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 216.3 - Misrepresentation of policy provisions

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 216.3

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

(a) No insurer shall knowingly misrepresent to a claimant the terms, benefits or advantages of the insurance policy pertinent to the claim.

(b) No insurer shall deny any element of a claim on the grounds of a specific policy provision, condition or exclusion unless reference to such provision, condition or exclusion is made in writing.

(c) Any payment, settlement or offer of settlement which, without explanation, does not include all amounts which should be included according to the claim filed by the claimant and investigated by the insurer shall, provided it is within the policy limits, be deemed to be a communication which misrepresents a pertinent policy provision.

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