reglab/statecodes huggingface dataset:
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3224-D - Prescription Synchronization.

§  3224-d. Prescription synchronization. (a) Every individual or group
health  insurance  policy  providing  prescription  drug  coverage  when
applicable  to  permit  synchronization  shall  permit and apply a daily
pro-rated cost-sharing rate to prescriptions that  are  dispensed  by  a
network  pharmacy  for  less than a thirty day supply, when it is agreed
among  the  covered  individual,  a  health  care  practitioner,  and  a
pharmacist  that  synchronization  of  multiple  prescriptions  for  the
treatment of a chronic illness is in the best interest  of  the  covered
individual  for  the  management  or  treatment  of that chronic illness
provided that all of the following apply:
(i) The medications are covered by the policy or plan.
(ii) The medications are used for treatment and management of  chronic
conditions that are subject to refills.
(iii)  The medications are not a Schedule II controlled substance or a
Schedule III controlled substance containing hydrocodone.
(iv) The medications meet all prior authorization criteria specific to
medications at the time of the synchronization request.
(v) The medications are of a formulation that can be effectively split
over required short fill periods to achieve synchronization.
(vi) The medications do not have quantity limits or dose  optimization
criteria   or   requirements   that  would  be  violated  in  fulfilling
synchronization.
(b)  No  individual  or  group  health  insurance   policy   providing
prescription  drug  coverage shall deny coverage for the dispensing of a
medication for partial fill when it is for purposes of synchronizing the
patient's medications. When applicable to permit synchronization,  every
individual  or  group  health  insurance policy must allow a pharmacy to
override any denial  codes  indicating  that  a  prescription  is  being
refilled too soon for the purposes of medication synchronization.
(c)  Dispensing  fees  for  partially filled or refilled prescriptions
shall be paid in full for each prescription dispensed, regardless of any
pro-rated copay for the beneficiary or fee paid for alignment services.
(d) Nothing in this section shall be deemed  to  require  health  care
practitioners  and  pharmacists to synchronize the refilling of multiple
prescriptions for a covered individual.
(e) The requirements of this paragraph shall apply only once for  each
prescription  drug  subject  to  medication  synchronization except when
either of the following occurs:
(i) The prescriber changes the dosage or frequency  of  administration
of the prescription drug subject to a medication synchronization; or
(ii) The prescriber prescribes a different drug.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3225 - Eligibility for Health Insurance in Cases of Exposure to Des.

§  3225. Eligibility for health insurance in cases of exposure to DES.
  No policy of accident or health insurance, or group or blanket  accident
  or  health insurance or renewals thereof shall be denied or cancelled by
  the insurer, solely because the  insured  person  has  been  exposed  to
  diethylstilbestrol, commonly referred to as DES.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3227 - Interest Upon Surrenders, Policy Loans and Other Funds.

§  3227.  Interest  upon surrenders, policy loans and other funds. (a)
Interest, at the rate provided for in section three thousand two hundred
fourteen of this article, shall be payable by life  insurers,  fraternal
benefit societies, and life insurance departments of savings banks upon:
(1)  the value of policies surrendered by policyholders for cash values,
including the rollover of annuity funds to other entities, and  (2)  the
funds disbursed as policy loans. Such interest payment shall be added to
and  be a part of the total sum paid or be paid separately at the option
of the insurer.
(b) The interest calculated on amounts described in paragraphs one and
two of subsection (a) hereof shall  be  calculated  from  the  date  the
documentation  necessary  to complete the transaction is received by the
insurer and shall be payable if the funds are not mailed or delivered by
the insurer within ten working days of said receipt.
(c) No interest need be payable pursuant to this  section  unless  the
amount  of  such  interest  is  at  least  twenty-five dollars or if the
payment of benefits by the insurer has been deferred pursuant  to  other
provisions of this chapter.
(d)  Irrespective  of  the  payment of interest in accordance with the
above provisions, such life insurers, fraternal  benefit  societies  and
life  insurance  departments  of  savings banks shall make disbursements
under paragraphs one and two of subsection (a) hereof  as  expeditiously
as possible.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3228 - Individual Accident and Health Insurance Policies; Premium Refund at Death of Insured.

§  3228.  Individual  accident  and health insurance policies; premium
  refund at death of insured. If the death of the  insured  or  a  covered
  dependent  occurs  during  a  period  for  which  the  premium  under an
  individual accident and health  insurance  policy  has  been  paid,  the
  insurer  shall refund the premium or the portion of the premium actually
  paid by the insured for that person for any period beyond the end of the
  policy month in which such death occurred.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3229 - Minimum Benefit Standards for Certain Long Term Care Plans.

§  3229.  Minimum  benefit standards for certain long term care plans.
(a) The minimum standards for an insurance plan, which may qualify under
the partnership for long term care program  pursuant  to  section  three
hundred  sixty-seven-f  of the social services law, shall be established
by  regulations  of  the  superintendent,  in  consultation   with   the
commissioner  of  health  and  the  director of the state office for the
aging, as approved by the director of the budget, which shall require at
a minimum (1) a residential health care facility benefit in an amount to
be determined by the regulations of the superintendent; (2) a home  care
benefit  with  personal  care,  nursing  care, adult day health care and
respite care services, which shall provide total benefits in  an  amount
determined  by  regulations  of  the  superintendent;  (3) a duration of
benefits not less than twelve months; and (4) arrangements  through  the
insurance  plan  for managed care including preauthorized assessment and
referral programs, utilization controls and use of approved providers.
(b) In establishing minimum  benefit  standards  for  insurance  plans
pursuant  to  this  section, the superintendent shall seek to ensure the
cost effectiveness  of  the  partnership  for  long  term  care  program
established  pursuant  to  section  three  hundred  sixty-seven-f of the
social services law, and  may  establish  minimum  permissible  payments
under  such  insurance  plans.  The  superintendent shall not approve an
insurance plan which includes an exclusion for  pre-existing  conditions
that  exceeds six months, or which does not comply with paragraph six of
subsection (b) of section one thousand one  hundred  seventeen  of  this
chapter.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3231*2 - Health Insurance Policies and Subscriber Contracts; Prohibited Claims.

* §   3231.   Health  insurance  policies  and  subscriber  contracts;
prohibited claims. (a) For the purposes of this section the terms health
care provider,  practitioner,  clinical  laboratory  services,  pharmacy
services, radiation therapy services, physical therapy services or x-ray
or  imaging  services  shall  have the same meanings as are set forth in
section two hundred thirty-eight of the public health law.
(b) No health care provider or practitioner may demand or request  any
payment  for  clinical laboratory services, pharmacy services, radiation
therapy services, physical therapy services or x-ray or imaging services
furnished pursuant to  a  referral  prohibited  by  subdivision  one  of
section two hundred thirty-eight-a of the public health law.
(c)  No  insurer  shall  be  required  to pay any claim, bill or other
demand or request for payment by a health  care  provider  for  clinical
laboratory  services,  pharmacy  services,  radiation  therapy services,
physical  therapy  services  or  x-ray  or  imaging  services  furnished
pursuant  to  a  referral  prohibited  by subdivision one of section two
hundred thirty-eight-a of the public health law.
(d)  Every  policy  of  accident  or  health  insurance  issued  by  a
commercial  insurer  and  every subscriber contract issued by a hospital
service corporation,  health  service  corporation  or  medical  expense
indemnity  corporation  which  provides coverage for clinical laboratory
services,  pharmacy  services,  radiation  therapy  services,   physical
therapy  services or x-ray or imaging services shall include a provision
excluding payment of any claim, bill or  other  demand  or  request  for
payment for such services furnished pursuant to a referral prohibited by
subdivision  one  of  section  two  hundred thirty-eight-a of the public
health law.
(e) Every insurer subject to the  provisions  of  this  section  shall
report  to  the  commissioner  of  health  any  pattern of submission of
claims, bills or other demands or  requests  for  payment  submitted  in
violation  of  subsection  (b) of this section, within thirty days after
such insurer has knowledge of such pattern.
(f) Notwithstanding the requirements of subsections (c), (d)  and  (e)
of   this  section,  an  insurer  reimbursing  for  clinical  laboratory
services,  pharmacy  services,  radiation  therapy  services,   physical
therapy  services  or x-ray or imaging services is not required to audit
or investigate any claim, bill or other demand or  request  for  payment
for such items or services furnished pursuant to a referral.
* NB There are 2 § 3231's
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3232-A - Certification of Creditable Coverage.

§  3232-a. Certification of creditable coverage. (a) Every insurer who
delivers or issues for delivery individual health insurance policies  or
group or blanket accident and health insurance policies shall provide to
covered   individuals   written   certification,   in   a  form  as  the
superintendent may approve, of:
(1) the period of creditable coverage, as  defined  in  section  three
thousand two hundred thirty-two of this article, of the individual under
such  policy and any continuation coverage of the individual pursuant to
state or federal law; and
(2) any waiting period or affiliation period (if  applicable)  imposed
with respect to the individual for any coverage under the policy.
(b) The insurer shall provide such written certification:
(1)  at  the time an individual ceases to be covered under the policy,
including any period of time such individual was covered pursuant to any
right of continuation under such policy; and
(2) on the request on behalf of an  individual  made  not  later  than
twenty-four months after the date of cessation of the coverage described
in paragraph one of this subsection.
(c)  In  the event of an election by an insurer or a group health plan
to count the period of creditable coverage based on coverage of benefits
within classes or categories of benefits as provided in state or federal
law, if that insurer or group health  plan  enrolls  an  individual  for
coverage  under  its policy or plan and such individual provides written
certification of coverage of the individual pursuant to  subsection  (a)
of this section, then upon request of such insurer or group health plan,
the insurer that issued the certification of coverage so provided by the
individual  shall  promptly disclose to such requesting insurer or group
health plan information on coverage of classes and categories of  health
benefits   available  under  its  policy.  An  insurer  disclosing  such
information may charge the requesting plan or insurer for the reasonable
cost of such disclosure.
(d) An insurer who delivers or issues for delivery  group  or  blanket
accident  and  health insurance policies is deemed to have satisfied the
requirements of subsection (a) of this section if  the  policyholder  by
written  agreement  with  the  insurer  actually  provides  the  written
certification in accordance with this section.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3234 - Pre-Existing Condition Provisions in Group and Blanket Disability Policies.

* §  3234.  Pre-existing  condition  provisions  in  group and blanket
disability policies. (a) Every group or blanket policy issued or  issued
for  delivery  in  this  state  which provides benefits by reason of the
disability of the insured and which includes  a  pre-existing  condition
provision   shall  contain  in  substance  the  following  provision  or
provisions which in the opinion of the superintendent are more favorable
to the members of the group:
(1) In determining whether a pre-existing condition provision  applies
to  an  eligible  person,  the  group or blanket disability policy shall
credit the time the person was previously covered under a previous group
or blanket disability insurance  plan  or  policy  or  employer-provided
disability  benefit arrangement, if the previous coverage was continuous
to a date not more than sixty days prior to the effective  date  of  the
new  coverage.  The  credit  shall apply to the extent that the previous
coverage or level of benefits  was  substantially  similar  to  the  new
coverage or level of benefits; and
(2)  No  pre-existing condition provision shall exclude coverage for a
period in excess of  twelve  months  following  the  effective  date  of
coverage for the covered person.
(b)  Nothing  herein  shall  be  construed  to prohibit or restrict an
insurer from utilizing other forms of underwriting for  the  members  of
the  group  in  lieu  of,  or in addition to, the pre-existing condition
provision described in subsection (a) of this section.
* NB There are 2 § 3234's
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3234*2 - Limitations on Administrative Services and Stop-Loss Coverage.

* §   3234.  Limitations  on  administrative  services  and  stop-loss
  coverage.  No insurer, subsidiary of an insurer, or controlled person of
  a holding company system may act as an administrator  or  claims  paying
  agent,  as  opposed  to an insurer, on behalf of a group which denies or
  limits benefits for a specific disease or condition or for  a  procedure
  or treatment unique to a specific disease or condition in a manner which
  would  be  inconsistent  with this chapter or regulations promulgated by
  the superintendent  had  the  group  purchased  insurance.  No  insurer,
  subsidiary  of an insurer, or controlled person of a holding company may
  provide stop loss, catastrophic or reinsurance coverage to groups  which
  deny  or  limit  benefits  for  a specific disease or condition or for a
  procedure or treatment unique to a specific disease or  condition  in  a
  manner  which  would  be  inconsistent  with this chapter or regulations
  promulgated by the superintendent had the group purchased  insurance.  A
  limit,  maximum, or other mechanism that controls total coverage without
  regard to a specific disease or condition shall not be deemed  one  that
  denies  or limits benefits for a specific disease or condition, or for a
  procedure or treatment  unique  to  a  specific  disease  or  condition.
  Nothing  herein shall be construed to mandate the inclusion of specified
  benefits in an employer group plan, if such plan is not subject  to  the
  provisions of this chapter.
* NB There are 2 § 3234's
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3236 - Public Health Law Assessments.

§  3236. Public health law assessments.  Any insurer licensed pursuant
to this  chapter  and  any  health  maintenance  organization  certified
pursuant  to  article  forty-four  of  the public health law or licensed
pursuant to this chapter shall reflect the methodology for financing the
costs of graduate medical education in general hospitals and  affiliated
sites,  uncompensated  care  in  general  hospitals  and  diagnostic and
treatment centers, and  other  publicly  financed  programs  established
pursuant  to sections twenty-eight hundred seven-j, twenty-eight hundred
seven-k, twenty-eight hundred  seven-l,  twenty-eight  hundred  seven-m,
twenty-eight   hundred   seven-p,   twenty-eight   hundred  seven-s  and
twenty-eight hundred seven-t of the public health law for  hospital  and
other health care services provided on and after January first, nineteen
hundred   ninety-seven   in   policies   and   contracts  which  provide
reimbursement for, and in  arrangements  reflecting  anticipated  claims
costs for, any of the following services:
(a)  inpatient hospital services provided by a general hospital issued
an operating certificate pursuant to article twenty-eight of the  public
health law;
(b) outpatient hospital services provided by a general hospital issued
an  operating certificate pursuant to article twenty-eight of the public
health law;
(c) emergency services  provided  by  a  general  hospital  issued  an
operating  certificate  pursuant  to  article twenty-eight of the public
health law;
(d) ambulatory surgical services provided by a general hospital issued
an operating certificate pursuant to article twenty-eight of the  public
health law;
(e)   ambulatory  surgical  services  provided  by  a  diagnostic  and
treatment center issued an operating  certificate  pursuant  to  article
twenty-eight of the public health law;
(f) health care services provided by a diagnostic and treatment center
issued  an operating certificate pursuant to article twenty-eight of the
public health law;
(g) clinical laboratory services provided  by  a  clinical  laboratory
issued  a  permit  pursuant  to title five of article five of the public
health law.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3237 - Health Insurance Coverage for Full-Time Students on Medical Leaves of Absence.

§  3237.  Health  insurance coverage for full-time students on medical
leaves of absence. (a) Every  individual  health  insurance  policy  and
every  group  or  blanket  accident  and  health  insurance  policy that
provides coverage for dependent children who are full-time students to a
higher age than other dependent children shall continue the coverage  of
a covered dependent student who takes a leave of absence from school due
to illness for a period of twelve months from the last day of attendance
in school, provided, however, that nothing in this section shall require
coverage  of  a dependent student beyond the age at which coverage would
otherwise terminate.
(b) In order to qualify under this section, the medical necessity of a
leave of absence from school must  be  certified  to  by  the  student's
attending  physician  who  is  licensed  to practice in the state of New
York. Written documentation of the illness  must  be  submitted  to  the
insurer.
(c)  The  rate charged for such extended coverage shall be the same as
that charged while the dependent is enrolled as a full-time student.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3243 - Discrimination Because of Sex or Marital Status in Hospital, Surgical or Medical Expense Insurance.

§  3243.  Discrimination because of sex or marital status in hospital,
surgical or medical expense insurance. (a) With regard  to  an  accident
and health insurance policy that provides hospital, surgical, or medical
expense  coverage  or a policy of student accident and health insurance,
as defined in subsection (a) of section three thousand two hundred forty
of this article, delivered or issued for  delivery  in  this  state,  no
insurer  shall  because  of  sex,  marital status or based on pregnancy,
false  pregnancy,  termination  of  pregnancy,  or  recovery  therefrom,
childbirth or related medical conditions:
(1)  make  any distinction or discrimination between persons as to the
premiums or rates  charged  for  the  policy  or  in  any  other  manner
whatever;
(2)  demand  or  require  a  greater  premium  from any person than it
requires at that time from others in similar cases;
(3) make or require any rebate, discrimination or  discount  upon  the
amount to be paid or the service to be rendered on any policy;
(4)  insert  in  the  policy  any  condition, or make any stipulation,
whereby the  insured  binds  his  or  herself,  or  his  or  her  heirs,
executors,  administrators or assigns, to accept any sum or service less
than the full value or amount of such policy in case of a claim  thereon
except  such  conditions  and stipulations as are imposed upon others in
similar cases; and any such stipulation or condition so made or inserted
shall be void;
(5) reject any application for a policy issued or sold by it;
(6) cancel or refuse  to  issue,  renew  or  sell  such  policy  after
appropriate application therefor;
(7)  fix  any lower rate or discriminate in the fees or commissions of
insurance agents or insurance brokers for writing  or  renewing  such  a
policy; or
(8) engage in sexual stereotyping.
(b)  For  the  purposes  of  this  section, "sex" shall include sexual
orientation, gender identity or expression, and transgender status.
2023 New York Laws › ISC - Insurance › Article 32 - Insurance Contracts - Life, Accident and Health, Annuities › 3245 - Liability to Providers in the Event of an Insolvency.

§  3245.  Liability to providers in the event of an insolvency. In the
  event an insurance company authorized  to  do  an  accident  and  health
  insurance  business  in  this  state is deemed insolvent, as provided in
  section one thousand three hundred nine  of  this  chapter,  no  insured
  covered under a policy delivered or issued for delivery in this state by
  the  insurance  company  shall  be liable to any provider of health care
  services for any covered services of the insolvent insurance company. No
  provider of health care services or any representative of such  provider
  shall  collect  or attempt to collect from the insured sums owed by such
  insurance company, and no provider or representative  of  such  provider
  may  maintain  any action at law against an insured to collect sums owed
  to such provider by such insurance company.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3401 - Insurable Interest in Property.

§  3401.  Insurable  interest  in  property.  No contract or policy of
  insurance on property made or issued in this state, or  made  or  issued
  upon  any  property  in  this state, shall be enforceable except for the
  benefit of some person having an  insurable  interest  in  the  property
  insured.  In this article, "insurable interest" shall include any lawful
  and substantial economic interest  in  the  safety  or  preservation  of
  property from loss, destruction or pecuniary damage.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3402 - Executory Contract Not a Change in Interest, Title or Possession.

§  3402.  Executory  contract  not  a  change  in  interest,  title or
  possession. The making of  a  contract  to  sell  or  to  exchange  real
  property  shall  not  constitute  a  change  in  the  interest, title or
  possession, within the meaning  of  the  applicable  provisions  of  any
  contract of fire insurance, including any contract supplemental thereto,
  covering property located in this state.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3405 - Fire Insurance Contract; Losses From Nuclear Reaction or Radiation.

§  3405.  Fire  insurance  contract;  losses  from nuclear reaction or
radiation. (a) Insurers  issuing  the  standard  fire  insurance  policy
pursuant to section three thousand four hundred four of this article are
authorized  to  affix  or include in the policy a written statement that
such policy does not cover loss or damage caused by nuclear reaction  or
nuclear  radiation or radioactive contamination, all whether directly or
indirectly resulting from an insured peril under such policy.
(b) This section shall not prohibit the attachment to any such  policy
of  an  endorsement  specifically  assuming  coverage for loss or damage
caused  by  nuclear  reaction  or  nuclear  radiation   or   radioactive
contamination.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3406 - Copy of Examination of Insured to Be Delivered to Insured.

§ 3406. Copy of examination of insured to be delivered to insured. (a)
If  any  policy  or  contract  of  insurance  against  loss or damage to
property located in this state  contains  any  provision  requiring  the
insured to permit any examination by the insurer of the insured, or of a
member of his family, or of any employee of the insured, and if any such
examination takes place and is reduced to writing, whether or not signed
by the insured or by such person so examined, such insurer shall, within
ten days from the time when the insured shall have requested the same in
writing,  deliver  to the insured a copy of such  examination so reduced
to writing.
(b) If such copy is not delivered to the insured as required, no  part
of  the  examination shall be used by the insurer as a part of the proof
of loss or damage or as evidence in any action or proceeding based  upon
or involving such policy or contract.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3407 - Property Insurance; Proofs of Loss; Notice of Loss.

§  3407.  Property  insurance; proofs of loss; notice of loss. (a) The
failure of any person insured against loss or damage to  property  under
any contract of insurance, issued or delivered in this state or covering
property located in this state, to furnish proofs of loss to the insurer
or  insurers  as  specified  in  such  contract  shall not invalidate or
diminish any claim of such person insured under  such  contract,  unless
such  insurer or insurers shall, after such loss or damage, give to such
insured a written notice that it or they desire proofs  of  loss  to  be
furnished  by  such  insured  to  such insurer or insurers on a suitable
blank form or forms. If the insured shall furnish proofs of loss  within
sixty  days  after the receipt of such notice and such form or forms, or
within any longer period of time specified in such notice, such  insured
shall be deemed to have complied with the provisions of such contract of
insurance relating to the time within which proofs of loss are required.
Neither  the giving of such notice nor the furnishing of such blank form
or forms by the insurer shall constitute a waiver of any stipulation  or
condition of such contract, or an admission of liability thereunder.
(b)  If  any  contract of insurance issued or delivered in this state,
covering loss of or damage to property by fire provides that the insured
give immediate notice, in writing,  to  the  insurer,  of  any  loss  or
damage, it shall be sufficient compliance if immediate written notice is
given,  by  or  on  behalf  of the insured, to any licensed agent of the
insurer in this state,  with  particulars  sufficient  to  identify  the
insured  and  the property insured under such contract and to notify the
insurer of the time and place of such loss or damage.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3407-A - Property/casualty Insurance Contract and Policy Standard Provisions.

§  3407-a.  Property/casualty  insurance  contract and policy standard
  provisions. No property/casualty insurance policy or contract  shall  be
  issued  or  issued  for  delivery  on a risk located or resident in this
  state insuring against damage to the insured's real property  unless  it
  contains  in  substance  the following provision or a provision which is
  equal or more favorable to the insured: a provision that in the event of
  a pending claim for damage to real property, upon request,  the  insurer
  shall furnish to the insured's representative, designated in writing, or
  if  none  has  been  designated,  to  the insured, a copy of any written
  estimate or estimates of the cost of damages to real property  resulting
  from  the  loss which the insurer has independently prepared for its own
  purposes, or had prepared on its behalf for its own purposes, specifying
  all appropriate deductions, within thirty  days  after  the  request  or
  preparation,  whichever  is  later,  of  such  estimate or estimates. An
  insurer shall not be required to  provide  an  estimate  on  claims  for
  damages to real property unless it has independently prepared one or had
  one prepared on its behalf for the insurer's own purposes.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3408 - Fire Insurance; Appraisal of Loss; Procedure for Selection of Umpire on Failure to Agree.

§  3408. Fire insurance; appraisal of loss; procedure for selection of
umpire on failure to agree. (a) Whenever application shall be  made  for
the  selection  of  an  umpire  pursuant  to  the provisions relating to
appraisals contained in the standard fire insurance policy of the  state
of  New York it shall be made to a justice of the supreme court residing
in the county or to a county judge of the county in which  the  lost  or
damaged  property  is  or  was located. The application shall be on five
days' notice in writing to the other party. Any such notice in  writing,
when  served  by  the insured, may be served upon any local agent of the
insurer.
(b) The court shall, on proof by affidavit of the failure  or  neglect
of  the  appraisers  to  agree upon and select an umpire within the time
provided in such policy, and  of  the  service  of  notice  pursuant  to
subsection  (a)  hereof, forthwith appoint a competent and disinterested
person to act as such umpire in the ascertainment of the amount of  such
loss or damage.
(c)  In  the  event  of a covered loss, whenever an insured or insurer
fails to proceed with an appraisal upon  demand  of  the  other,  either
party may apply to the court in the manner provided in subsection (a) of
this  section  for  an  order  directing  the  other to comply with such
demand.  An  appraisal  shall  determine  the  actual  cash  value,  the
replacement cost, the extent of the loss or damage and the amount of the
loss  or damage which shall be determined as specified in the policy and
shall proceed pursuant to the terms of the applicable  appraisal  clause
of  the  insurance policy and not as an arbitration. Notwithstanding the
provisions of this subsection, an appraisal shall not determine  whether
the  policy  actually  provides  coverage for any portion of the claimed
loss or damage.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3409 - Distribution of Hazardous Material Report Forms.

§   3409.   Distribution  of  hazardous  material  report  forms.  The
  superintendent shall require every insurance company issuing a policy of
  fire insurance against a risk located in this state to annually issue to
  each of its fire insurance policyholders   engaged in commerce  in  this
  state  a  suitable  supply  of  forms  supplied  by  the  office of fire
  prevention and control for reporting the presence of hazardous materials
  as required by section two hundred nine-u of the general municipal law.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3410 - Fire Insurance Contract; Payment of Liens on Proceeds; Certain Cases.

§ 3410. Fire insurance contract; payment of liens on proceeds; certain
cases. (a) Every fire insurance policy insuring the interest of an owner
pursuant  to  this  article shall include a statement that, prior to the
payment of any proceeds thereunder otherwise payable to the insured  for
damages  resulting  to  the premises from a loss occasioned by fire, the
insurer will deduct and pay the claim of any tax district which  renders
a  certificate  of  lien  pursuant  to  the  provisions of section three
hundred thirty-one of this chapter.
(b) Such statement shall further relate that upon the payment of  such
claim the insurer shall, to the extent of such payment, be released from
any  obligation  to  pay the same to the insured and that the payment of
any such claim within thirty days of  receipt  by  the  insurer  of  the
certificate  of  lien  shall,  as  between  the insured and the insurer,
operate as a conclusive  presumption  that  such  claim  was  valid  and
properly paid.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3413 - Standard Claim Forms for Fire Losses.

§  3413.  Standard  claim  forms for fire losses. (a) (1) On or before
April first,  nineteen  hundred  eighty-two,  the  superintendent  shall
establish  a  standard  claim  form  to be used for all fire loss claims
under an insurance policy which is issued or issued for delivery in this
state covering such losses for property located in this state.
(2) The superintendent shall investigate and review claim forms  which
are currently utilized prior to establishing such standard claim form.
(3)  All  insurers  shall  require  the  completion  and filing of the
standard claim form.
(b) The adoption of such standard claim  form  by  the  superintendent
shall  not  preclude  an insurer from obtaining any necessary additional
information regarding a claim from the claimant or any other source.
(c) (1) The superintendent is authorized and empowered  to  take  such
action as he shall deem appropriate for the proper implementation hereof
and  to  provide  by regulation that any form which does not comply with
this section shall not be issued or reissued.
(2) The regulation so promulgated shall  specify  an  effective  date,
which  shall  not be less than one hundred eighty days after the date of
promulgation, after  which  no  insurer  may  require  any  claimant  to
complete a form differing from the one prescribed by the superintendent,
other  than  additional  requests for information pursuant to subsection
(b) of this section.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3414 - Reports by Insurers of Certain Casualty Loss on Property Owned or Operated by Religious Organizations.

§ 3414. Reports by insurers of certain casualty loss on property owned
or  operated  by  religious organizations. (a) Insurers shall report all
claims in excess of two hundred fifty dollars filed for casualty  losses
resulting  from  desecration,  vandalism and theft of religious articles
sustained by a "Religious Corporations Law  corporation",  "incorporated
church" or "unincorporated church", as such terms are defined in section
two  of  the  religious  corporations  law,  to the division of criminal
justice services for a period  of  twelve  months  commencing  with  the
effective  date  of the rules and regulations required to be promulgated
pursuant to subsection (b) of this section.
(b) Such division shall promulgate rules and regulations within ninety
days of the effective date of this section  detailing  the  contents  of
such reports which shall require at least the following information:
(1) name and address of the claimant;
(2) nature, substance and approximate dollar value of the claim;
(3) date and specific place in which the claim arose.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3421 - Homeowners' Liability Insurance; Dogs.

§  3421.  Homeowners'  liability  insurance;  dogs. 1. With respect to
  homeowners' insurance policies as defined in section two thousand  three
  hundred  fifty-one  of this chapter, no insurer shall refuse to issue or
  renew, cancel, or charge or impose an increased premium or rate for such
  policy or contract, or exclude,  limit,  restrict,  or  reduce  coverage
  under  such policy or contract based solely upon harboring or owning any
  dog of a specific breed or mixture of breeds.
2. The provisions of this section shall not prohibit an  insurer  from
  refusing  to  issue  or  renew  or  from  canceling any such contract or
  policy, nor from imposing a reasonably increased  premium  or  rate  for
  such  a  policy  or  contract based upon the designation of a dog of any
  breed or mixture of breeds as a dangerous dog pursuant  to  section  one
  hundred  twenty-three of the agriculture and markets law, based on sound
  underwriting and actuarial principles reasonably related  to  actual  or
  anticipated  loss  experience  subject  to  the applicable provisions of
  section three thousand four hundred twenty-five of this article.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3422 - Hate Crimes; Coverage Refusal.

§  3422.  Hate  crimes;  coverage  refusal.  (a)  For purposes of this
section, "insured" means a current policyholder or a  person  or  entity
that is covered under an insurance policy.
(b)  This  section shall apply to policies of insurance if the insured
or proposed insured is:
(1) an individual;
(2) a business entity that is independently  owned  and  operated  and
employs one hundred or fewer individuals;
(3) a religious organization;
(4) an educational organization; or
(5)  any  other  nonprofit organization that is organized and operated
for religious, charitable or educational purposes.
(c) An insurer that issues or delivers a policy in  this  state  shall
not cancel, refuse to issue, refuse to renew, or increase the premium of
a  policy  or  exclude,  limit,  restrict, or reduce coverage under such
policy solely on the basis that  one  or  more  claims  have  been  made
against  any policy during the preceding sixty months for a loss that is
the result of a hate crime, as defined pursuant to article four  hundred
eighty-five  of  the penal law, committed against the person or property
insured if the named insured provides evidence to the insurer  that  the
act  causing  such  loss is a result of a hate crime and that an insured
was not the perpetrator of the hate crime.
(d) Nothing in this section shall prohibit an insurer from  canceling,
refusing  to  renew,  increasing  the  premium of an insurance policy or
excluding, limiting, restricting, or reducing coverage under such policy
due to other factors that are permitted by any  other  section  of  this
chapter,  including  the factors set forth in section two thousand three
hundred three of this chapter.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3429 - Geographical Location of Risks; Fire, Fire and Extended Coverage Policies; Private Passenger Automobile Insurance Policies.

§  3429.  Geographical  location  of  risks;  fire,  fire and extended
coverage policies; private passenger automobile insurance policies.  (a)
No insurer shall refuse to issue or renew or shall cancel a policy of:
(1) fire insurance or fire and extended coverage insurance, or
(2)  automobile  insurance  subject  to  section  three  thousand four
hundred twenty-five of this article
based solely on the geographical location of the risk within this state.
Such prohibition shall not preclude an insurer from refusing to issue or
renew or from cancelling such policies based on sound  underwriting  and
actuarial  principles  reasonably  related to actual or anticipated loss
experience  subject  to  the  applicable  provisions  of  section  three
thousand four hundred twenty-five of this article.
(b)  The  superintendent shall by regulation establish procedures with
respect to notification to insureds of the insurer's specific reason  or
reasons  for  refusal  to  issue  or  renew  or for cancellation of such
policy.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3429-A - Geographical Location of Risks in Area Serviced by a Volunteer Fire Department; Fire, Fire and Extended Coverage Policies.

§  3429-a.  Geographical  location  of  risks  in  area  serviced by a
volunteer fire department; fire, fire and  extended  coverage  policies.
(a)  No  insurer  shall  refuse  to  issue  or  renew  or shall cancel a
homeowner's insurance  policy  including  fire  insurance  or  fire  and
extended  coverage  insurance based solely on the insured residing in an
area that is serviced by a volunteer fire department.  Such  prohibition
shall  not  preclude  an insurer from refusing to issue or renew or from
canceling such  policies  based  on  sound  underwriting  and  actuarial
principles  reasonably  related to actual or anticipated loss experience
subject to the applicable provisions  of  section  three  thousand  four
hundred twenty-five of this article.
(b)  The  superintendent shall by regulation establish procedures with
respect to notification to insureds of the insurer's specific reason  or
reasons  for  refusal  to  issue  or  renew  or for cancellation of such
policy.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3430 - Right of Insured, Agent or Broker Aggrieved on Basis of Geographical Location of Property or Risks.

§  3430.  Right  of  insured,  agent  or  broker aggrieved on basis of
geographical location of property or risks. (a) An insured aggrieved  by
an inability to obtain:
(1)  homeowner's  insurance,  including  fire  insurance  or  fire and
extended coverage insurance, other  than  from  the  New  York  property
insurance underwriting association, or
(2)  automobile  insurance  subject  to  section  three  thousand four
hundred twenty-five of this article, other than  through  the  New  York
automobile insurance plan,
from any insurer or through any insurance agent or broker because of the
geographical  location  of  the  risk  or property within the state or a
licensed agent or broker whose contract or account was terminated or not
renewed because of the geographical location of the agent or  broker  or
the  geographical  location  of  the  risks  within  the state for which
coverage is afforded through the agent or broker and the  grievance  was
not  the  result  of the application of sound underwriting and actuarial
principles reasonably related to actual or anticipated  loss  experience
may  file  a  complaint to that effect with the superintendent on a form
prescribed by him.
(b) The superintendent shall investigate  the  complaint  pursuant  to
rules and regulations promulgated by him. In addition to any other power
or  procedure authorized by this chapter, the superintendent may require
the physical inspection of the risk or property or hold  a  hearing,  or
both,  for  the  purpose  of  assisting  him in his determination of the
issues raised by the complaint.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3431 - Immunity; Insurers' Reports to Insureds, to Applicants for Insurance and to Terminated Agents or Brokers.

§  3431.  Immunity;  insurers'  reports to insureds, to applicants for
insurance and to terminated agents or brokers. (a) In any written notice
of:
(1) refusal to issue,
(2) cancellation,
(3) reduction of limits,
(4) substitution of policy form,
(5) elimination of coverages,
(6) conditioned renewal,
(7) non-renewal, or
(8) termination or refusal  to  renew  a  contract  or  account  of  a
licensed  agent  or  broker,  or  in  any  other  communication, oral or
written, specifying the reasons for  such  action,  there  shall  be  no
liability  on  the  part  of, and no cause of action of any nature shall
arise against any insurer, its authorized  representatives,  agents,  or
employees or any licensed agent or broker for any statement made in good
faith  by any of them or for providing information pertaining thereto or
for statements made or evidence submitted at any hearings in  connection
therewith.
(b)  Subsection  (a) hereof shall provide immunity with respect to all
obligations and duties performed pursuant  to  sections  three  thousand
four  hundred twenty-five, three thousand four hundred twenty-six, three
thousand four  hundred  twenty-nine  and  three  thousand  four  hundred
thirty-three of this article.
(c) Notwithstanding subsection (a) hereof in the case of any statement
made  pursuant to section three thousand four hundred twenty-six of this
article, there shall be no liability unless the statement  is  shown  to
have been in bad faith and with malice in fact.
2023 New York Laws › ISC - Insurance › Article 34 - Insurance Contracts-Property/casualty › 3432 - Immunity; Reports to Certain Public Officials and to Designated Organizations.

§   3432.  Immunity;  reports  to  certain  public  officials  and  to
designated organizations. (a) In the absence  of  fraud  or  bad  faith,
there  shall  be  no liability on the part of, and no cause of action of
any nature shall arise against, an insurer or a hospital or  any  person
acting on their behalf, with respect to obligations and duties performed
pursuant to the sections referred to in subsection (b) hereof.
(b) The immunity shall apply to:
(1) reports and statements, made in good faith, to the commissioner of
motor vehicles required by subsection (l) of section three thousand four
hundred eleven of this article;
(2)    information,    reports,   notification   and   assistance   in
investigations, made in the absence of fraud or bad faith,  pursuant  to
section  three  thousand  four  hundred  twelve of this article and this
immunity  extends  to  a  central   organization   designated   by   the
superintendent  pursuant  to  such  section  or any person acting on its
behalf;
(3) reports required by section three hundred fifteen of this chapter,
made in good faith (which shall be presumed)  and  without  malice,  and
this immunity includes any liability, civil or criminal;
(4)  information, reports, assistance in investigations, notification,
made in the absence of  fraud  or  bad  faith,  to  any  authorized  law
enforcement  agency  pursuant  to section three hundred nineteen of this
chapter, and this immunity, civil or criminal, extends to an  authorized
law  enforcement  agency defined in such section or any person acting on
its behalf; and
(5) reports  required  by  section  three  hundred  eighteen  of  this
chapter,  made  in  the  absence  of  fraud  or  bad faith, to a central
organization designated by the superintendent, and this immunity extends
to the central organization or any person acting on its behalf.
(6) information required by the insurer or provided by the insurer  in
the  absence  of fraud or bad faith to a local fire investigation agency
pursuant to section three thousand four hundred fifteen of this article.