Current through Register Vol. 46, No. 12, March 20, 2024
(a)
(1) Except as set forth in paragraph (2) of
this subdivision, at no later than policy delivery or the establishment of an
account and upon any change of insured, owner, account holder, or beneficiary,
an insurer shall request information sufficient to ensure that all benefits or
other monies are distributed to the appropriate persons upon the death of the
insured or account holder, including, at a minimum, the name, address, date of
birth, social security number, and telephone number of every owner, account
holder, insured and beneficiary of such policy or account, as
applicable.
(2) Where an insurer
issues a policy or provides for an account based on information received
directly from an insured's employer, the insurer may obtain the beneficiary
information described in paragraph (1) of this subdivision by communicating
with the insured after the insurer's receipt of the information from the
insured's employer.
(b)
(1) An insurer shall use the latest available
updated version of the death index to cross-check every policy and account
subject to this Part, except as specified in subdivision (h) of this section.
The cross-checks shall be performed no less frequently than quarterly. An
insurer may submit a request to the superintendent for the insurer to perform
the cross-checks less frequently than quarterly, but in no event shall the
cross-checks be performed less frequently than semi-annually. The
superintendent may grant such a request upon the insurer's demonstration of
hardship.
(2) The cross-checks
shall be performed using:
(i) the insured or
account holder's social security number; or
(ii) where the insurer does not know the
insured or account holder's social security number, the name and date of birth
of the insured or account holder.
(3) An insurer may comply with the
requirements of this subdivision by using the full death index once annually
and using the death index update files for the remaining cross-checks in that
year.
(c) If an insurer
uses a resource instead of or in addition to a death index in order to
terminate benefits or close an account, the insurer shall also use that
resource when cross-checking policies or accounts pursuant to subdivision (b)
of this section.
(d) If an insurer
uses a resource more frequently than quarterly in order to terminate benefits
or close an account, the insurer shall use that resource with the same
frequency when cross-checking policies or accounts pursuant to subdivision (b)
of this section.
(e) Every insurer
shall implement reasonable procedures to account for common variations in data
that would otherwise preclude an exact match with a death index, including:
(1) nicknames, initials used in lieu of a
first or middle name, use of a middle name, compound first and middle names,
and interchanged first and middle names;
(2) compound last names, and blank spaces or
apostrophes in last name;
(3)
incomplete date of birth data, and transposition of the "month" and "date"
portions of the date of birth;
(4)
incomplete social security number; and
(5) common data entry errors in name, date of
birth and social security data.
(f) If an insurer only has a partial name,
social security number, date of birth, or a combination thereof, of the insured
or account holder under a policy or account, then the insurer shall use the
available information to perform the cross-check pursuant to subdivision (b) of
this section, which may be accomplished by using the procedures outlined in
subdivision (e) of this section.
(g) Every insurer shall establish reasonable
procedures to locate beneficiaries and shall make prompt payments or
distributions in accordance with Part 216 of this Title (Insurance Regulation
64).
(h) This section shall not
apply to any policy or any account:
(1) where
the insurer has fully satisfied all obligations under the policy or account
prior to the date that the cross-check is performed;
(2) where the insurer has paid full death
benefits on all insureds under the policy, or where the remaining obligations
have been transferred to one or more new policies or accounts providing
benefits of any kind in the event of the death of the insured or account
holder;
(3) where the insurer has
paid full surrender benefits on the policy, including a policy that is replaced
after full surrender;
(4) where the
policy has been rescinded and the insurer has returned all paid
premiums;
(5) where the policy has
been returned under a free-look provision and the insurer has returned all paid
premiums;
(6) where the insurer has
paid full maturity benefits under the policy;
(7) where the insurer does not maintain or
control the records containing the information necessary to comply with the
requirements of this section under a group policy administered by the group
policyholder;
(8) where all monies
due under the policy or account have escheated in accordance with state
unclaimed property statutes;
(9)
where the insurer has novated the policy;
(10) where the policy is a group annuity
contract that funds employer-sponsored retirement plans and the insurer is not
obligated by the terms of the contract to pay death benefits directly to the
plan participant's beneficiary;
(11) where the insurer receives payroll
deduction contributions for either a group or individual policy and a payment
has been made in the 90 days prior to a cross-check;
(12) except as to retired employees, where
premiums are wholly paid by an employer on an individual or group policy;
or
(13) where a policy has lapsed
or terminated with no benefits payable that was cross-checked with a death
index within the 18 months preceding the effective date of this Part or that
was cross-checked with a death index more than 18 months prior to the most
recent cross-check conducted by the insurer.
