New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter IX - Unfair Trade Practices
Part 216 - Unfair Claims Settlement Practices And Claim Cost Control Measures
Section 216.0 - Preamble

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 216.0

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Section 2601 of the Insurance Law prohibits insurers doing business in this State from engaging in unfair claims settlement practices and provides that, if any insurer performs any of the acts or practices proscribed by that section without just cause and with such frequency as to indicate a general business practice, then those acts shall constitute unfair claims settlement practices. This Part contains claim practice rules which insurers must apply to the processing of all first- and third-party claims arising under policies subject to this Part. In addition, specific rules are provided for the processing of first-party motor vehicle physical damage claims and third-party property damage claims arising under motor vehicle liability insurance contracts.

(b) This Part is issued for the purpose of defining certain minimum standards which, if violated without just cause and with such frequency as to indicate a general business practice, would constitute unfair claims settlement practices. This Part is not exclusive, and other acts, not herein specified, may also be found to constitute such practices.

(c) Section 3411 (i) of the Insurance Law has been implemented by section 216.7 of this Part.

(d) Section 3412 of the Insurance Law has been implemented by section 216.8 of this Part.

(e) Claim practice principles to be followed by all insurers.

(1) Have as your basic goal the prompt and fair settlement of all claims.

(2) Assist the claimant in the processing of a claim.

(3) Do not demand verification of facts unless there are good reasons to do so. When verification of facts is necessary, it should be done as expeditiously as possible.

(4) Clearly inform the claimant of the insurer's position regarding any disputed matter.

(5) Respond promptly, when response is indicated, to all communications from insureds, claimants, attorneys and any other interested persons.

(6) Every insurer shall distribute copies of this regulation to every person directly responsible for the supervision, handling and settlement of claims subject to this regulation, and every insurer shall satisfy itself that all such personnel are thoroughly conversant with, and are complying with, this regulation.

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