2023 New York Laws › ISC - Insurance › Article 42 - Life Insurance Companies and Accident and Health Insurance Companies and Legal Services Insurance Companies › 4224 - Life, Accident and Health Insurance; Discrimination and Rebating; Prohibited Inducements and Interdependent Sales.

§  4224.  Life,  accident  and  health  insurance;  discrimination and
rebating; prohibited inducements and interdependent sales. (a)  No  life
insurance  company  doing  business  in  this  state  and no savings and
insurance bank shall:
(1) make or permit any unfair discrimination  between  individuals  of
the  same  class  and  of  equal  expectation  of life, in the amount or
payment or return of premiums, or rates charged  for  policies  of  life
insurance  or  annuity  contracts, or in the dividends or other benefits
payable thereon, or in any of the terms and conditions thereof;
(2) refuse to insure, refuse  to  continue  to  insure  or  limit  the
amount, extent or kind of coverage available to an individual, or charge
a different rate for the same coverage solely because of the physical or
mental  disability,  impairment or disease, or prior history thereof, of
the insured or potential insured, except where the  refusal,  limitation
or  rate  differential is permitted by law or regulation and is based on
sound actuarial  principles  or  is  related  to  actual  or  reasonably
anticipated  experience,  in  which  case  the  insurer,  subject to the
limitations contained in  section  twenty-six  hundred  eleven  of  this
chapter,  shall  notify the insured or potential insured of the right to
receive, or to designate a medical professional to receive, the specific
reason or reasons for such refusal, limitation or rate differential;
(3) knowingly permit, and no agent thereof and no  licensed  insurance
broker  shall  offer  to  make  or make, any policy of life insurance or
annuity contract or agreement as to such policy or contract  other  than
as plainly expressed in the policy or contract.
(b) No insurer doing in this state the business of accident and health
insurance,  as specified in paragraph three of subsection (a) of section
one thousand one hundred thirteen of this chapter,  and  no  officer  or
agent  of such insurer and no licensed insurance broker, and no employee
or other representative of such insurer, agent or broker shall:
(1) make or permit any unfair discrimination  between  individuals  of
the  same class in the amount of premiums, policy fees, or rates charged
for any policy of accident and health  insurance,  or  in  the  benefits
payable  thereon, or in any of the terms or conditions of such policies,
or in any other manner whatsoever;
(2) refuse to insure, refuse  to  continue  to  insure  or  limit  the
amount, extent or kind of coverage available to an individual, or charge
a different rate for the same coverage solely because of the physical or
mental  disability,  impairment or disease, or prior history thereof, of
the insured or potential insured, except where the  refusal,  limitation
or  rate  differential is permitted by law or regulation and is based on
sound actuarial  principles  or  is  related  to  actual  or  reasonably
anticipated  experience,  in  which  case  the  insurer,  subject to the
limitations contained in  section  twenty-six  hundred  eleven  of  this
chapter  shall  notify  the insured or potential insured of the right to
receive, or to designate a medical professional to receive, the specific
reason or reasons for such refusal, limitation or rate differential;
(3) knowingly permit or offer to make or make, any policy of  accident
and health insurance, other than as plainly expressed in the policy.
(c)  Except  as  permitted  by  section  three  thousand  two  hundred
thirty-nine of this chapter or subsection (f) of this section,  no  such
life  insurance  company  and  no such savings and insurance bank and no
officer, agent, solicitor or representative thereof and no such  insurer
doing in this state the business of accident and health insurance and no
officer,  agent,  solicitor  or  representative thereof, and no licensed
insurance broker and no employee or other  representative  of  any  such
insurer,  agent  or  broker,  shall pay, allow or give, or offer to pay,
allow or give, directly or indirectly, as an inducement to any person to

insure, or shall give, sell or purchase,  or  offer  to  give,  sell  or
purchase,  as such inducement, or interdependent with any policy of life
insurance  or  annuity  contract  or  policy  of  accident  and   health
insurance,  any  stocks, bonds, or other securities, or any dividends or
profits accruing or to accrue thereon, or any valuable consideration  or
inducement  whatever not specified in such policy or contract other than
any valuable consideration, including but not limited to merchandise  or
periodical  subscriptions,  not  exceeding twenty-five dollars in value;
nor shall any person in this state knowingly receive as such inducement,
any rebate of premium or policy fee or any special favor or advantage in
the dividends or  other  benefits  to  accrue  on  any  such  policy  or
contract,  or  knowingly  receive  any  paid  employment or contract for
services of any  kind,  or  any  valuable  consideration  or  inducement
whatever which is not specified in such policy or contract.
(d)  (1)  No  insurer  authorized  to  do  one or more of the kinds of
insurance  business  specified  in  paragraph  one,  two  or  three   of
subsection  (a)  of  section  one  thousand one hundred thirteen of this
chapter or authorized to do the kind of insurance business specified  in
section  three  thousand  two  hundred  twenty-two of this chapter shall
directly or indirectly, or by any of its agents or  representatives,  or
by any broker or brokers, participate in any plan to offer or effect any
kind  or kinds of such insurance business in this state as an inducement
to, or interdependent with, the purchase by the  public  of  any  goods,
securities,   commodities,   housing,   services   or  subscriptions  to
periodicals, except as provided  by  subsection  (e)  of  section  three
thousand  four  hundred thirty-six, paragraph three of subsection (b) of
section  four  thousand  two  hundred  sixteen  of  this   article,   by
subparagraph  (E)  of  paragraph  one  of subsection (c) of section four
thousand two hundred thirty-five of this article or by article forty-six
of the public health law.
(2) This  subsection  shall  not  prohibit  payment  plans  which  are
otherwise in compliance with this subsection and this chapter.
(e)  This section shall not prohibit the giving by any company, in its
discretion,  of  medical  examinations  and  diagnoses  and  of  nursing
services to all or any part of its policyholders, under reasonable rules
and regulations.
(f)  (1)  This  subsection shall apply only with respect to a group or
blanket accident and  health  insurance  policy  issued  by  an  insurer
licensed to write accident and health insurance in this state or a group
contract   issued   by  a  corporation  organized  pursuant  to  article
forty-three of  this  chapter,  or  a  health  maintenance  organization
certified pursuant to article forty-four of the public health law.
(2)  Notwithstanding  subsection (c) of this section, a licensed agent
or insurance broker may  develop,  implement,  and  administer  wellness
programs  established  in  accordance  with  section  three thousand two
hundred thirty-nine of this chapter without charging a service  fee  or,
in  the  case  of a licensed insurance broker, for a reduced service fee
pursuant to a written memorandum made in accordance with subsection  (c)
of  section  two  thousand one hundred nineteen of this chapter, if such
programs are  provided  in  a  fair  and  nondiscriminatory  manner  and
incidental  to  a  group  or  blanket  policy  or  contract  sold by the
insurance agent or insurance broker.