Provides that payment of interest payment and attorney fees to claimant when payment of a claim is overdue shall be exclusive remedy when insurer fails to make timely payment; such failure of insurer to make timely payment or issue denial within 30 days after proof of claim has been submitted to insurer shall not preclude such insurer from issuing a denial or asserting a defense after the 30 day period has elapsed.
TITLE OF BILL: An act to amend the insurance law, in relation to payment of interest penalty and attorney fees to a claimant when a claim is overdue and the ability of an insurer to assert a defense or deny a claim if timely payment is not made within thirty days after proof of claim has been submitted
PURPOSE: This bill would amend the insurance law law and would allow insurers additional time to investigate potentially fraudulent no-fault automobile insurance claims.
SUMMARY OF PROVISIONS: Section 1 amends subsection (a) of section 5106 of the insurance law to include "payment of the interest and reasonable attorney fees to a claimant when payment of a claim is overdue shall be the exclusive remedy when an insurer fails to make timely payment. The failure of an insurer to make timely payment or issue a denial within thirty days after proof of claim has been submitted to an insurer shall not preclude such insurer from issuing a denial or asserting a defense after the thirty day period has elapsed."
Section 2 of this bill states that this act shall take effect sixty days after it shall become a law.
JUSTIFICATION: This bill will help to reduce no fault insurance fraud thereby reducing premiums paid by consumers. This legislation clarifies the exclusive penalty for an overdue payment to be interest and reasonable attorney fees. Additionally, the legislation permits the insurer to issue a denial after the thirty days and assert a defense after the thirty day period. Often times in cases of fraud the investigation takes longer than thirty days and requires additional time to determine the appropriate course of action.
LEGISLATIVE HISTORY: S.6448 of 2010; S.2638 of 2007-08
FISCAL IMPLICATIONS: Minimal.
EFFECTIVE DATE: This act shall take effect sixty days after it shall become a law.
STATE OF NEW YORK ________________________________________________________________________ 1686 2011-2012 Regular Sessions IN SENATE January 11, 2011 ___________Introduced by Sen. SEWARD -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to payment of interest penalty and attorney fees to a claimant when a claim is overdue and the ability of an insurer to assert a defense or deny a claim if time- ly payment is not made within thirty days after proof of claim has been submitted THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (a) of section 5106 of the insurance law is amended to read as follows: (a) Payments of first party benefits and additional first party bene- fits shall be made as the loss is incurred. Such benefits are overdue if not paid within thirty days after the claimant supplies proof of the fact and amount of loss sustained. If proof is not supplied as to the entire claim, the amount which is supported by proof is overdue if not paid within thirty days after such proof is supplied. All overdue payments shall bear interest at the rate of two percent per month. If a valid claim or portion was overdue, the claimant shall also be entitled to recover his attorney's reasonable fee, for services necessarily performed in connection with securing payment of the overdue claim, subject to limitations promulgated by the superintendent in regulations. PAYMENT OF THE INTEREST PENALTY AND REASONABLE ATTORNEY FEES TO A CLAIM- ANT WHEN PAYMENT OF A CLAIM IS OVERDUE SHALL BE THE EXCLUSIVE REMEDY WHEN AN INSURER FAILS TO MAKE TIMELY PAYMENT. THE FAILURE OF AN INSURER TO MAKE TIMELY PAYMENT OR ISSUE A DENIAL WITHIN THIRTY DAYS AFTER PROOF OF CLAIM HAS BEEN SUBMITTED TO AN INSURER SHALL NOT PRECLUDE SUCH INSUR- ER FROM ISSUING A DENIAL OR ASSERTING A DEFENSE AFTER THE THIRTY DAY PERIOD HAS ELAPSED. S 2. This act shall take effect on the sixtieth day after it shall have become a law.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD05836-01-1