New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter IX - Unfair Trade Practices › Part 220 - Holocaust Victims Insurance Claims And Reports › Section 220.2 - Standards for diligent and expeditious investigation of claims

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Any insurer
				organized, registered, licensed, or accredited to do an insurance business in
				New York State shall diligently and expeditiously investigate any claim arising
				from an occurrence during the period between January 1, 1929 and December 31,
				1945 which is made by an individual that the insurer knows, or reasonably
				should have known, is a Holocaust victim as defined in section 2701 (a)  of the Insurance
				Law.
(b) All claims by Holocaust
				victims and all available evidence relating thereto shall be reviewed by an
				insurer in a diligent and expeditious manner in accordance with the standards
				of proof described in section
				220.3 
				of this Part. In reviewing claims, an insurer shall give due consideration to
				any facts which tend to establish the bona fides of the claim, including in
				particular any circumstances which indicate that the person is a Holocaust
				victim as defined in section 2701 (a)  of the Insurance
				Law. The review process to be established by the insurer shall include, but not
				be limited to, the following actions:
(1)
				Holocaust claims unit. The insurer shall establish a Holocaust claims unit
				staffed with personnel fully familiar with the standards of proof described in
				section
				220.3 
				of this Part.
(2) Contact person
				and inquiries. The insurer shall designate a named contact person to handle
				inquiries related to Holocaust victim claims. The contact person's name and
				telephone number shall be made a part of the annual filing with the
				superintendent required by section 2705  of the Insurance Law and section
				220.5(e) 
				of this Part. The contact person shall be fully familiar with the standards of
				proof described in section
				220.3 
				of this Part. In responding to any inquiry by a claimant or other party, the
				contact person shall inform the person making the inquiry of the existence of
				the New York State Holocaust Claims Processing Office and shall provide the
				then current toll-free telephone number of such office. The providing of such
				information shall be in addition to and not in substitution for any other
				action required to be taken by the insurer.
(3) Research of policies issued. In order to
				facilitate matching of Holocaust victim claims with insurer records, each
				insurer shall diligently research its records related to insurance policies as
				defined in section 2701 (c)  of the Insurance
				Law which were issued through December 31, 1945. Based on this research, the
				insurer shall compile the following information regarding policies issued to
				Holocaust victims that remain unpaid or were paid to or expropriated or seized
				by a government located in an area that was or had been under Nazi influence
				that was not the named beneficiary of such insurance policy:
--Type of policy- life, accident and health, annuities,
				  property, casualty, education, dowry, or other;
--Insured name or names;
--Policy owner's name or names, if applicable;
--Policy beneficiary's name or names, if applicable;
--Policy effective dates and issue dates;
--Policy limits, face amount or pay-out value;
--Whether a claim was made to the insurer; name of claimant
				  or claimants;
--Whether a claim was denied; if denied, date and reason for
				  denial;
--Claims paid arising from an occurrence during the period
				  between January 1, 1929 and December 31, 1945;
--Dates any claims were paid;
--Names of payee or payees;
--Whether a claim, surrender value, benefits or proceeds
				  under the policy were paid to a government located in an area that was or had
				  been under Nazi influence, and if so, in what manner;
--Whether a claim, surrender value, benefits or proceeds
				  under the policy were expropriated or seized by a government located in an area
				  that was or had been under Nazi influence, and if so, in what manner;
--Whether attempts were made by the insurer to locate the
				  beneficiaries of any such insurance policies for which no claim of benefits has
				  been made.
(4) Research of
				abandoned, expropriated or seized property. To further aid Holocaust victims in
				their rightful recovery of insurance proceeds, each insurer shall also research
				its records for evidence of assets or funds turned over to various
				jurisdictions as abandoned, expropriated or seized property, to locate any such
				information relevant to policies issued to Holocaust victims. The insurer shall
				compile the same categories of information as required by paragraph (3) of this
				subdivision, to the extent applicable, together with the identity of the
				jurisdiction to which the assets or funds were turned over, the date the assets
				or funds were turned over, and the value thereof. Such information shall be
				submitted to the superintendent upon request.
(5) Expeditious treatment of claims.
(i) Insurance claims of Holocaust victims
				shall be treated in an expeditious manner pursuant to the standards set forth
				in this paragraph. The provisions of Part 216 (Regulation 64) of this Title
				shall not apply to such claims.
(ii) Each insurer shall establish procedures
				to commence an investigation of a claim filed by such a claimant, or a
				claimant's authorized representative, within 15 business days of receipt of
				notice of the claim. Within 30 business days after receipt by the insurer of a
				notice of claim and any statements, affidavits or other evidence filed in
				support of the claim, the insurer shall advise the claimant, or the claimant's
				authorized representative, in writing, of the acceptance or rejection of the
				claim by the insurer. If the insurer needs more time to investigate the claim,
				it shall so notify the claimant, or the claimant's authorized representative,
				within 30 business days after receipt of the notice of claim and shall request
				any further necessary statements, affidavits or evidence consistent with the
				standards set forth in section
				220.3 
				of this Part. Such notification shall include the reason why additional time is
				needed for investigation. If the claim remains unsettled, unless the matter is
				in litigation or arbitration, the insurer shall, 90 days from the date of the
				initial letter setting forth the need for further time to investigate, and
				every 90 days thereafter, send to the claimant, or the claimant's authorized
				representative, a letter setting forth the reason why additional time is needed
				for investigation. In any case where the claim is rejected, the insurer shall
				notify the claimant, or the claimant's authorized representative, in writing,
				of its specific reason for rejecting the claim. In any case where there is no
				dispute as to one or more elements of a claim, payment for such element(s)
				shall be made notwithstanding the existence of disputes as to other elements of
				the claim where such payment can be made without prejudice to either party. Any
				notice rejecting any element of a claim shall contain the following statement
				prominently set out:
"Should you wish to receive further advice on this matter,
				  you may write to the New York State Holocaust Claims Processing Office, at Two
				  Rector Street, New York, New York 10006."
(6) The provisions of this subdivision shall
				be deemed to be complied with by an insurer if the insurer is participating in
				the international commission or successor entity and the criteria set forth in
				section
				220.7 
				of this Part are being met by the insurer and the international commission or
				successor entity; and the superintendent has found that the insurer is fully
				complying with the standards for diligent and expeditious investigation of
				claims established by such commission or successor entity.