reglab/housing_qa huggingface dataset:
NY Ins L § 3204 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3204 - Policy to Contain Entire Contract; Statements of Applicant to Be Representations and Not Warranties; Alterations.

§  3204. Policy to contain entire contract; statements of applicant to be representations and not warranties; alterations. (a) (1) Every policy of life, accident or health insurance, or contract of annuity, delivered or issued for delivery in this state, shall contain the entire  contract between  the  parties,  and  nothing  shall  be  incorporated therein by reference to any writing, unless a copy  thereof  is  endorsed  upon  or attached to the policy or contract when issued.  (2)  No  application  for  the issuance of any such policy or contract shall be admissible in evidence unless a true copy was attached to  such policy or contract when issued.  (3)  Such policy or contract cannot be modified, nor can any rights or requirements be waived, except in a writing signed by a person specified by the insurer in such policy or contract.  (b) Subsection (a) hereof shall not apply to a table  or  schedule  of rates,   premiums   or   other  payments  which  is  on  file  with  the superintendent for use in connection with such policy or contract.  (c) All statements made by, or by the authority of, the applicant  for the  issuance,  reinstatement  or renewal of any such policy or contract shall be deemed representations and not warranties.  (d) No insertion in or other alteration of any written application for any such policy or contract shall be made by any person other  than  the applicant  without  his  written  consent, except that insertions may be made by the insurer for administrative purposes only in such  manner  as to  indicate  clearly  that the insertions are not to be ascribed to the applicant.  (e) If any policy of life, accident and health insurance delivered  or issued  for  delivery  in this state is reinstated or renewed, or if any such policy of life insurance  provides  that  a  change  in  the  death benefit  or other policy provisions may be made on application or by the written notice of exercise of  one  or  more  options  provided  in  the policy,  and  the  insured or the beneficiary or assignee of such policy makes written request to the insurer for a copy of the  application,  if any, for such reinstatement or renewal or change in the death benefit or other  policy provisions or of the written notice of exercise of such an option, the insurer shall, within fifteen days after the receipt of such request at its home office or any branch office of the insurer,  deliver or mail to the person making such request, a copy of such application or notice.  If  such  copy is not delivered or mailed, the insurer shall be precluded from introducing such application or notice as evidence in any action or  proceeding  based  upon  or  involving  such  policy  or  its reinstatement, renewal or change.  (f) Any waiver of the provisions of this section shall be void.
NY Ins L § 3208 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3208 - Antedating of Life Insurance Policies and Burial Agreements Prohibited.

§  3208.  Antedating  of life insurance policies and burial agreements prohibited. (a) No insurer shall knowingly deliver or issue for delivery in this state any policy of life insurance that purports  to  have  been issued  or  to have taken effect more than six months before the date on which the application therefor was  made,  if  thereby  the  premium  is reduced below the premium that would be payable thereon as determined by the  insured's  birthday  nearest  the date on which the application was made.  (b) No agent, other representative  of  an  insurer  or  broker  shall prepare,  submit  or  accept  in  this  state  any  application for life insurance dated earlier than the date on which the application was  made by  the  insured  or the applicant, if thereby the premium is reduced as above stated.  (c) This section shall not be construed  to  invalidate  any  contract made  in  violation  of  the  provisions  hereof;  nor  to  prohibit the exchange, alteration or conversion of any policy of life insurance as of the original date thereof if the amount of insurance of the  new  policy does not exceed the greater of that of the original policy or that which the premium paid for the original policy would have purchased if the new policy  had been originally applied for; nor to prohibit the exercise of any conversion privilege contained in any policy.  (d) No person, firm, association, society, or corporation  engaged  in this  state  in  the  business  of providing for the payment of funeral, burial or other expenses of deceased  members,  whether  or  not  it  be subject to the other provisions of this chapter, and no insurer shall:  (1) deliver or issue for delivery in this state any contract or policy whereby  the benefit or any part thereof accruing under such contract or policy, upon the death of such member or of the person insured, shall be payable to a  designated  or  restricted  funeral  director  or  funeral directing  concern or other person engaged in such trade or business, or to any official or designated group of them; or  (2) pay any such benefit or any part thereof to any  funeral  director or  funeral  directing  concern or other person engaged in such trade or business or to any official or designated group  of  them,  without  the consent  of  the  person or persons entitled to such benefits, or to pay any commission or other consideration to any funeral director or funeral directing concern or employee thereof to induce such person to  sell  or offer to sell any contract or policy of insurance designated or marketed as payable for funeral or burial expenses upon the death of the insured; or  (3)  in  any  way deprive the personal representative or family of the deceased of the advantages of competition in  procuring  and  purchasing supplies  and  services  in  connection  with  the  funeral  and  burial arrangements of such deceased.
NY Ins L § 3210 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3210 - Incontestability After Reinstatement.

§  3210.  Incontestability  after reinstatement. Any policy of life or   non-cancellable disability insurance or contract of annuity delivered or   issued  for  delivery  in  this  state  that  is  reinstated  shall   be   incontestable after the same period following reinstatement and with the   conditions  and  exceptions  provided  in  the  policy  or contract with   respect to incontestability.
NY Ins L § 3213 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3213 - Payment of Proceeds.

§  3213.  Payment  of proceeds. Where the proceeds of a policy of life   insurance delivered or issued for delivery in this  state  are  payable,   according to its terms, to two or more beneficiaries without designation   of  their  respective  interests,  the  proceeds  shall  be paid to such   beneficiaries in equal portions.
NY Ins L § 3214 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3214 - Interest Upon Proceeds of Life Insurance Policies and Annuity Contracts.

§  3214. Interest upon proceeds of life insurance policies and annuity contracts. (a) If an action to recover the proceeds due under  a  policy of  life  insurance  or  contract  of  annuity  delivered  or issued for delivery in this state  results  in  a  judgment  against  the  insurer, interest thereon shall be paid from the date of the death of the insured or  annuitant  in  connection  with  a  death  claim on a policy of life insurance or contract of annuity and from the date  of  maturity  of  an endowment  contract to the date the verdict is rendered or the report or decision is made, computed pursuant to the provisions of subsection  (c) hereof,  and  thereafter  in accord with the provisions of sections five thousand two and five thousand three  of  the  civil  practice  law  and rules.  (b)  If  an action to recover is commenced and a settlement is reached before the verdict is rendered  or  the  report  or  decision  is  made, interest  on  the settlement shall be paid from the date of the death of the insured or annuitant in connection with a  death  claim  on  such  a policy  of  life  insurance  or contract of annuity and from the date of maturity of an endowment contract to the date of payment computed  under the provisions of subsection (c) hereof.  (c)  If  no action has been commenced, interest upon the principal sum paid to the beneficiary or policyholder shall be computed daily  at  the rate  of  interest  currently paid by the insurer on proceeds left under the interest settlement option, from the date of the death of an insured or annuitant in connection with a death claim on such a policy  of  life insurance  or  contract  of  annuity and from the date of maturity of an endowment contract to the date of payment and shall be added to and be a part of the total sum paid.  (d) This section shall not require the payment  of  interest  for  any period  during  which  an  insurer is required to pay interest under any state or federal law pertaining to interpleader.  (e) This section shall not apply to policies or contracts issued prior to  September  first,  nineteen  hundred  seventy-five,  which   contain specific provisions to the contrary.
NY Ins L § 3217-C (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-C - Primary and Preventive Obstetric and Gynecologic Care.

§  3217-c.  Primary and preventive obstetric and gynecologic care. (a) No insurer subject to this article shall by contract, written policy  or procedure  limit  a  female  insured's  direct  access  to  primary  and preventive  obstetric  and  gynecologic   services,   including   annual examinations,   care   resulting  from  such  annual  examinations,  and treatment of acute gynecologic conditions, from a qualified provider  of such services of her choice from within the plan or for any care related to  a  pregnancy,  provided  that: (1) such qualified provider discusses such services  and  treatment  plan  with  the  insured's  primary  care practitioner in accordance with the requirements of the insurer; and (2) such  qualified  provider agrees to adhere to the insurer's policies and procedures, including any applicable procedures regarding referrals  and obtaining  prior  authorization  for  services  other than obstetric and gynecologic services rendered by such qualified provider, and agrees  to provide  services  pursuant to a treatment plan (if any) approved by the insurer.  (b) An insurer shall treat the provision of obstetric and  gynecologic care,  and  the  ordering of related obstetric and gynecologic items and services, pursuant to the direct access described in subsection  (a)  of this  section by a participating qualified provider of such services, as the authorization of the primary care provider.  (c) It shall be the duty of the administrative officer or other person in charge of each insurer subject to the provisions of this  article  to advise  each  female  insured,  in  writing,  of  the provisions of this section.
NY Ins L § 3217-D (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-D - Grievance Procedure and Access to Specialty Care.

§  3217-d.  Grievance  procedure  and access to specialty care. (a) An insurer that issues a comprehensive policy that utilizes  a  network  of providers and is not a managed care health insurance contract as defined in  subsection  (c)  of  section four thousand eight hundred one of this chapter shall establish and maintain a  grievance  procedure  consistent with the requirements of section four thousand eight hundred two of this chapter.  (b)  An  insurer  that  issues  a comprehensive policy that utilizes a network of providers and is not a managed care health insurance contract as defined in subsection (c) of section four thousand eight hundred  one of this chapter and requires that specialty care be provided pursuant to a  referral  from  a  primary care provider shall provide access to such specialty care consistent with the requirements of subsections (b),  (c) and  (d)  of  section  four thousand eight hundred four of this chapter; provided, however, that nothing in this section shall  be  construed  to require  that  an  insurer,  or a primary care provider on behalf of the insurer, make a referral to a provider that  is  not  in  the  insurer's network.  (c)  An  insurer  that  issues  a comprehensive policy that utilizes a network of providers and is not a managed care health insurance contract as defined in subsection (c) of section four thousand eight hundred  one of  this  chapter  shall  provide access to transitional care consistent with the requirements  of  subsections  (e)  and  (f)  of  section  four thousand eight hundred four of this chapter.  (d)  An  insurer  that  issues  a comprehensive policy that utilizes a network of providers and is not a managed care health insurance contract as defined in subsection (c) of section four thousand eight hundred  one of  this  chapter,  shall  provide  access  to  out-of-network  services consistent with the requirements  of  subsection  (a)  of  section  four thousand eight hundred four of this chapter, subsections (g-6) and (g-7) of section four thousand nine hundred of this chapter, subsections (a-1) and  (a-2)  of  section four thousand nine hundred four of this chapter, paragraphs three and four of subsection (b)  of  section  four  thousand nine  hundred  ten  of  this  chapter,  and subparagraphs (C) and (D) of paragraph four of subsection (b) of section four thousand  nine  hundred fourteen of this chapter.
NY Ins L § 3217-E (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-E - Choice of Health Care Provider.

§  3217-e.  Choice of health care provider. An insurer that is subject   to this article and requires or provides for designation by  an  insured   of  a  participating  primary  care provider shall permit the insured to   designate any participating primary care provider who  is  available  to   accept  such  individual,  and  in the case of a child, shall permit the   insured  to  designate  a  physician  (allopathic  or  osteopathic)  who   specializes  in  pediatrics as the child's primary care provider if such   provider participates in the network of the insurer.
NY Ins L § 3217-F (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-F - Prohibition on Lifetime and Annual Limits.

§  3217-f.  Prohibition  on lifetime and annual limits. (a) An insurer shall not establish a lifetime limit on the dollar amount  of  essential health  benefits  in an individual, group or blanket policy of hospital, medical, surgical or prescription drug expense insurance.  (b) An insurer shall not establish  an  annual  limit  on  the  dollar amount  of  essential health benefits in an individual, group or blanket policy of hospital,  medical,  surgical  or  prescription  drug  expense insurance  for  policy  years  beginning  on  and after January one, two thousand fourteen.  (c) For policy years beginning prior  to  January  one,  two  thousand fourteen,  an  insurer  may  establish  restricted  annual limits on the dollar amount of essential health benefits in an individual,  group,  or blanket  policy  of  hospital,  medical,  surgical  or prescription drug expense insurance consistent with section  2711  of  the  Public  Health Service Act, 42 U.S.C. § 300gg-11 or any regulations thereunder.  (d)  The requirements of subsections (b) and (c) of this section shall not be applicable to an individual policy that is a grandfathered health plan. For purposes of this section, "grandfathered  health  plan"  means coverage  provided  by an insurer in which an individual was enrolled on March twenty-third, two  thousand  ten  for  as  long  as  the  coverage maintains grandfathered status in accordance with section 1251(e) of the Affordable Care Act, 42 U.S.C. § 18011(e).  (e)  For  purposes  of this section, "essential health benefits" shall have the meaning ascribed by section 1302(b) of the Affordable Care Act, 42 U.S.C. § 18022(b).
NY Ins L § 3217-G (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-G - Maternal Depression Screenings.

§  3217-g.  Maternal  depression  screenings.  To  the extent a policy   provides coverage for maternal depression screening, no insurer  subject   to  this  article shall by contract, written policy or procedure limit a   patient insured's direct access to screening and referral  for  maternal   depression,  as  defined  in  subdivision  one  of  section  twenty-five   hundred-k of the public health law,  from  a  provider  of  obstetrical,   gynecologic,  or  pediatric  services  of  her choice; provided that the   patient insured's access  to  such  services,  coverage  and  choice  of   provider  is otherwise subject to the terms and conditions of the policy   under which the patient insured is covered.
NY Ins L § 3217-H (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3217-H - Telehealth Delivery of Services.

§  3217-h.  Telehealth  delivery of services. (a) An insurer shall not exclude from coverage a service that is otherwise covered under a policy that provides comprehensive coverage for hospital, medical  or  surgical care  because  the  service is delivered via telehealth, as that term is defined in subsection (b) of this section; provided,  however,  that  an insurer  may  exclude  from coverage a service by a health care provider where the provider is not otherwise covered under the policy. An insurer may subject the coverage  of  a  service  delivered  via  telehealth  to co-payments,  coinsurance or deductibles provided that they are at least as favorable to the insured as those established for  the  same  service when  not  delivered via telehealth. An insurer may subject the coverage of  a  service  delivered  via  telehealth  to  reasonable   utilization management  and  quality assurance requirements that are consistent with those  established  for  the  same  service  when  not   delivered   via telehealth.  (b)  For  purposes  of  this  section,  "telehealth"  means the use of electronic information and communication technologies by a  health  care provider  to deliver health care services to an insured individual while such individual is located at a site that is  different  from  the  site where the health care provider is located.
NY Ins L § 3218 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3218 - Medicare Supplemental Insurance Policies.

§ 3218. Medicare supplemental insurance policies. (a) In this section:  (1) "Medicare"  means the coverage of health care costs provided under subchapter XVIII of the federal Social Security Act, 42 U.S.C.  §§  1395 et seq.  (2) "Medicare  supplemental  insurance"  means any individual or group accident and health policy issued for delivery in this state on or after June tenth, nineteen  hundred  eighty,  providing  for  the  payment  or reimbursement  for health care services not provided by medicare, except that such  terms  shall  not  include  a  contract  issued  pursuant  to subsections (c) and (d) of section four thousand two hundred thirty-five or section four thousand three hundred five of this chapter which covers employees  of firms doing business in more than one state or the benefit structure of which was the subject of  collective  bargaining  affecting employees of firms doing business in more than one state.  (b) The superintendent shall promulgate rules and regulations which:  (1)  Establish  as  a  separate  classification, medicare supplemental insurance.  (2) Provide for minimum standards for medicare supplemental  insurance policies.  (3)  Require  the ratio of benefits to premiums to be not less than an appropriate percentage determined by the  superintendent  and  requiring the   annual   filing  of  data  that  will  demonstrate  the  insurer's compliance.  (4) Provide a uniform system of designation for  said  policies  which indicates the type and scope of coverage afforded.  (5)  Provide  for  full disclosure of coverage in a clear and coherent manner using words with common everyday language.  (6) Prohibit the advertisement, sale, or solicitation of any  accident or  health  insurance  policy as being supplemental to medicare coverage unless it  conforms  to  minimum  standards  for  medicare  supplemental insurance policies provided by this section.  (7)  Provide  for  the  publication  and dissemination of a consumer's shopping guide for medicare supplemental insurance.  (c) No authorized insurer shall issue or deliver  in  this  state  any medicare   supplemental   insurance   policy   other   than  a  medicare supplemental insurance policy which includes the  minimum  standards  as approved by the superintendent.  (d)  (1)  Every  authorized insurer engaged in issuing for delivery in this state, policies for medicare supplemental insurance as set forth in this section shall file with the superintendent a report of  all  claims experience  for such coverage for each twelve month period preceding the dates fixed by the superintendent for the filing of such reports.   Such reports  shall  be  made  in  writing  and  on  a form prescribed by the superintendent not  less  than  annually  on  dates  determined  by  the superintendent.  (2)  The  provisions  of  this  subsection shall remain in force until December thirty-first, nineteen hundred eighty-three.
NY Ins L § 3224 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3224 - Standard Claim Forms; Accident and Health Insurance.

§  3224.  Standard claim forms; accident and health insurance. (a) The superintendent shall establish standard claim forms for the services  of hospitals, physicians and other health care providers to be used for all accident  and  health  insurance  claims.  All  insurers  providing such insurance shall accept said standard claim forms  when  submitted  by  a hospital,  physician  or  other  health  care provider covering services rendered to an individual covered by the policy or when submitted by  an insured  covering  these  same  services.  Corporations  operating under article forty-three of this chapter shall be required  to  use  standard claim  forms  as  established  by  the  superintendent  pursuant to this section.  (b) The adoption of any uniform  claim  forms  by  the  superintendent pursuant  hereto  shall  not  preclude  an  insurer  from  obtaining any necessary additional information regarding a claim  from  the  claimant, provider of health care or treatment, or certifier of coverage.  (c) The superintendent is authorized and empowered to take such action as  he  deems  appropriate  for  the proper implementation hereof and to provide by rule and regulation that any form which does not comply  with the  provisions  of  this  section  shall not be issued or reissued. The rules and regulations so adopted shall specify an effective date,  which shall  not  be  less  than  one  hundred  eighty  days after the date of adoption or  promulgation,  after  which  no  insurer  may  require  any hospital,  physician,  other health care provider or insured to complete forms differing from those prescribed  by  the  superintendent  pursuant hereto,  other  than  additional  requests  for  information pursuant to subsection (b) hereof.