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 216.1 - Definitions

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 216.1

Current through Register Vol. 46, No. 12, March 20, 2024

The definitions set forth in this section shall govern the construction of the terms used in this Part.

(a) Agent shall mean any person, firm, association or corporation authorized to act as the representative of an insurer and licensed pursuant to the provisions of article 21 of the Insurance Law. With respect to group life and group accident and health policies, the group policyholder shall be the agent of the insurer to the extent such policyholder has been authorized to act on behalf of such insurer.

(b) Claimant shall mean any person who attempts to obtain a benefit from an insurer.

(c) Investigation shall mean any procedure adopted by an insurer to determine whether to accept or reject a claim.

(d) Business day shall mean a day other than Saturday, Sunday or a New York State legal holiday.

(e) Notice of claim shall mean any notification, whether in writing or otherwise, to an insurer or its agent, by any claimant who reasonably apprises the insurer of the facts pertinent to a claim.

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