N.Y. Comp. Codes R. & Regs. tit. 11 § 41.6

Current through Register Vol. 46, No. 43, October 23, 2024

Section 41.6 - Benefit eligibility

(a)

(1) The life insurance policy shall provide for the accelerated payment of death benefits pursuant to Insurance Law section 1113(a)(1)(A), based on the occurrence of the qualifying event of a diagnosis of terminal illness where the life expectancy will not exceed 12 months or a shorter period as specified in the contract.

(2) The policy may also provide for payment pursuant to:

(i) Insurance Law section 1113(a)(1)(B), based on the qualifying event of a diagnosis of a medical condition requiring extraordinary medical care or treatment regardless of life expectancy;

(ii) Insurance Law section 1113(a)(1)(C) or (D), as provided in section 41.8 of this Part; and

(iii) Insurance Law section 1113(a)(1)(E) or (F).

(3) Any policy may specify whether benefits may be accelerated pursuant to Insurance Law section 1113(a)(1)(A), (B), (C), (D), (E) or (F) singly or in combination. However, any policy providing benefits pursuant to Insurance Law section 1113(a)(1)(E) or (F) shall provide that the death benefit will first be accelerated under any Insurance Law section 1113(a)(1)(A), (B), (C) or (D) triggers for which the policyowner or certificateholder qualifies under the same policy. A policy that provides for accelerated payment of the death benefit pursuant to Insurance Law section 1113(a)(1)(B), (C), (D), (E) or (F) shall also provide that the death benefit may be accelerated pursuant to Insurance Law section 1113(a)(1)(A).

(b) The accelerated death benefit provision shall be effective on the issue date of the policy, certificate or rider.

(c) Accelerated payment of death benefits may be made available for in-force policies by written notification to the policyowner or certificateholder. Written acceptance by the policyowner or certificateholder will be required for all riders which provide for a separate premium charge or cost of insurance charge if the policyowner or certificateholder is required to pay such charges.

(d) This Part shall not apply to policies providing benefits subject to section 52.12 or 52.13 of this Title, except as expressly provided for in this Part, in the case of policies that accelerate the death benefit pursuant to Insurance Law section 1113(a)(1)(C) or (D). This Part shall not apply to policies providing benefits subject to sections 39.0, 39.1, 39.2 and 39.3 of this Title.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 41.6

Amended New York State Register November 27, 2019/Volume XLI, Issue 48, eff. 11/27/2019