensY
AbinantYCookYGibsonERKellnerYMontesaYRobertsYStirpeY
ArroyoYCorwinNOGiglioYKimYMorelleYRobinsoYSweeneyY
AubryYCrespoYGjonajYKolbNOMosleyYRodriguERTediscoNO
BarclayNOCrouchYGlickYLalorNOMoyaYRosaYTenneyNO
BarrettYCurranYGoldfedYLavineYNojayNORosenthYThieleY
BarronYCusickYGoodellNOLentolYNolanYRozicYTitoneY
BenedetYCymbrowYGottfriYLiftonYOaksNORussellYTitusY
BlankenNODenDekkYGrafYLopezYO'DonneYRyanYWalterNO
BorelliYDinowitYGuntherYLupardoYOrtizYSaladinYWeinsteY
BoylandYDiPietrNOHawleyNOLupinacYOtisYSantabaYWeisenbY
BraunstYDupreyNOHeastieYMageeYPalmesaNOScarborYWeprinY
BrennanYEnglebrYHennessYMagnareYPaulinYSchimelYWrightY
BrindisYEspinalYHevesiYMaiselYPeoplesYSchimmiYZebrowsY
BronsonYFahyYHikindYMalliotYPerryYSepulveYMr SpkrY
Brook-KERFarrellYHooperYMarkeyYPretlowYSimanowY
BuchwalYFinchNOJacobsYMayerYQuartYSimotasY
ButlerNOFitzpatNOJaffeeYMcDonalYRaYSkartadY
CahillYFriendNOJohnsYMcDonouYRabbittYSkoufisY
CamaraYGabryszYJordanNOMcKevitYRaiaYSolagesY
CerettoYGalefYKatzNOMcLaughYRamosYStecNO
ClarkYGanttYKavanagYMillerYReilichNOSteckY

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A01092 Memo:

BILL NUMBER:A1092A

TITLE OF BILL:  An act to amend the insurance law, in relation to
standards for prompt investigation and settlement of claims arising
from states of emergency

Purpose Or General Idea Of Bill:  The purpose of this bill is to
establish claim investigation and settlement standards for insurance
companies to follow in the event of a disaster.

Summary Of Specific Provisions:  This bill would require every insurer
authorized to writes policies in New York State that cover loss or
damage to real property, personal property, or other liabilities for
loss of, damage to, or injury to persons or property to begin
investigating a claim arising from a declared disaster or emergency
and inform the insured of all items, statements, and forms that the
insurer believed will be required of the claimant in accordance with
regulations promulgated by. the Superintendent of Financial Services.
If the insurer wishes the investigation to include an inspection of
damaged or destroyed property, such inspection would have to occur in
accordance with regulations promulgated by the Superintendent. In
addition, insurers would have to allow claimants to make certain
repairs necessary to protect health and safety and to accept an
alternative proof of loss from the claimant.

Within fifteen business days after receiving all the items,
statements, and forms that the insurer required from the claimant, the
insurer would be required to advise the claimant in writing whether
the insurer has accepted or rejected the claim. An insurer would be
allowed a one-time extension of fifteen additional business days to
continue its investigation, provided that the insurer notifies the
claimant of the reasons additional time is needed for the
investigation.

If the insurer has accepted the claim, the claimant would have to be
notified of the amount the insurer is offering to settle the claim and
of all applicable policy provisions regarding the claimant's right to
reject and appeal the insurer's offer. If the insurer rejects the
claim, the insurer would have to inform the claimant of all applicable
policy provisions regarding the claimant's right to appeal the
decision.

An insurer would be required to pay the claim not later than three
business days from the settlement of the claim.

Justification:  When a disaster or emergency strikes, policyholders
frequently rely on their insurance policies to be made whole again.
Insurance payouts are often necessary for homeowners and businesses to
make repairs or to replace damaged property. In addition, repairs
often need to be made quickly in order to ensure the health and safety
of the policyholders and the community. Moreover, a delay in insurance
payments can result in a delay in FEMA assistance, as FEMA will not
provide payment for damages until insurance claims are fully
processed.

Following Superstorm Sandy and Tropical Storms Irene and Lee, it was
found that there were often lengthy delays in the time it was taking


insurance companies to investigate and process claims and make
payments to policyholders. Following Sandy, the Department of
Financial Services found it necessary to issue an emergency regulation
that required insurers to begin an investigation within 6 business
days of receiving a Sandy-related claim; if the insurer sought an
inspection of the damaged property, the inspection would have to be
performed within those 6 business days.

This bill would address this issue by requiring insurers to respond to
a claim arising from a disaster or emergency in accordance with
regulations established by the Superintendent of Financial Services,
accept or reject a claim within fifteen business days of closing the
investigation, and pay a claim within three business days of the claim
being settled.

Prior Legislative History:  New bill.

Fiscal Implications For State And Local Governments:  None.

Effective Date:  Immediately.
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A01092 Text:

                           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:

    1    Section  1.  The insurance law is amended by adding a new section 2616
    2  to read as follows:
    3    S 2616. 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

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD05809-04-3
       A. 1092--A                          2

    1  THE INSURER, AN INDEPENDENT ADJUSTER, OR  OTHER  REPRESENTATIVE  OF  THE
    2  INSURER,  SHALL  OCCUR IN ACCORDANCE WITH REGULATIONS PROMULGATED BY THE
    3  SUPERINTENDENT.  FURTHERMORE, WHERE NECESSARY TO PROTECT THE HEALTH  AND
    4  SAFETY  OF  THE  CLAIMANT, IMMEDIATE REPAIRS TO WINDOWS, EXTERIOR WALLS,
    5  EXTERIOR DOORS, ROOFS, HEATING SYSTEMS,  WATER  SYSTEMS  AND  ELECTRICAL
    6  SYSTEMS  MAY  BE MADE AND ALTERNATIVE PROOF OF LOSS SUCH AS PHOTOGRAPHS,
    7  VIDEO RECORDINGS, INVENTORIES AND ALL RECEIPTS FOR REPAIRS  OR  REPLACE-
    8  MENT PROPERTY SHALL SATISFY POLICY REQUIREMENTS;
    9    (3)  A CLAIM FILED WITH AN AGENT OF AN INSURER SHALL BE DEEMED TO HAVE
   10  BEEN FILED WITH THE INSURER UNLESS, CONSISTENT WITH LAW OR CONTRACT, THE
   11  AGENT NOTIFIES THE PERSON FILING THE CLAIM THAT THE AGENT IS NOT AUTHOR-
   12  IZED TO RECEIVE NOTICES OF CLAIM; AND
   13    (4) AN INSURER SHALL FURNISH TO SUCH CLAIMANT, OR  CLAIMANT'S  AUTHOR-
   14  IZED  REPRESENTATIVE, A NOTIFICATION OF ALL ITEMS, STATEMENTS AND FORMS,
   15  IF ANY, WHICH THE INSURER REASONABLY BELIEVES WILL BE  REQUIRED  OF  THE
   16  CLAIMANT  IN  ORDER  TO  INVESTIGATE SUCH CLAIM IN ACCORDANCE WITH REGU-
   17  LATIONS PROMULGATED BY THE SUPERINTENDENT.
   18    (B)(1) AN INSURER SHALL, WITHIN FIFTEEN BUSINESS DAYS  OF  RECEIPT  OF
   19  ALL  ITEMS,  STATEMENTS  AND FORMS REQUESTED UNDER THIS SECTION FROM THE
   20  CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, ADVISE THE CLAIM-
   21  ANT IN WRITING WHETHER THE INSURER HAS ACCEPTED OR REJECTED THE CLAIM.
   22    (2) AN INSURER SHALL BE GRANTED A ONE-TIME EXTENSION OF FIFTEEN  BUSI-
   23  NESS  DAYS  TO DETERMINE WHETHER A CLAIM SHOULD BE ACCEPTED OR REJECTED.
   24  IF THE INSURER ELECTS TO UTILIZE THIS EXTENSION, IT SHALL SO NOTIFY  THE
   25  CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE, IN WRITING.  SUCH
   26  NOTIFICATION SHALL INCLUDE THE REASONS ADDITIONAL TIME IS NEEDED FOR THE
   27  INVESTIGATION.
   28    (3)  ONCE  THE  CLAIM  IS  ACCEPTED  BY THE INSURER, THE INSURER SHALL
   29  ADVISE THE CLAIMANT, OR THE  CLAIMANT'S  AUTHORIZED  REPRESENTATIVE,  IN
   30  WRITING  OF  THE AMOUNT THE INSURER IS OFFERING TO SETTLE THE CLAIM. THE
   31  INSURER SHALL ALSO PROVIDE TO THE CLAIMANT, OR THE CLAIMANT'S AUTHORIZED
   32  REPRESENTATIVE, IN WRITING, OF ALL APPLICABLE POLICY PROVISIONS  REGARD-
   33  ING THE CLAIMANT'S RIGHT TO REJECT AND APPEAL THE OFFER.
   34    (4) IN ANY CASE WHERE THE CLAIM IS REJECTED BY THE INSURER, THE INSUR-
   35  ER  SHALL  NOTIFY  THE  CLAIMANT, OR THE CLAIMANT'S AUTHORIZED REPRESEN-
   36  TATIVE, IN WRITING, OF ALL APPLICABLE POLICY  PROVISIONS  REGARDING  THE
   37  CLAIMANT'S RIGHT TO APPEAL THE DECISION.
   38    (C)  AN INSURER SHALL PAY THE CLAIM NOT LATER THAN THREE BUSINESS DAYS
   39  FROM THE SETTLEMENT OF THE CLAIM.
   40    (D) THE SUPERINTENDENT MAY PROMULGATE ANY RULES OR REGULATIONS  NECES-
   41  SARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
   42    S 2. This act shall take effect immediately.
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