•  Summary 
  •  
  •  Actions 
  •  
  •  Committee Votes 
  •  
  •  Floor Votes 
  •  
  •  Memo 
  •  
  •  Text 
  •  
  •  LFIN 
  •  
  •  Chamber Video/Transcript 

A06010 Summary:

BILL NOA06010A
 
SAME ASSAME AS S00166-A
 
SPONSORHooks
 
COSPNSRGonzalez-Rojas, Tapia, Taylor, Fall, Kassay, Bronson, Brabenec
 
MLTSPNSR
 
Add §2601-a, amd §3425, Ins L
 
Relates to claim settlement practices when an insurer refuses to pay or is delaying payment of a settlement; provides a policyholder a private right of action against such insurer doing business in the state who has refused or delayed payment of an insurance claim.
Go to top

A06010 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         6010--A
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 25, 2025
                                       ___________
 
        Introduced  by  M.  of  A.  HOOKS,  GONZALEZ-ROJAS, TAPIA, TAYLOR, FALL,
          KASSAY -- 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 unfair  claim  settle-
          ment practices

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. This act shall be known and  may  be  cited  as  the  "fair
     2  insurance settlement practice act (FISPA)".
     3    §  2.  The  insurance law is amended by adding a new section 2601-a to
     4  read as follows:
     5    § 2601-a. Unfair claim settlement practices.  (a) Unfair claim settle-
     6  ment practices. For the purposes  of  this  section,  an  unfair  claims
     7  settlement  practice shall consist of any of the following acts or omis-
     8  sions:
     9    (1) misrepresenting or omitting pertinent facts  or  insurance  policy
    10  provisions  relating to the coverage at issue, including but not limited
    11  to, in connection with litigation, failing  to  disclose  all  available
    12  coverage  amounts  in  compliance with subdivision (f) of section thirty
    13  one hundred one of the civil practice law and rules;
    14    (2) failing to acknowledge and act reasonably promptly  upon  communi-
    15  cations with respect to claims arising under insurance policies;
    16    (3) failing to adopt and implement reasonable standards for the prompt
    17  investigation of claims arising under insurance policies;
    18    (4)  refusing  to  pay claims without conducting a reasonable investi-
    19  gation based upon all available information;
    20    (5) failing to affirm or deny coverage of claims within  a  reasonable
    21  time after proof of loss statements have been completed;
    22    (6)  failing  to  effectuate prompt, fair and equitable settlements of
    23  claims in which liability has become reasonably clear;
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00680-03-5

        A. 6010--A                          2
 
     1    (7) compelling insureds to institute litigation to recover amounts due
     2  under an insurance  policy  by  offering  substantially  less  than  the
     3  amounts ultimately recovered in actions brought by such insureds;
     4    (8)  attempting  to settle a claim for less than the amount to which a
     5  reasonable person would have believed they were entitled by reference to
     6  written or printed advertising material accompanying or made part of  an
     7  application;
     8    (9)  attempting  to settle claims on the basis of an application which
     9  was altered without notice to, or knowledge or consent of, the insured;
    10    (10) making claims payments to insured or beneficiaries  not  accompa-
    11  nied  by a statement setting forth the coverage under which payments are
    12  being made;
    13    (11) making known to insured or claimants a policy of  appealing  from
    14  arbitration  awards in favor of insureds or claimants for the purpose of
    15  compelling them to accept  settlements  of  compromises  less  than  the
    16  amount awarded in arbitration;
    17    (12) delaying the investigation or payment of claims by requiring that
    18  an insured or claimant, or the physician of either, submit a preliminary
    19  claim  report  and  then  requiring  the subsequent submission of formal
    20  proof of loss forms, both of which submissions contain substantially the
    21  same information;
    22    (13) failing to settle claims promptly,  where  liability  has  become
    23  reasonably  clear, under one portion of the insurance policy coverage in
    24  order to influence settlements under other  portions  of  the  insurance
    25  policy coverage; or
    26    (14) failing to promptly provide a reasonable explanation of the basis
    27  in  the  insurance policy in relation to the facts or applicable law for
    28  denial of a claim or for the offer of a compromise settlement.
    29    (b) Enforcement. (1) Any person who has been injured or  whose  rights
    30  are  affected  by the use or employment by an insurer of any method, act
    31  or practice declared to be unlawful by this section, may, in addition to
    32  any other cause of action authorized by law, bring an action in  supreme
    33  court  for damages and equitable relief, including an injunction, or any
    34  other remedy as the court deems to be necessary and proper. Such  action
    35  may also be filed or maintained by a representative of such person.
    36    (2) At least thirty days prior to the filing of any such action pursu-
    37  ant  to  paragraph  one of this subsection, a written demand for relief,
    38  identifying the claimant and reasonably describing the unfair or  decep-
    39  tive  act  or  practice  relied  upon  and the injury suffered, shall be
    40  mailed or delivered by the claimant to  the  appropriate  person  at  an
    41  applicable  insurer.  An insurer receiving such a demand for relief who,
    42  within thirty days of the delivery of the demand, makes a written tender
    43  of settlement which is rejected by the claimant may, in  any  subsequent
    44  action,  file  such  written  tender  and  an  affidavit  concerning the
    45  rejection of such written tender and thereby limit any recovery  to  the
    46  relief  tendered if the court finds that the relief tendered was reason-
    47  able in relation to the injury actually suffered by the petitioner.
    48    (3) If the court finds that  any  practice  deemed  unlawful  by  this
    49  section  has  been  committed  willfully  and with intent to defraud any
    50  person then the court shall award two times  the  damages  sustained  by
    51  such  person,  plus  costs and attorneys' fees to the person bringing an
    52  action under this section.
    53    (4) No contract for insurance issued or delivered  in  the  state  may
    54  require  an  insured  to waive the right to a jury trial to adjudicate a
    55  dispute arising from a violation of this section.

        A. 6010--A                          3
 
     1    § 3. Section 3425 of the insurance law is  amended  by  adding  a  new
     2  subsection (t) to read as follows:
     3    (t)  No insurer shall refuse to issue or renew a covered policy solely
     4  on the grounds that the policyholder has brought an action  pursuant  to
     5  section two thousand six hundred one-a of this chapter.
     6    §  4.  This  act shall take effect on the ninetieth day after it shall
     7  have become a law and shall apply to all acts and omissions by  insurers
     8  occurring on or after such effective date; provided, however, that para-
     9  graph  (4)  of  subsection  b  of section 2601-a of the insurance law as
    10  added by section one of this act shall only apply to insurance contracts
    11  entered into after such effective date.
Go to top