A01092 Summary:

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

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

submitted in accordance with Assembly Rule III, Sec 1(f)
SPONSOR: Skoufis
  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 investi- gating 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, insur- ers 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 investi- gation, 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 busi- ness 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 insur- ers 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 busi- ness days. This bill would address this issue by requiring insurers to respond to a claim arising from a disaster or emergency in accordance with regu- lations established by the Superintendent of Financial Services, accept or reject a claim within fifteen business days of closing the investi- gation, 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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