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NEW YORK INSURANCE
ISC

Last update: 2011-11-13


  • Article 1. General Provisions 101 - 110
  • Article 2. Organization of the Insurance Department 205 - 214
  • Article 3. Administrative and Procedural Provisions 301 - 341
  • Article 4. Insurance Frauds Prevention 401 - 411
  • Article 11. Licensing of Insurers 1101 - 1123
  • Article 12. Organization and Corporate Procedure 1201 - 1221
  • Article 13. Assets and Deposits 1301 - 1325
  • Article 14. Investments 1401 - 1414
  • Article 15. Holding Companies 1501 - 1510
  • Article 16. Subsidiaries of Domestic Property/casualty Insurance Companies and Certain other Entities 1601 - 1612
  • Article 17. Subsidiaries of Domestic Life Insurance Companies and Certain other Entities 1701 - 1716
  • Article 21. Agents, Brokers, Adjusters, Consultants and Intermediaries 2101 - 2137
  • Article 22. Certification of Employees of Insurers and Savings Banks Offering Life Insurance 2201 - 2209
  • Article 23. Property/casualty Insurance Rates 2301 - 2352
  • Article 24. Unfair Methods of Competition and Unfair and Deceptive Acts and Practices 2401 - 2409
  • Article 25. Prohibitions Against Controlled Business 2502 - 2505
  • Article 26. Unfair Claim Settlement Practices; other Misconduct; Discrimination 2601 - 2615
  • Article 27. Holocaust Victims Insurance Act of 1998 2701 - 2711
  • Article 28. Use of Credit Infomation 2801 - 2809
  • Article 31. Insurance Contracts - General 3101 - 3113
  • Article 32. Insurance Contracts - Life, Accident and Health, Annuities 3201 - 3239
  • Article 34. Insurance Contracts-property/casualty 3401 - 3454
  • Article 41. Property/casualty Insurance Companies 4101 - 4121
  • Article 42. Life Insurance Companies and Accident and Health Insurance Companies and Legal Services Insurance Companies 4202 - 4241
  • Article 43. Non-profit Medical and Dental Indemnity, or Health and Hospital Service Corporations 4301 - 4327
  • Article 44. Employee Welfare Funds 4401 - 4414
  • Article 45. Fraternal Benefit Societies 4501 - 4530
  • Article 46. Retirement Systems 4601 - 4608
  • Article 47. Municipal Cooperative Health Benefit Plans 4701 - 4714
  • Article 48. Managed Care Health Insurance Contracts 4801 - 4805
  • Article 49. Utilization Review and External Appeal
    • Title 1. Registration of Agents and Review Process 4900 - 4908
    • Title 2. Right to External Appeal 4910 - 4917
  • Article 51. Comprehensive Motor Vehicle Insurance Reparations 5101 - 5109
  • Article 52. Motor Vehicle Accident Indemnification Corporation 5201 - 5225
  • Article 53. Motor Vehicle Insurance Assigned Risk Plans 5301 - 5304
  • Article 54. New York Property Insurance Underwriting Association 5401 - 5414
  • Article 55. Medical Malpractice Insurance Association 5501 - 5517-A
  • Article 56. Health Care Arbitrations 5601 - 5605
  • Article 59. Risk Retention Groups and Purchasing Groups 5901 - 5913
  • Article 61. Reciprocal Insurers and Lloyds Underwriters 6101 - 6116
  • Article 62. New York Insurance Exchange 6201 - 6203
  • Article 63. Special Risks; Filing Exemption 6301 - 6304
  • Article 64. Title Insurance Corporations 6401 - 6411
  • Article 65. Mortgage Guaranty Insurance Companies 6501 - 6508
  • Article 66. Co-operative Property/casualty Insurance Companies 6601 - 6626
  • Article 67. Nonprofit Property/casualty Insurance Companies 6701 - 6708
  • Article 68. Bail Bonds 6801 - 6804
  • Article 69. Financial Guaranty Insurance Corporations 6901 - 6909
  • Article 70. Captive Insurance Companies 7001 - 7012
  • Article 71. Merger, Consolidation, Redomestication, Acquisition of Assets and Acquisition of Certain Shares of Insurers 7101 - 7121
  • Article 72. Domestication of the United States Branch of an Alien Insurer 7201 - 7205
  • Article 73. Conversion to Different Type of Insurer 7301 - 7317
  • Article 74. Rehabilitation, Liquidation, Conservation and Dissolution of Insurers 7401 - 7436
  • Article 75. Life Insurance Guaranty Fund 7501 - 7507
  • Article 76. Property/casualty Security Funds 7601 - 7614
  • Article 77. The Life Insurance Company Guaranty Corporation of New York Act 7701 - 7718
  • Article 78. Life Settlements 7801 - 7820
  • Article 79. Service Contracts 7901 - 7913
  • Article 91. Taxes and Fees 9101 - 9111-C
  • Article 99. Time of Taking Effect 9901

Article 1
General Provisions

Section 101. Short title.

This chapter shall be known and may be cited as the "insurance law".

Section 102. Declaration.

The legislature hereby declares that the purpose of this chapter is to recodify, without substantive change, the insurance law in effect immediately prior to the effective date of this chapter.

Section 103. Explanation of order of provisions.

In this recodification of the insurance law, the provisions have been divided in descending order of application, with illustrations, as follows: Article 1

Section 101

Subsection (a)

Paragraph (1) Subparagraph (A) Item (i) Clause (I) Subitem (aa) Subclause (aaa)

Section 104. Continuation of existing offices, licenses, approvals and proceedings.

(a) All persons who, at the effective date of this chapter, held any office in the department shall continue to hold such office under and subject to this chapter.

(b) Every license of an insurer, insurance agent, insurance broker, public adjuster, reinsurance intermediary, insurance consultant or other licensee in force immediately prior to the effective date of this chapter shall continue in force until its date of expiration or until terminated pursuant to this chapter.

(c) Every insurer doing business in this state as an authorized insurer at the effective date of this chapter may continue to transact the kind or kinds of insurance business it was licensed to transact on such date until the date of expiration of its license or until the license is terminated pursuant to this chapter.

(d) Every form of policy, contract, certificate, application, rider or endorsement in use immediately prior to the effective date of this chapter which was approved by the superintendent pursuant to any law herein repealed may, unless he prescribes otherwise, continue to be issued in accordance with the approval:

(1) following such effective date, if the form complies with this chapter and did comply with the repealed law, or

(2) for six months following such effective date, if it does not comply with this chapter but did comply with the repealed law.

(e) No action or proceeding commenced before the effective date of this chapter, and no violation of any provision of law hereby repealed, shall be affected by such repeal, but all procedure hereafter taken in reference thereto shall conform to the provisions of this chapter as far as practicable.

Section 106. Construction of references.

(a) In this chapter, unless otherwise stated or required by the context:

(1) All references to a part, title, article or section number or letter refer to the part, title, article or section so numbered or lettered in this chapter, and all references in any section of this chapter to a numbered or lettered subsection, paragraph, subparagraph, item or clause refer to the subsection, paragraph, subparagraph, item or clause so numbered or lettered in such section.

(2) All references to former provisions of chapter twenty-eight of the consolidated laws refer to provisions of the former insurance law enacted by chapter eight hundred eighty-two of the laws of nineteen hundred thirty-nine.

(b) In other laws of this state, references to the former insurance law repealed by this chapter, and to any article, section or other provision thereof, refer to this chapter and its provisions which correspond to the repealed article, section or other provision.

Section 107. Definitions of terms of general use in this chapter.

(a) In this chapter, unless the context otherwise requires:

(1) "Accident and health insurance company", means any corporation having power to do the kinds of insurance business specified in item (i) of paragraph three of subsection (a) of section one thousand one hundred thirteen of this chapter or items (i) and (ii) of such paragraph, provided such company does not have power to do any other kind or kinds of insurance business.

(2) "Accredited reinsurer" means an assuming insurer not authorized to do an insurance business in this state but which (i) presents satisfactory evidence to the superintendent that it meets the applicable standards of solvency required in this state, (ii) is in compliance with the conditions prescribed by regulation under which a ceding insurer may be allowed credit for reinsurance recoverable from an insurer not authorized in this state, and (iii) has received a certificate of recognition as an accredited reinsurer issued by the superintendent pursuant to such regulation; provided that no insurer shall be an accredited reinsurer with respect to any kind of insurance not provided for in such certificate.

(3) "Admitted assets" means assets of an insurer which conform to the requirements of section one thousand three hundred one of this chapter.

(4) "Affiliate" means a corporation a majority of whose shares is owned or controlled by shareholders, directors or officers of another corporation, who own or control a majority of the shares of the other corporation.

(5) "Alien insurer" means any insurer incorporated or organized under the laws of any foreign nation, or of any province or territory not included under the definition of foreign insurer.

(6) "American institution" means an institution created or existing under the laws of the United States of America or of any state, district or territory thereof.

(7) "Articles of association", when used in reference to an unincorporated association, means the basic instrument prescribing the powers, purposes and organization of the association.

(8) "Assuming insurer" means an insurer which, under a contract of reinsurance, incurs to another insurer, called the ceding insurer, an obligation the performance of which is contingent upon the ceding insurer's incurring liability or loss under its contract or contracts of insurance, guaranty or suretyship made with third persons.

(9) "At last year-end" means the end of the next preceding calendar year.

(10) "Authorized insurer" means an insurer authorized as such to do an insurance business in this state in compliance with this chapter, by reason of a license so to do issued and in force pursuant to the laws of this state or of a corporate charter granted and in force pursuant to the laws of this state, but not including any insurer herein exempted from compliance with the requirement that it obtain a license to do business.

(11) "Board of directors" means the body having power and responsibility for management and control of a corporation and the advisory committee or similar body having such power in reference to a reciprocal insurer or Lloyds underwriters.

(12) "Capital", when used in reference to a stock insurance company, means the aggregate par value of all classes of shares of capital stock issued and outstanding.

(13) "Ceding insurer" means the insurer to which an assuming insurer is obligated.

(14) "Charter" means the basic instrument, by whatever name called, prescribing the powers, purposes and organization of a corporation.

(15) "Company" means a corporation.

(16) "Control". Except for the purposes of article fifteen of this chapter, "control", including the terms "controlling", "controlled by" and "under common control with", means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of an institution, whether through the ownership of voting securities, by contract or otherwise.

(17) "Department" means the department of financial services of this state.

(18) "Deputy" means a deputy superintendent of insurance of this state.

(19) "Domestic insurer" means any authorized insurer incorporated or organized under any law of this state.

(20) "Firm" means a partnership, limited or unlimited, general or special.

(21) "Foreign insurer" means any insurer incorporated or organized under the laws of any state, as herein defined, other than this state.

(22) "Fraternal benefit society" has the meaning ascribed to it by subsection (a) of section four thousand five hundred one of this chapter.

(23) "Independent insurance agent" has the meaning ascribed to it by section two thousand one hundred one of this chapter.

(24) "Institution" means a corporation, a joint-stock company, an association, a trust, a business partnership, a business joint venture or any similar entity.

(25) "Insurance agent" has the meaning ascribed to it by section two thousand one hundred one of this chapter.

(26) "Insurance broker" has the meaning ascribed to it by section two thousand one hundred one of this chapter.

(27) "Insurance contract" has the meaning ascribed to it by section one thousand one hundred one of this chapter.

(28) "Life insurance company" means any corporation having power to do either one or both of the kinds of insurance business specified in paragraphs one and two of subsection (a) of section one thousand one hundred thirteen of this chapter.

(29) "Lloyds underwriters" means any aggregation of individuals, who under a common name engage in the business of insurance for profit through an attorney-in-fact having authority to obligate the underwriters severally, within such limits as may be lawfully specified in the power of attorney, on contracts of insurance made or issued by such attorney-in-fact, in the name of such aggregation of individuals, to and with any person or persons insured.

(30) "Minimum surplus" means the minimum amount by which the admitted assets of an insurer without capital stock must exceed its liabilities in order to be permitted to do business in this state.

(31) "Minor" or "infant" means a person who has not attained the age of eighteen years.

(32) "Mortgage" includes a deed of trust.

(33) "Obligations" includes bonds, debentures, notes and other evidences of indebtedness (whether or not liability for payment extends beyond the security therefor) as well as participation interests in any of the foregoing.

(34) "Officer" means any person charged with active management and control, in an executive capacity, of the affairs of a corporation, including the president, vice-president, secretary, assistant secretary, treasurer, assistant treasurer, general counsel, actuary, comptroller and any other person appointed or elected by the board of directors to exercise similar powers, and including the manager, attorney-in-fact, or other person appointed or elected by the board of directors to exercise similar powers, of a United States branch of an alien insurer, and the attorney-in-fact of a reciprocal insurer or Lloyds underwriters, and in case such manager or attorney-in-fact is a corporation, including the officers of such corporation.

(35) "Parent corporation" has the meaning assigned to it in the definition of subsidiary.

(36) "Property/casualty insurance company" means any company having power to write any one or more of the basic kinds of insurance specified in subsection (a) of section four thousand one hundred one of this chapter.

(37) "Reciprocal insurer" means any aggregation of persons, firms or corporations or, in the alternative, New York counties, towns, cities, villages, district corporations (as defined in paragraph three of section 2.00 of the local finance law), or school districts and boards of cooperative educational services, called "subscribers" in article sixty-one of this chapter, who or which under a common name engage in the business of inter-insurance or exchanging contracts of insurance on the reciprocal plan through an attorney-in-fact having authority to obligate the subscribers severally, within such limits as may lawfully be specified in the subscriber's agreement, on contracts of insurance made with any subscriber as a policyholder through such attorney-in-fact acting on behalf of all other subscribers. Such term includes any reciprocal or inter-insurance exchange, by whatever name known, and any reference thereto as an insurer shall be deemed to mean any such aggregation of inter-insurers operating through an attorney-in-fact individually and collectively as an insurance organization for the benefit of its policyholders.

(38) "Renewal license" means a license which becomes effective immediately following the expiration of a license previously issued and in force, and which differs from such previous license only as to the date of expiration.

(39) "State" means any state of the United States, the commonwealth of Puerto Rico and the District of Columbia.

(40) "Subsidiary" means an institution controlled, directly or indirectly, by another institution or by a retirement system. "Parent corporation" means an institution or a retirement system that, directly or indirectly, controls another institution. For the purposes of the definitions in this subsection:

(A) an institution is conclusively presumed to be controlled by an institution or retirement system that, directly or indirectly, with power to vote, owns, controls or holds a majority of the outstanding voting securities of such institution;

(B) no presumption, either of control or of absence of control, arises if such ownership, control or holding of voting securities is less than a majority but more than five percent;

(C) absence of control is presumed if such ownership, control or holding of voting securities is five percent or less; and

(D) in determining control, voting securities held in separate accounts of an institution or retirement system shall be deemed to be owned by the institution or retirement system, but voting securities in an investment advisory account that are not owned by an institution but are held in an account as to which the institution is an investment adviser shall not be deemed to be controlled or held by such institution.

(41) "Superintendent" means the superintendent of financial services of this state.

(42) "Surplus to policyholders" means the excess of total admitted assets over the liabilities of an insurer, which is the sum of all capital and surplus accounts minus any impairment thereof.

(43) "United States". Except for the purposes of article fourteen of this chapter, when used to signify place, means only the states of the United States, the commonwealth of Puerto Rico and the District of Columbia.

(44) "United States branch" means, as the context may require, the business unit through which business is transacted within the United States by an alien insurer, or the assets and liabilities of such insurer within the United States pertaining to such business or the management powers pertaining to such business and to such assets and liabilities or any combination of these three.

(45) "Voting securities" means securities of any class or any ownership interest having voting power for the election of directors, trustees or management of an institution, other than securities having such power only by reason of the happening of a contingency.

(46) "Doing an insurance business" has the meaning ascribed to it by section one thousand one hundred one of this chapter.

(47) "Commercial risk insurance" means insurance not subject to section three thousand four hundred twenty-five of this chapter issued or issued for delivery in this state, on a risk located in this state, insuring any of the following contingencies:

(A) loss of or damage to real property;

(B) loss of or damage to personal property;

(C) losses or liabilities arising out of the ownership, operation or use of a motor vehicle;

(D) liabilities of persons acting as officers or directors; or

(E) other liabilities, including product liability, for loss of, damage to, or injury to persons or property.

(48) "Product liability" means liability of the insured for damages for personal injury, death or property damage, where liability is based upon negligence, implied warranty or strict liability, arising out of a design, inspection, testing or manufacturing defect, or any other defect in a product, or is based upon any failure to warn, or to properly instruct in the use of a product or for any liability for any damage arising out of the handling or use of any product manufactured, sold, handled or distributed by the insured or work completed by or on behalf of the insured.

(49) "Professional liability insurance" means insurance covering liability arising out of the practice of any profession for which a license is required by a governmental authority of this state or, with respect to treatment of patients, arising out of the operation of a duly certified hospital.

(50) "Public entity insurance" means commercial risk insurance issued to a public entity.

(51) "Public entity" means:

(A) the state of New York;

(B) a county, city, town, village or any other political subdivision or civil department or division of the state;

(C) a school district, board of cooperative educational services or any other governmental entity or combination or association of governmental entities operating a public school, college, community college or university;

(D) a fire district, fire company, volunteer fire department, or any other entity that contracts with a municipality or other political subdivision to provide fire protection;

(E) a public library, as defined in section two hundred fifty-three of the education law, authorized to operate in this state;

(F) a public corporation, including a municipal corporation, district corporation or public benefit corporation;

(G) an improvement district, special district or other district authorized by the village law, town law, county law or any other law;

(H) a public corporation, public authority, commission, agency, municipal or other public housing authority, or project organized pursuant to article two of the private housing finance law; or

(I) any other governmental instrumentality or unit in the state of New York.

(52) "Gap amount" means:

(A) in the case of a lease of personal property, the difference, if any, between:

(i) the amount owed by the lessee, under the early termination provision of the lease, as of the date of a total loss of the leased property caused by its theft or physical damage, or the amount which would have been owed by the lessee had the lessor not waived such obligations; and

(ii) the sum of: (I) any unpaid rental payments and other unpaid charges, arising from the failure of the lessee to fulfill the lessee's obligations under the lease, that had accrued prior to the date of the loss; and (II) the actual cash value of the personal property as of the date of the loss. If the lessee is required under the lease agreement to maintain a physical damage insurance policy on the personal property which is the subject of the lease agreement, and that policy is in effect on the date of the loss, then "actual cash value" shall have the same meaning as under the physical damage insurance policy.

(B) In the case of a loan or other credit transaction on the purchase of personal property, the difference, if any, between:

(i) the amount owed by the debtor under the loan or other credit transaction as of the date of a total loss of the personal property which is the subject of the loan or other credit transaction agreement caused by its theft or physical damage, or the amount that would have been owed by the debtor had the creditor not waived such obligation; and

(ii) the sum of: (I) any unpaid payments and other unpaid charges, arising from the failure of the debtor to fulfill the obligations under the loan or other credit transaction agreement, that had accrued prior to the date of the loss; and (II) the actual cash value of the personal property as of the date of the loss. If the debtor is required under the loan or other credit transaction agreement to maintain a physical damage insurance policy on the personal property which is the subject of the loan or other credit transaction agreement, and that policy is in effect on the date of the loss, then "actual cash value" shall have the same meaning as under the physical damage insurance policy.

(53) "Nonprofit property/casualty insurance company" means an insurer organized pursuant to section six thousand seven hundred three of this chapter and that is subject to the provisions of article sixty-seven of this chapter.

(b) Whenever the terms "include", "including" or terms of similar import appear in this chapter, unless the context requires otherwise, such terms shall not be construed to imply the exclusion of any person, class or thing not specifically included.

(c) A reference in this chapter to any other law or statute of this state, or of any other jurisdiction, means such law or statute as amended to the effective date of this chapter and, unless the context otherwise requires, as amended thereafter.

Section 108. Applicability of business corporation law to insurers.

(a) The business corporation law applies to every corporation heretofore or hereafter formed under:

(1) this chapter, except corporations subject to section one thousand one hundred ten or article forty-three, forty-five, forty-six or sixty-seven of this chapter, or a captive insurance company formed in accordance with the not-for-profit corporation law, or

(2) any other statute of this state, or any other law, if the corporation's purposes include a purpose for which a corporation may be formed under this chapter.

(b) (1) If any provision of the business corporation law conflicts with any provision of this chapter, the provision of this chapter shall prevail, and the conflicting provision of the business corporation law shall not apply.

(2) If any provision of this chapter relates to a matter embraced in the business corporation law but is not in conflict therewith, both provisions shall apply.

(c) The following provisions of the business corporation law shall not apply to a domestic stock insurer or an authorized stock insurer: section one hundred six, subsection (a) of section two hundred one, sections five hundred ten, five hundred eleven, five hundred seventeen, five hundred eighteen, seven hundred nineteen, nine hundred eight, articles three, ten and twelve.

(d) The following provisions of the business corporation law shall not apply to a domestic incorporated mutual insurer or an authorized incorporated mutual insurer: section one hundred six, subsection (a) of section two hundred one, sections seven hundred nine, and seven hundred nineteen, articles three, five, six (except section six hundred nineteen), nine, ten and twelve.

(e) The following provisions of the business corporation law, in addition to those referred to in subsections (c) and (d) hereof, do not apply to an incorporated foreign insurer or an incorporated alien insurer: sections thirteen hundred one, thirteen hundred two, sections thirteen hundred four through thirteen hundred six inclusive, sections thirteen hundred eight through thirteen hundred eleven inclusive, sections thirteen hundred fifteen, thirteen hundred sixteen and thirteen hundred eighteen.

(f) A provision of the business corporation law which is referred to in section thirteen hundred seventeen or thirteen hundred nineteen thereof is not applicable to an incorporated foreign insurer or an incorporated alien insurer if such provision of the business corporation law is made inapplicable to such insurer under subsection (b), (c) or (d) hereof.

(g) In applying the business corporation law to any corporation pursuant to this section, unless the context otherwise requires, the following terms in such law have the following respective meanings:

(1) "Secretary of state" means "superintendent of insurance".

(2) "Department of state" means "insurance department".

(3) "Corporation" and "domestic corporation" mean an incorporated "domestic insurer" as defined in section one hundred seven of this article.

(4) "Foreign corporation" means both an incorporated "foreign insurer" and an incorporated "alien insurer", as defined in section one hundred seven of this article.

(5) "Stated capital" means "capital" as defined in section one hundred seven of this article.

(h) A member of a domestic mutual insurer shall have the rights given to a "shareholder" in section six hundred nineteen of the business corporation law.

Section 109. Penalties; civil actions.

(a) Every violation of any provision of this chapter shall, unless the same constitutes a felony, be a misdemeanor.

(b) Every penalty imposed by this section shall be in addition to any penalty or forfeiture otherwise provided by law.

(c) (1) If the superintendent finds after notice and hearing that any authorized insurer, representative of the insurer, licensed insurance agent, licensed insurance broker, licensed adjuster, or any other person or entity licensed, certified, registered, or authorized pursuant to this chapter, has wilfully violated the provisions of this chapter or any regulation promulgated thereunder, then the superintendent may order the person or entity to pay to the people of this state a penalty in a sum not exceeding one thousand dollars for each offense.

(2) Failure to pay such penalty within thirty days after the order, unless it is suspended by an order of a court of competent jurisdiction, shall constitute a further violation of the provisions of this chapter.

(3) No penalty shall be imposed pursuant to this subsection if a monetary penalty is otherwise provided in this chapter.

(d) The superintendent may maintain a civil action in the name of the people of the state to recover a judgment for a money penalty imposed by law for the violation of any provision of this chapter.

Section 110. Cooperation with other regulatory agencies.

(a) In order to assist in the performance of the superintendent's duties under this chapter, the superintendent:

(1) may share documents, materials or other information, including the confidential and privileged documents, materials or information with other state, federal, and international regulatory agencies, with the National Association of Insurance Commissioners, its affiliates or subsidiaries, and with state, federal, and international law enforcement authorities, provided that the recipient has the authority and agrees to maintain the confidentiality and privileged status of the document, material or other information; provided, however, that this paragraph shall not be construed as limiting access to records pursuant to article six of the public officers law;

(2) may receive documents, materials or information, including otherwise confidential and privileged documents, materials or information, from the National Association of Insurance Commissioners, its affiliates or subsidiaries and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information;

(3) may enter into agreements governing sharing and use of documents, materials or information consistent with this subsection.

(b) No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the superintendent under this section or as a result of sharing as authorized in this section.

Article 2
Organization of the Insurance Department

Section 205. Gratuities; prohibited payments to department personnel.

(a) No insurer or other person subject to this chapter, nor any other insurer or person shall directly or indirectly confer, or offer to confer, any money or other valuable benefit, whether in the form of payment, loan, credit, or otherwise, upon the superintendent, any deputy, or any employee of the department, by way of gratuity or for service or pretended service. Neither the superintendent, any deputy, nor any employee of the department shall accept, or offer to accept, any such money or benefit.

(b) Subsection (a) hereof shall not prohibit the payment of compensation to any stenographer for transcripts of hearings or conferences, except that the superintendent may prescribe, by regulation, the conditions under which such transcripts may be furnished and the compensation therefor.

Section 206. Annual report of superintendent; pamphlets.

(a) The superintendent shall submit a report to the legislature annually, on or before the date required by section one hundred sixty-four of the executive law. Such report shall contain the following items, with respect to the preceding calendar year:

(1) A general review of the insurance business utilizing the most current information available.

(2) Amendments enacted to the insurance law, with explanations thereof.

(3) A summary of regulations and circular letters issued.

(4) A table showing the number and kinds of authorized insurers according to classes of business, and their total assets, liabilities, premiums written, and insurance in force, as shown by the annual statements filed with the superintendent by such insurers.

(5) Lists of (i) insurers organized, admitted, merged, withdrawn, or placed in liquidation, conservation, or rehabilitation, (ii) domestic insurers which have amended their charters or have increased or decreased their capital stock, together with a statement of the extent thereof, and (iii) domestic insurers which have changed their corporate names.

(6) A list of department reports filed on examination of authorized insurers.

(7) An evaluation of the impact on automobile insurance rates of motor vehicle theft prevention programs of the department of motor vehicles.

(8) A statement of the expenses of administering the property/casualty insurance security fund and the public motor vehicle liability security fund pursuant to article seventy-six of this chapter.

(b) Such report of the superintendent shall also contain the following items:

(1) Legislative recommendations which are deemed by him necessary or desirable.

(2) A summary of the department's receipts and expenses for the twelve month period ending March thirty-first of the preceding year.

(3) Tables relative to liquidation, conservation or rehabilitation proceedings by the department for prior years including the preceding calendar year.

(c) Such report shall be supplemented by tables, arranged in classes according to the kinds of insurance business transacted:

(1) of annual statements, which may be audited or reviewed by the superintendent, filed with him for the preceding calendar year; or

(2) derived from annual statements filed with the superintendent during such year.

(d) The superintendent may, in addition to the above requirements, include in such report any other matter or data concerning insurance or his duties under this chapter which in his judgment is of general interest or import.

(e) Pamphlets containing statistical tables compiled from annual statements filed with the superintendent by all insurers licensed to transact business in this state may be furnished upon request, without charge, to citizens of this state.

Section 208. Transfer or destruction of records.

The superintendent may, in accordance with the provisions of section one hundred eighty-six of the state finance law, effect the transfer, or destruction, of any records made, acquired, or received by the department, if such records are, in his judgment, of no further material value to the state; but, subject to the provisions of section 57.29 of the arts and cultural affairs law, no records or other data required to be filed with the department during his administration, pursuant to any provision of this chapter, may be so destroyed.

Section 210. Annual consumer guide of health insurers, and entities certified pursuant to article forty-four of the public health law.

(a) The superintendent shall annually publish on or before September first, nineteen hundred ninety-nine, and annually thereafter, a consumer guide to insurers providing managed care products, individual accident and health insurance or group or blanket accident and health insurance and entities licensed pursuant to article forty-four of the public health law providing comprehensive health service plans which includes, in detail, a ranking from best to worst based upon each company's claim processing or medical payments record during the preceding calendar year using criteria available to the department, adjusted for volume of coverage provided. Such ranking shall also take into consideration the corresponding total number or percentage of claims denied which were reversed or compromised after intervention by the department and the department of health, consumer complaints to the department and the department of health, violations of section three thousand two hundred twenty-four-a of this chapter and other pertinent data which would permit the department to objectively determine a company's performance. The department in publishing such consumer guide shall publish one state-wide guide or no more than five regional guides so as to facilitate comparisons among individual insurers and entities within a service market area. Such rankings shall be printed in a format which ranks all health insurers and all entities certified pursuant to article forty-four of the public health law in one combined list.

(b) Beginning September first, nineteen hundred ninety-nine and annually thereafter, the superintendent shall include in such guide, and insurers and entities certified pursuant to article forty-four of the public health law shall provide to the superintendent the information required for such guide in a timely fashion, the following information:

(1) The number of grievances filed pursuant to section forty-four hundred eight-a of the public health law or article forty-eight of this chapter and the number of such grievances in which an adverse determination of the insurer or entity was reversed in whole or in part versus the number of such determinations which were upheld; and

(2) The number of appeals to utilization review determinations which were filed pursuant to article forty-nine of the public health law or article forty-nine of this chapter and the number of such determinations which were reversed versus the number of such determinations which were upheld.

(c) Beginning September first, nineteen hundred ninety-nine and annually thereafter, in addition to the information required in subsections (a) and (b) of this section, the superintendent, in conjunction with the commissioner of health, in consultation with the National Committee on Quality Assurance or a similar national organization, shall include in such guide the following additional information, for the most recent year in which such information is available and where applicable, for health insurers, health insurers providing managed care products and entities certified under article forty-four of the public health law providing comprehensive health service plans pursuant to such article:

(1) the percentage of physicians who are either board certified or board eligible;

(2) the percentage of primary care physicians who remained participating providers, provided however, that such percentage shall exclude voluntary terminations due to physician retirement, relocation or other similar reasons;

(3) the percentage of enrollees aged twenty-three to thirty-nine and forty to sixty-four who had one or more visits to a health plan practitioner during the three years of their continual enrollment.

(4) the methods used to compensate primary care physicians and other providers, provided however, that nothing in this section shall be construed to require disclosure of the specific details of any financial arrangement between the insurer or entity and an individual provider or practice;

(5) the national accreditation status of insurers and entities, where applicable;

(6) indices of the quality of care provided, such as the rates of mammography, prostate, and cervical cancer screening, prenatal care, well-child care, immunization and such other information collected by the commissioner of health through the health plan employer data and information set (HEDIS); or through the quality assurance reporting requirements for entities not otherwise required to collect and report health plan employer data and information set (HEDIS) data;

(7) the results of a consumer satisfaction survey among enrollees of the various health insurers and entities, which shall be conducted by the superintendent and commissioner of health, in consultation with the National Committee on Quality Assurance or a similar national organization;

(8) a toll-free telephone number for each health insurer or plan;

(9) toll-free telephone numbers at the department and the department of health to which consumers can make complaints about insurers or entities; and

(10) except as required in paragraph seven of this subsection, health insurers and entities certified pursuant to article forty-four of the public health law shall report the information required under this subdivision to the commissioner of health, and the commissioner shall provide such information to the superintendent for inclusion in the annual consumer guide.

(d) Health insurers and entities certified pursuant to article forty-four of the public health law shall provide annually to the superintendent and the commissioner of health, and the commissioner of health shall provide to the superintendent, all of the information necessary for the superintendent to produce the annual consumer guide. In compiling the guide, the superintendent shall make every effort to ensure that the information is presented in a clear, understandable fashion which facilitates comparisons among individual insurers and entities, and in a format which lends itself to the widest possible distribution to consumers. The superintendent shall either include the information from the annual consumer guide in the consumer shopping guide required by subsection (a) of section four thousand three hundred twenty-three of this chapter or combine the two guides as long as consumers in the individual market are provided with the information required by subsection (a) of section four thousand three hundred twenty-three of this chapter.

(e) The superintendent shall contract with a national organization for the purposes of drafting and designing the guide, including the preparation of relevant explanatory material. Such organization shall have actual experience in preparing a similar guide for at least one other state. The superintendent, in consultation with the commissioner of health, may also contract with one or more national organizations to assist such commissioner in the collection of data and the analysis and auditing of the clinical measurers. Such organizations shall consult periodically with associations representing health insurers and health maintenance organizations as well as with consumer representatives in New York in preparing the consumer guide.