Bill Text: NY S05242 | 2023-2024 | General Assembly | Amended

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Bill Title: Prohibits insurers from reducing disability benefits due to the actual or anticipated receipt of social security disability benefits unless certain conditions are met.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-06-05 - SUBSTITUTED BY A6126A [S05242 Detail]

Download: New_York-2023-S05242-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         5242--A
            Cal. No. 879

                               2023-2024 Regular Sessions

                    IN SENATE

                                    February 28, 2023
                                       ___________

        Introduced  by  Sens. BRESLIN, COONEY -- read twice and ordered printed,
          and when printed to be committed to  the  Committee  on  Insurance  --
          recommitted  to  the  Committee on Insurance in accordance with Senate
          Rule 6, sec. 8 -- reported favorably from said committee,  ordered  to
          first  and  second  report,  ordered  to  a third reading, amended and
          ordered reprinted, retaining its place in the order of third reading

        AN ACT to amend the insurance law, in relation to  prohibiting  insurers
          from reducing disability benefits unless certain conditions are met

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Section 3216 of the insurance law is amended by adding  two
     2  new subsection (n) to read as follows:
     3    (n) No insurer may offset or reduce benefits payable under a policy of
     4  accident  and health insurance providing disability insurance due to the
     5  actual or estimated receipt  of  social  security  disability  insurance
     6  benefits unless:
     7    (1)  the  insurer has a reasonable, good faith belief that the insured
     8  is entitled to such benefits and a means of  reasonably  estimating  the
     9  amount payable;
    10    (2)  the insurer notifies the insured that the insured may qualify for
    11  such benefits and to pursue such benefits through any required  adminis-
    12  trative appeals;
    13    (3)  the  insurer  makes  a good faith effort to assist the insured in
    14  applying for such benefits; and
    15    (4) the insured fails to apply for,  or  pursue,  such  benefits  with
    16  reasonable  diligence  during  the  application  process or any required
    17  appeals.
    18    § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
    19  subsection (u) to read as follows:
    20    (u) No insurer may offset or reduce benefits payable under a policy of
    21  accident  and health insurance providing disability insurance due to the

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09886-02-4
        S. 5242--A                          2

     1  actual or estimated receipt  of  social  security  disability  insurance
     2  benefits unless:
     3    (1)  the  insurer has a reasonable, good faith belief that the insured
     4  is entitled to such benefits and a means of  reasonably  estimating  the
     5  amount payable;
     6    (2)  the insurer notifies the insured that the insured may qualify for
     7  such benefits and to pursue such benefits through any required  adminis-
     8  trative appeals;
     9    (3)  the  insurer  makes  a good faith effort to assist the insured in
    10  applying for such benefits; and
    11    (4) the insured fails to apply for,  or  pursue,  such  benefits  with
    12  reasonable  diligence  during  the  application  process or any required
    13  appeals.
    14    § 3.  This act shall take effect immediately.