2023 New York Laws › ISC - Insurance › Article 23 - Property/casualty Insurance Rates › 2319 - Information to Be Furnished Insureds; Aggrieved Person.

§  2319.  Information  to be furnished insureds; aggrieved person. (a)
Every insurer and rate service organization shall  within  a  reasonable
time  after  receiving  written  request therefor, and upon payment of a
reasonable charge, furnish to any insured affected by a rate made by it,
or to the  authorized  representative  of  the  insured,  all  pertinent
information as to the rate.
(b)  Except  as  provided  in  subsection  (c)  of this section, every
insurer or rate service organization shall  provide  within  this  state
reasonable  means whereby any person aggrieved by the application of its
rating  system  may  be  heard,  in   person   or   by   an   authorized
representative,  on  written  request to review the manner in which such
rating system has been applied in connection with the insurance afforded
or offered. If the insurer or rate service organization fails  to  grant
or  reject  the request within thirty days, applicant may proceed in the
same manner as if the application had been rejected. Any party  affected
by the action of the insurer or rate service organization on the request
may within thirty days after written notice of such action appeal to the
superintendent,  who,  after  a hearing held upon not less than ten days
written notice to the appellant and  to  the  insurer  or  rate  service
organization, may affirm, modify or reverse such action.
(c)  (1)  Subject  to  the  regulations  of  the superintendent, every
workers' compensation rate  service  organization  shall  establish  and
implement  procedures  for  the  review  of  its determination to make a
rating classification, relating  to  insurance  authorized  pursuant  to
paragraph  fifteen of subsection (a) of section one thousand one hundred
thirteen of this chapter, which has been filed with and approved by  the
superintendent.  Such  procedures  for review shall (A) ensure that such
organization shall, within a reasonable period of time  after  receiving
written  request  therefor,  furnish  any  insured  affected by a rating
classification  made  by  the  organization,  or   to   the   authorized
representative  of  the  insured,  any  information  pertaining  to  the
insured's file and any information,  upon  request,  pertaining  to  the
application  of the classification, and (B) require an insured aggrieved
by such determination to submit a written  request  for  review  of  the
rating  classification. The failure of such rate service organization to
respond in writing to a  written  request  submitted  pursuant  to  this
subsection  within  sixty days, shall authorize the applicant for review
to proceed as though the classification challenged  was  disapproved  by
the rate service organization. If the workers' compensation rate service
organization   cannot,   within   such   sixty  day  period,  make  such
determination or advise the insured that an inspection, audit  or  study
is  required,  the  organization  shall  submit a written request to the
superintendent, within the sixty day  period,  requesting  a  reasonable
extension of the time period in which to make such determination.
(2)  Any insured adversely affected by a review, completed pursuant to
paragraph one of this subsection, may, within thirty days  of  receiving
written  notice  of  the  results  of  the review, appeal such review in
writing to the superintendent. Such appeal shall specify the grounds  to
be  relied  upon  by  the  appellant.  The  superintendent  shall make a
determination and notify the insured within sixty days of receipt of the
request for an appeal as to whether he or she finds that the application
is made in good faith, that the applicant would be so aggrieved  if  his
grounds are established, and that such grounds otherwise justify holding
such a hearing. If the superintendent determines that such criteria have
been  met  by  the  insured's application, then the superintendent shall
hold a hearing on such matter  within  sixty  days  of  receipt  of  the
request  for an appeal, but upon no less than ten days written notice to

the parties of the hearing. The superintendent  may  affirm,  modify  or
reverse the review of the rate service organization.
(3) Any determination by the superintendent, pursuant to paragraph two
of   this   subsection,   shall   be   reviewable  pursuant  to  article
seventy-eight of the civil practice law and rules.