N.Y. Comp. Codes R. & Regs. tit. 11 § 185.11

Current through Register Vol. 46, No. 25, June 18, 2024

Section 185.11 - Payment of claims

(a) All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.

(b) All claims shall be paid either by draft drawn upon the insurer, by the insurer or its claim representative, payable to the individual or firm to whom payment of the claim is due or, upon direction of such individual or firm, to a person designated by such individual or firm.

(c) No plan or arrangement shall be used whereby any person, firm or corporation, other than the insurer or its designated claim representative, shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the insurer, draw drafts in payment of claims due to the group policyholder subject to audit and review by the insurer. The insurer shall make periodic audits of claim payments made on its behalf by claim representatives or group policyholders.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 185.11