NY Ins L § 5106 (2021)
2021 New York Laws ISC - Insurance Article 51 - Comprehensive Motor Vehicle Insurance Reparations 5106 - Fair Claims Settlement.

§  5106.  Fair claims settlement. (a) Payments of first party benefits and additional first party  benefits  shall  be  made  as  the  loss  is incurred.    Such  benefits  are  overdue if not paid within thirty days after the claimant supplies  proof  of  the  fact  and  amount  of  loss sustained.  If  proof is not supplied as to the entire claim, the amount which is supported by proof is overdue if not paid  within  thirty  days after  such  proof is supplied. All overdue payments shall bear interest at the rate of two percent per month. If a valid claim  or  portion  was overdue,  the  claimant shall also be entitled to recover his attorney's reasonable fee, for services necessarily performed  in  connection  with securing   payment   of   the  overdue  claim,  subject  to  limitations promulgated by the superintendent in regulations.  (b) Every  insurer  shall  provide  a  claimant  with  the  option  of submitting  any  dispute  involving the insurer's liability to pay first party benefits, or additional first party benefits, the  amount  thereof or  any  other matter which may arise pursuant to subsection (a) of this section  to  arbitration  pursuant  to  simplified  procedures   to   be promulgated   or   approved   by  the  superintendent.  Such  simplified procedures shall include an expedited eligibility hearing  option,  when required,  to designate the insurer for first party benefits pursuant to subsection (d) of this section. The expedited eligibility hearing option shall be a forum for eligibility disputes only, and  shall  not  include the submission of any particular bill, payment or claim for any specific benefit  for  adjudication,  nor  shall it consider any other defense to payment.  (c) An award by an arbitrator shall be binding except where vacated or modified by a master arbitrator in accordance with simplified procedures to be promulgated or approved by the  superintendent.  The  grounds  for vacating or modifying an arbitrator's award by a master arbitrator shall not  be  limited  to  those  grounds  for  review  set  forth in article seventy-five of the civil practice law and rules. The award of a  master arbitrator  shall be binding except for the grounds for review set forth in article seventy-five  of  the  civil  practice  law  and  rules,  and provided further that where the amount of such master arbitrator's award is   five  thousand  dollars  or  greater,  exclusive  of  interest  and attorney's fees, the insurer or  the  claimant  may  institute  a  court action to adjudicate the dispute de novo.  (d)  (1) Except as provided in paragraph two of this subsection, where there is reasonable belief more than one insurer would be the source  of first  party benefits, the insurers may agree among themselves, if there is a valid basis therefor, that one of them  will  accept  and  pay  the claim  initially.  If there is no such agreement, then the first insurer to whom notice of claim is given shall be responsible for  payment.  Any such  dispute  shall  be  resolved  in  accordance  with the arbitration procedures established pursuant to section  five  thousand  one  hundred five   of   this   article   and   regulations  as  promulgated  by  the superintendent, and any insurer paying  first-party  benefits  shall  be reimbursed  by other insurers for their proportionate share of the costs of the claim and the allocated expenses  of  processing  the  claim,  in accordance  with  the  provisions entitled "other coverage" contained in regulation and the provisions entitled  "other  sources  of  first-party benefits"  contained  in regulation. If there is no such insurer and the motor vehicle accident occurs in this state, then an applicant who is  a qualified  person  as defined in article fifty-two of this chapter shall institute the claim against the motor vehicle  accident  indemnification corporation.  (2)  A  group  policy  issued  pursuant to section three thousand four hundred fifty-five of this chapter shall provide  first  party  benefits  when  a  dispute  exists as to whether a driver was using or operating a motor vehicle in connection with a transportation network  company  when loss,  damage, injury, or death occurs. A transportation network company shall  notify  the  insurer  that issued the owner's policy of liability insurance of the dispute within ten business days of becoming aware that the dispute exists. When there is a dispute, the  group  insurer  liable for  the payment of first party benefits under a group policy shall have the right to recover the amount paid from the driver's  insurer  to  the extent  that  the  driver  would  have  been liable to pay damages in an action at law.