N.Y. Comp. Codes R. & Regs. tit. 11 § 216.3

Current through Register Vol. 46, No. 51, December 18, 2024

Section 216.3 - Misrepresentation of policy provisions

(a) No insurer shall knowingly misrepresent to a claimant the terms, benefits or advantages of the insurance policy pertinent to the claim.

(b) No insurer shall deny any element of a claim on the grounds of a specific policy provision, condition or exclusion unless reference to such provision, condition or exclusion is made in writing.

(c) Any payment, settlement or offer of settlement which, without explanation, does not include all amounts which should be included according to the claim filed by the claimant and investigated by the insurer shall, provided it is within the policy limits, be deemed to be a communication which misrepresents a pertinent policy provision.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 216.3