Bill Text: NY A04288 | 2011-2012 | General Assembly | Introduced

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Bill Title: Establishes certain terms to be included in no-fault automobile liability insurance policies; provides that any covered person under such a policy shall have 6 months to provide the insurer of his or her claim for compensation; authorizes service of notice of claim upon the state insurance fund when the appropriate insurer liable for a claim cannot be ascertained; authorizes extensions of the 6 month filing requirement if the claimant has a reasonable justification based on the preponderance of the evidence.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2012-09-04 - enacting clause stricken [A04288 Detail]

Download: New_York-2011-A04288-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         4288
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                   February 2, 2011
                                      ___________
       Introduced  by  M.  of  A.  P. RIVERA  --  read once and referred to the
         Committee on Insurance
       AN ACT to amend the insurance law, in relation to  the  terms  of  motor
         vehicle liability insurance policies
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Section 5103 of the insurance law is amended  by  adding  a
    2  new subsection (i) to read as follows:
    3    (I)  EVERY  OWNER'S  POLICY  OF  LIABILITY INSURANCE ISSUED ON A MOTOR
    4  VEHICLE OR A MOTORCYCLE IN SATISFACTION OF THE REQUIREMENTS  OF  ARTICLE
    5  SIX OR EIGHT OF THE VEHICLE AND TRAFFIC LAW SHALL CONTAIN THE PROVISIONS
    6  SPECIFIED  IN  THIS  SUBSECTION  IN  THE  WORDS IN WHICH SUCH PROVISIONS
    7  APPEAR, EXCEPT THAT AN INSURER MAY, AT ITS OPTION, SUBSTITUTE FOR ONE OR
    8  MORE OF SUCH PROVISIONS CORRESPONDING PROVISIONS  OF  DIFFERENT  WORDING
    9  APPROVED  BY  THE  SUPERINTENDENT  WHICH  ARE  NOT LESS FAVORABLE IN ANY
   10  RESPECT TO THE INSURED OR ANY COVERED PERSON. EACH  PROVISION  CONTAINED
   11  IN  THE  POLICY  SHALL  BE PRECEDED BY THE APPLICABLE CAPTION OR, AT THE
   12  INSURER'S OPTION, BY SUCH APPROPRIATE CAPTIONS  OR  SUBCAPTIONS  AS  THE
   13  SUPERINTENDENT MAY APPROVE.
   14    (1)  EACH  POLICY SHALL, EXCEPT WITH RESPECT TO DESIGNATION BY NUMBERS
   15  OR LETTERS, CONTAIN THE FOLLOWING PROVISIONS:
   16    (A) ACTION AGAINST INSURER. NO ACTION SHALL LIE  AGAINST  THE  INSURER
   17  UNLESS,  AS  A  CONDITION  PRECEDENT THERETO, THERE SHALL HAVE BEEN FULL
   18  COMPLIANCE WITH THE TERMS OF THIS COVERAGE.
   19    (B) NOTICE. IN THE EVENT OF AN ACCIDENT, WRITTEN NOTICE SETTING  FORTH
   20  DETAILS  SUFFICIENT  TO IDENTIFY THE ELIGIBLE INJURED PERSON, ALONG WITH
   21  REASONABLY OBTAINABLE INFORMATION REGARDING THE TIME, PLACE AND  CIRCUM-
   22  STANCES OF THE ACCIDENT, SHALL BE GIVEN BY, OR ON BEHALF OF, EACH ELIGI-
   23  BLE  INJURED  PERSON, TO THE INSURER, OR ANY OF THE INSURER'S AUTHORIZED
   24  AGENTS, AS SOON AS REASONABLY PRACTICABLE, BUT IN NO EVENT MORE THAN SIX
   25  MONTHS AFTER THE DATE OF  THE  ACCIDENT,  UNLESS  THE  ELIGIBLE  INJURED
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD00410-01-1
       A. 4288                             2
    1  PERSON  SUBMITS  WRITTEN PROOF PROVIDING A JUSTIFICATION FOR THE FAILURE
    2  TO COMPLY WITH SUCH TIME LIMITATION WHICH IS REASONABLE BY A  PREPONDER-
    3  ANCE  OF  EVIDENCE. IF AN ELIGIBLE INJURED PERSON OR THAT PERSON'S LEGAL
    4  REPRESENTATIVE  INSTITUTES  A PROCEEDING TO RECOVER DAMAGES FOR PERSONAL
    5  INJURY UNDER SUBSECTION (B) OF SECTION FIVE THOUSAND ONE HUNDRED FOUR OF
    6  THIS ARTICLE, A COPY OF THE  SUMMONS  AND  COMPLAINT  OR  OTHER  PROCESS
    7  SERVED  IN  CONNECTION  WITH  SUCH  ACTION SHALL BE FORWARDED WITHIN SIX
    8  MONTHS AFTER THE DATE OF THE ACCIDENT TO  THE  INSURER  OR  ANY  OF  THE
    9  INSURER'S  AUTHORIZED  AGENTS  BY  SUCH  ELIGIBLE INJURED PERSON OR THAT
   10  PERSON'S LEGAL REPRESENTATIVE.   IN ANY INSTANCE IN  WHICH  AN  ELIGIBLE
   11  INJURED  PERSON  IS UNABLE AFTER MAKING A REASONABLE EFFORT TO ASCERTAIN
   12  WHETHER THE INSURER IS LIABLE FOR SUCH PERSON'S CLAIM, NOTICE  SHALL  BE
   13  DEEMED  TO  HAVE  BEEN MADE UPON THE APPROPRIATE INSURER, IF SUCH NOTICE
   14  SHALL HAVE BEEN SERVED UPON  THE  STATE  INSURANCE  FUND.  THE  ELIGIBLE
   15  INJURED  PERSON  SHALL  BE  DEEMED  TO  HAVE MADE A REASONABLE EFFORT TO
   16  ASCERTAIN THE APPROPRIATE INSURER, IF HE  OR  SHE  SHALL  HAVE  DIRECTED
   17  CORRESPONDENCE  TO  THE  INSURED  BY  A  MANNER OF SERVICE ENUMERATED IN
   18  SECTION THREE HUNDRED EIGHT OF THE CIVIL PRACTICE LAW AND RULES.
   19    (C) PROOF OF CLAIM; MEDICAL, WORK LOSS AND OTHER  NECESSARY  EXPENSES.
   20  IN THE CASE OF A CLAIM FOR HEALTH SERVICE EXPENSES, THE ELIGIBLE INJURED
   21  PERSON  OR  THAT  PERSON'S ASSIGNEE OR LEGAL REPRESENTATIVE SHALL SUBMIT
   22  WRITTEN PROOF OF CLAIM TO THE INSURER, INCLUDING FULL PARTICULARS OF THE
   23  NATURE AND EXTENT OF THE INJURIES AND  TREATMENT  RECEIVED  AND  CONTEM-
   24  PLATED,  AS  SOON  AS REASONABLY PRACTICABLE BUT, IN NO EVENT LATER THAN
   25  SIX MONTHS AFTER THE DATE SERVICES ARE INITIALLY RENDERED. THE  ELIGIBLE
   26  INJURED  PERSON OR THAT PERSON'S LEGAL REPRESENTATIVE SHALL SUBMIT WRIT-
   27  TEN PROOF OF CLAIM FOR  WORK  LOSS  BENEFITS  AND  FOR  OTHER  NECESSARY
   28  EXPENSES  TO THE INSURER WITHIN SIX MONTHS AFTER THE ACCIDENT. THE FORE-
   29  GOING TIME LIMITATIONS FOR THE SUBMISSION OF PROOF OF CLAIM SHALL  APPLY
   30  UNLESS THE ELIGIBLE INJURED PERSON OR THAT PERSON'S LEGAL REPRESENTATIVE
   31  SUBMITS  WRITTEN PROOF PROVIDING JUSTIFICATION FOR THE FAILURE TO COMPLY
   32  WITH SUCH TIME LIMITATION WHICH IS  REASONABLE  BY  A  PREPONDERANCE  OF
   33  EVIDENCE.  UPON  REQUEST  BY THE INSURER, THE ELIGIBLE INJURED PERSON OR
   34  THAT PERSON'S ASSIGNEE OR REPRESENTATIVE SHALL:
   35    (A) EXECUTE A WRITTEN PROOF OF CLAIM UNDER OATH;
   36    (B) AS MAY REASONABLY BE REQUIRED SUBMIT TO EXAMINATIONS UNDER OATH BY
   37  ANY PERSON NAMED BY THE INSURER AND SUBSCRIBE THE SAME;
   38    (C) PROVIDE AUTHORIZATION THAT  WILL  ENABLE  THE  INSURER  TO  OBTAIN
   39  MEDICAL RECORDS; AND
   40    (D) PROVIDE ANY OTHER PERTINENT INFORMATION THAT MAY ASSIST THE INSUR-
   41  ER IN DETERMINING THE AMOUNT DUE AND PAYABLE.
   42    THE  ELIGIBLE  INJURED  PERSON  SHALL SUBMIT TO MEDICAL EXAMINATION BY
   43  PHYSICIANS SELECTED BY, OR ACCEPTABLE TO,  THE  INSURER,  WHEN,  AND  AS
   44  OFTEN AS, THE INSURER MAY REASONABLY REQUIRE.
   45    (2)  THE DEPARTMENT SHALL PROMULGATE SUCH RULES AND REGULATIONS AS ARE
   46  NECESSARY TO IMPLEMENT THE  PROVISIONS  OF  THIS  SUBSECTION;  PROVIDED,
   47  HOWEVER,  THAT SUCH RULES AND REGULATIONS SHALL NOT BE LESS FAVORABLE IN
   48  ANY RESPECT TO ANY COVERED PERSONS, NOR SHALL ANY  ADDITIONAL  CONDITION
   49  PRECEDENT FOR COVERAGE OR FILING A CLAIM BE ESTABLISHED THEREBY.
   50    S 2. This act shall take effect on the one hundred twentieth day after
   51  it  shall  have  become  a  law; provided that any rules and regulations
   52  necessary to implement the provisions of this act on its effective  date
   53  are authorized and directed to be promulgated and shall become effective
   54  on such date.