Section 2601. Unfair claim settlement practices; penalties. 2602. Rebates on life insurance; witnesses` immunity. 2603. Issue or circulation of false literature. 2604. False statements as to insurers. 2605. Penalty for violating workers` compensation law. 2606. Discrimination because of race, color, creed, national origin, or disability. 2607. Discrimination because of sex or marital status. 2608. Discrimination because of treatment for a mental disability. 2608-a. Discrimination in enrollment against certain children. 2609. Discrimination in the issuance of performance or surety bonds. 2610. Collision or comprehensive coverage on motor vehicles; claims; repairs. 2611. HIV written informed consent. 2612. Discrimination based on being a victim of domestic violence. 2612. Genetic testing written informed consent. S 2601. Unfair claim settlement practices; penalties. (a) No insurer doing business in this state shall engage in unfair claim settlement practices. Any of the following acts by an insurer, if committed without just cause and performed with such frequency as to indicate a general business practice, shall constitute unfair claim settlement practices: (1) knowingly misrepresenting to claimants pertinent facts or policy provisions relating to coverages at issue; (2) failing to acknowledge with reasonable promptness pertinent communications as to claims arising under its policies; (3) failing to adopt and implement reasonable standards for the prompt investigation of claims arising under its policies; (4) not attempting in good faith to effectuate prompt, fair and equitable settlements of claims submitted in which liability has become reasonably clear, except where there is a reasonable basis supported by specific information available for review by the department that the claimant has caused the loss to occur by arson. After receiving a properly executed proof of loss, the insurer shall advise the claimant of acceptance or denial of the claim within thirty working days; (5) compelling policyholders to institute suits to recover amounts due under its policies by offering substantially less than the amounts ultimately recovered in suits brought by them; or (6) failing to promptly disclose coverage pursuant to subparagraph (A) of paragraph two of subsection (f) of section three thousand four hundred twenty of this chapter. (b) Evidence as to numbers and types of complaints to the department against an insurer and as to the department`s complaint experience with other insurers writing similar lines of insurance shall be admissible in evidence in any administrative or judicial proceeding under this section or article twenty-four or seventy-four of this chapter, but no insurer shall be deemed in violation of this section solely by reason of the numbers and types of such complaints. (c) If it is found, after notice and an opportunity to be heard, that an insurer has violated this section, each instance of noncompliance with subsection (a) hereof may be treated as a separate violation of this section for purposes of ordering a monetary penalty pursuant to subsection (b) of section one hundred nine of this chapter. A violation of this section shall not be a misdemeanor. S 2602. Rebates on life insurance; witnesses` immunity. (a) No person shall knowingly receive any rebate or allowance or deduction from any premium, or any valuable thing, special favor or advantage whatever not specified in the policy, as an inducement to take any policy of life insurance. (b) In any criminal proceeding before any court or grand jury for a violation of this section, the court or grand jury may confer immunity in accordance with the provisions of section 50.20 or 190.40 of the criminal procedure law. S 2603. Issue or circulation of false literature. No insurance corporation, or any officer, director or agent thereof, shall issue or circulate, or cause or permit to be issued or circulated, in this state any illustration, circular or statement indicating the corporation can transact in this state any business of a character except that which it is authorized to transact under its certificate of authority issued by the superintendent. S 2604. False statements as to insurers. No person shall either (i) wilfully make, circulate or transmit to another any statement written, printed or by word of mouth, which is untrue in fact and is directly or by inference derogatory to the financial condition, or affects the solvency or financial standing, of any insurer doing business in this state, or (ii) knowingly counsel, aid, procure or induce another to start, transmit or circulate any such statement. S 2605. Penalty for violating workers` compensation law. The superintendent may impose a penalty not to exceed twenty-five hundred dollars upon any insurer required to be licensed under the provisions of this chapter, if, after notice to and a hearing of such insurer, he finds it has unreasonably failed to comply with the workers` compensation law. S 2606. Discrimination because of race, color, creed, national origin, or disability. (a) Except as provided in section one thousand one hundred eight of this chapter, no individual or entity subject to the supervision of the superintendent shall because of race, color, creed, national origin, or disability: (1) Make any distinction or discrimination between persons as to the premiums or rates charged for insurance policies or in any other manner whatever. (2) Demand or require a greater premium from any persons 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 themselves, or their 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. (b) Except as provided in section one thousand one hundred eight of this chapter, no individual or entity subject to the superintendent`s supervision shall solely because of the applicant`s race, color, creed, national origin, or disability: (1) Reject any application for a policy of insurance issued and/or sold by it. (2) Refuse to issue, renew or sell such policy after appropriate application therefor. (3) Fix any lower rate or discriminate in the fees or commissions of agents or brokers for writing or renewing such a policy. (c) For the purposes of this section "disability" shall have the same meaning as ascribed thereto in subdivision twenty-one of section two hundred ninety-two of the executive law. (d) The prohibition of subsection (a) of this section shall not preclude an insurer from including a pre-existing condition provision as permitted pursuant to regulations of the superintendent or from establishing selection criteria on the basis of disability where the insurer can prove that its decision was based on sound underwriting and actuarial principles reasonably related to actual or anticipated loss experience. In such case the selection criteria permitted must be based on such principles. The insurer shall notify the insured of its specific reason or reasons for such decision. (e) If it can be proven that the provisions of subsection (d) of this section are inadequate to address such actual or anticipated loss experience, the prohibition of subsection (b) of this section shall not preclude an insurer from establishing selection criteria on the basis of disability. In such case the selection criteria permitted must be based on such principles. The insurer shall notify the insured of its specific reason or reasons for such decision. (f) Nothing in this section shall permit an insurer to include a pre-existing condition provision or establish selection criteria for individual and small group health insurance policies which are inconsistent with sections three thousand two hundred thirty-one, three thousand two hundred thirty-two, four thousand three hundred seventeen and four thousand three hundred eighteen of this chapter. S 2607. Discrimination because of sex or marital status. No individual or entity shall refuse to issue any policy of insurance, or cancel or decline to renew such policy because of the sex or marital status of the applicant or policyholder. S 2608. Discrimination because of treatment for a mental disability. (a) No individual or entity shall refuse to issue or renew, or shall cancel any policy of insurance because of any past treatment for a mental disability of the insured. (b) The prohibition of subsection (a) hereof shall not preclude an insurer from refusing to issue or renew or from cancelling a policy based on sound underwriting and actuarial principles reasonably related to actual or anticipated loss experience. The insurer shall notify the insured or his physician of its specific reason or reasons for refusal to issue or renew or for cancelling such policy. (c) In this section, mental disability has the meaning defined in subdivision three of section 1.03 of the mental hygiene law. S 2608-a. Discrimination in enrollment against certain children. (a) No employer, health insurer, group health plan, health maintenance organization, or other entity offering medical benefits whether by insurance or otherwise, including an employee retirement income security act or service benefit plan, shall deny enrollment of a child under the health coverage of the child`s parent on the ground that: (i) the child was born out of wedlock, (ii) the child is not claimed as a dependent on the parent`s federal income tax return, or (iii) the child does not reside with the parent or in the insurer`s service area. (b) Any inconsistent provisions of this title or other law notwithstanding, any insurer, in any case in which a child has health coverage through the insurer of a noncustodial parent, shall: (i) provide such information to the custodial parent as may be necessary for the child to obtain benefits through such coverage; (ii) permit the custodial parent, or a health care provider with the custodial parent`s approval, to submit claims for covered services without the approval of the non-custodial parent; and (iii) make payment on claims directly to such custodial parent, the provider, or the social services district furnishing medical assistance to a child. S 2609. Discrimination in the issuance of performance or surety bonds. No person, firm or corporation engaged in the business of issuing performance or surety bonds shall refuse to issue such a bond to any person, firm or corporation, solely because of the race, creed, color, sex, national origin, age or marital status of the applicant.
S 2610. Collision or comprehensive coverage on motor vehicles; claims; repairs. (a) Whenever a motor vehicle collision or comprehensive loss shall have been suffered by an insured, no insurer providing collision or comprehensive coverage therefor shall require that repairs be made to such vehicle in a particular place or shop or by a particular concern. (b) In processing any such claim (other than a claim solely involving window glass), the insurer shall not, unless expressly requested by the insured, recommend or suggest repairs be made to such vehicle in a particular place or shop or by a particular concern. S 2611. HIV written informed consent. (a) No insurer or its designee shall request or require an individual proposed for insurance coverage to be the subject of an HIV related test without receiving the written informed consent of such individual prior to such testing and without providing general information about AIDS and the transmission of HIV infection. (b) Written informed consent to an HIV related test shall consist of a written authorization that is dated and includes at least the following: (1) a general description of the test; (2) a statement of the purpose of the test; (3) a statement that a positive test result is an indication that the individual may develop AIDS and may wish to consider further independent testing; (4) a statement that the individual may identify on the authorization form the person to whom the specific test results may be disclosed in the event of an adverse underwriting decision, which person may be the individual or a physician or other designee at the discretion of the individual proposed for insurance; (5) the department of health`s statewide toll-free telephone number that may be called for futher information about AIDS, the meaning of HIV related test results, and the availability and location of HIV related counseling services; and (6) the signature of the applicant or individual proposed for insurance, or if such individual lacks capacity to consent, the signature of such other person authorized to consent for such individual. (c) In the event that an insurer`s adverse underwriting decision is based in whole or in part on the result of an HIV related test, the insurer shall notify the individual of the adverse underwriting decision and ask the individual to elect in writing, unless the individual has already done so, whether to have the specific HIV related test results disclosed directly to the individual or to such other person as the individual may designate. If the individual elects to receive the HIV related test results directly, the insurer shall advise the individual that he or she may call the department of health`s statewide toll-free telephone number for further information about AIDS, the meaning of HIV related test results, and the availability and location of HIV related counseling services and shall also advise such individual to consult with a physician about the meaning of and need for counseling, where appropriate, as to the HIV related test results. (d) As used in this section, the following terms shall have the following meanings: (1) "Adverse underwriting decision" means: (A) a declination of insurance coverage as applied for; or (B) an offer to issue insurance coverage at a higher than standard rate. (2) "AIDS" means acquired immune deficiency syndrome, as may be defined from time to time by the centers for disease control of the United States public health service. (3) "HIV infection" means infection with the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS. (4) "HIV related test" means any laboratory test or series of tests for any virus, antibody, antigen or etiologic agent whatsoever thought to cause or to indicate the presence of AIDS. (e) Any person who violates this section shall be subject to the provisions of article twenty-four of this chapter. (f) Nothing in this section shall be construed to create, impair, alter, limit, modify, enlarge, abrogate or restrict the specific authority of the department to allow or prohibit the use of HIV related tests or the consideration of HIV related test results for insurance coverage purposes. * S 2612. Discrimination based on being a victim of domestic violence. (a) No individual, insurer or entity subject to the supervision of the superintendent shall solely because a person is or has been a victim of domestic violence: (1) refuse to issue or renew, deny or cancel any insurance policy or contract; (2) demand or require a greater premium or payment from any person; (3) designate domestic violence as a preexisting condition, for which coverage will be denied or reduced; (4) fix any lower rate or discriminate in the fees or commissions of agents or brokers for writing or renewing such a policy. (b) The fact that a person is or has been a victim of domestic violence is not a permitted underwriting criterion. (c) For the purposes of this section, the following terms shall be defined as: (1) "victim of domestic violence" shall be as defined by subdivision one of section four hundred fifty-nine-a of the social services law. (2) "insurer" shall mean any insurer, article forty-three corporation, health maintenance organization, or agent, representative or designee thereof regulated pursuant to this chapter. (d) The prohibitions contained in subsection (a) of this section shall not preclude an insurer from taking any of the actions described in subsection (a) of this section so long as such insurer relies on underwriting criteria reasonably related to the physical or mental condition of a person, their property or claim history and the decision was based on sound underwriting and actuarial principles reasonably related to actual or anticipated loss experience. In such case the selection criteria permitted must be based on such principles. The insurer shall notify the insured of its specific reason or reasons for such decision. (e) An insurer that complies with subsection (a) of this section and acts in good faith shall not be subject to civil liability on account of compliance with such subsection. (f) The superintendent, in consultation with the department of social services and the office for the prevention of domestic violence, shall promulgate rules to guide and enable insurers to guard against the disclosure of the address and location of an insured who is a victim of domestic violence. * NB There are 2 S`s 2612`s * S 2612. Genetic testing written informed consent. (a) No authorized insurer or person acting on behalf of an authorized insurer shall request or require an individual proposed for insurance coverage to be the subject of a genetic test without receiving the written informed consent of such individual prior to such testing, in advance of the test. (b) Written informed consent to a genetic test shall consist of written authorization that is dated and signed and includes at least the following: (1) a general description of the test; (2) a statement of the purpose of the test; (3) a statement that a positive test result is an indication that the individual may be predisposed to or have the specific disease or condition tested for and may wish to consider further independent testing, consult their physician or pursue genetic counseling; (4) a general description of each specific disease or condition tested for; (5) the level of certainty that a positive test result for that disease or condition serves as a predictor of such disease. If no level of certainty has been established, this subparagraph may be disregarded; (6) the name of the person or categories of persons or organizations to whom the test results may be disclosed; (7) a statement that no tests other than those authorized shall be performed on the biological sample and that the sample shall be destroyed at the end of the testing process or not more than sixty days after the sample was taken; and (8) the signature of the individual subject of the test or, if that individual lacks the capacity to consent, the signature of the person authorized to consent for such individual. (c) A general waiver, wherein consent is secured for genetic testing without compliance with subsection (b) of this section, shall not constitute informed consent. (d) Any further disclosure of genetic test results to persons or organizations not named on the informed consent requires the further informed consent of the subject of the test. (e) In the event that an insurer`s adverse underwriting decision is based in whole or in part on the results of a genetic test, the authorized insurer shall notify the individual of the adverse underwriting decision and ask the individual to elect in writing, unless the individual has already done so, whether to have the specific test results disclosed directly to the individual or to the individual`s physician, at the discretion of the individual. (f) All records, findings and results of any genetic test performed on any person shall be deemed confidential and may not be disclosed without the written authorization as described in subsection (g) of this section of the person to whom such genetic test relates. This information may not be released to any person or organization not specifically authorized by the individual subject of the test. Unauthorized solicitation or possession of such information shall be unlawful, except for the unintentional possession of such information as part of a health record created prior to the date on which this section shall have become a law and provided no action adverse to the interests of the subject are taken as a result of such possession. (g) Written authorization to records, findings and/or results of genetic tests that have been performed prior to the effective date of this section, or which was done after the individual had given written informed consent pursuant to this section shall consist of a statement which specifically requests genetic test records, findings and/or results, the person or organizations to whom the records, findings and/or results shall be disclosed, the signature of the individual subject of the records, findings and/or results of the test or, if that person lacks the capacity to consent, the signature of the person authorized to consent for the subject. (h) No authorized insurer who lawfully possesses information derived from a genetic test on a biological sample from an individual shall incorporate such information into the records of a non-consenting individual who may be genetically related to the tested individual; nor shall any inferences be drawn, used, or communicated regarding the possible genetic status of the non-consenting individual. (i) For the purposes of this section, the term "adverse underwriting decision" shall have the same meaning as defined in section twenty-six hundred eleven of this article and the term "genetic test" shall have the same meaning as defined in section seventy-nine-l of the civil rights law. (j) If the superintendent determines after notice and a hearing that an authorized insurer or a person acting on behalf of an authorized insurer has violated this section, then the superintendent shall levy a fine up to five thousand dollars. Also, any authorized insurer or person acting on behalf of an authorized insurer who violates the provisions of this section shall be subject to the provisions of article twenty-four of this chapter. Violations of this section shall also be subject to the provisions of section one hundred nine of this chapter, except paragraph one of subsection (c) of such section. * NB There are 2 S`s 2612`s