N.Y. Comp. Codes R. & Regs. tit. 11 § 187.4

Current through Register Vol. 46, No. 50, December 11, 2024

Section 187.4 - Provisions of policies and certificates of insurance, disclosure to debtors

(a) No credit unemployment insurance shall be effected on a debtor unless evidenced by an individual policy or, in the case of group insurance, by a certificate of group insurance, which policy or certificate shall be delivered to the debtor at the time the credit unemployment insurance becomes effective or within 30 days thereafter.

(b) If a separate charge is made to the debtor and the insurer excludes eligibility for insurance because of age, employment status or other conditions for eligibility, the debtor's application for insurance, the notice of proposed group insurance, credit unemployment insurance disclosure statement or equivalent form shall include a question related to each such condition which would identify the debtor's eligibility or ineligibility. If a separate charge is not made to the debtor and the insurer excludes eligibility for insurance because of age, employment status or other conditions for eligibility, the debtor's application for insurance, the notice of proposed group insurance, credit unemployment insurance disclosure statement or equivalent form shall include a question or declaration related to each condition which would identify the debtor's eligibility or ineligibility. Prior to the delivery of the policy or certificate, such application, notice, credit unemployment insurance disclosure statement or equivalent form shall be completed and signed by the debtor.

(c) Each such individual policy or certificate of group insurance shall, in addition to other requirements of law, set forth:

(1) the name and home office address of the insurer;

(2) the identity of the debtor by name or otherwise;

(3) the amount and term of the coverage which, in the case of group insurance, may be by description rather than by stated amount and term;

(4) the amount of premium for an individual policy or the identifiable charge to the debtor, if any, under a group policy, separate from any other charges;

(5) the circumstances and formula under which refunds of premiums or identifiable charges are payable pursuant to the provisions of section 187.7 of this Part;

(6) a description of the insurance coverage including any exceptions, limitations or restrictions;

(7) a description of the eligibility requirements for the insurance, as referred to in subdivision (b) of this section; and

(8) a statement prominently displayed setting forth the following or its equivalent:

Your eligibility for this coverage may be dependent on your being eligible to receive State unemployment benefits. A change in your employment, may affect your eligibility for benefits. If you have any questions you should contact the insurance company.

In addition it shall state that the benefits shall be paid to the creditor to reduce or extinguish indebtedness to the creditor and, where the amount of insurance exceeds any such indebtedness, that any such excess shall be payable to the debtor or credited to the debtor's account. Any such certificate shall appropriately describe the refund provision required pursuant to section 187.8 of this Part. The insurer shall be responsible to ascertain that appropriate procedures are set up by the creditor to implement the above. Where appropriate, the insurer may pay any such excess directly.

(d) If said individual policy or certificate of group insurance is not delivered to the debtor at the time the credit unemployment insurance first becomes effective, a copy of the application for such individual policy, a copy of the application for such certificate of group insurance or a notice of proposed group insurance, signed by the debtor and setting forth:

(1) the name and home office address of the insurer;

(2) the name of the debtor;

(3) the amount of premium for an individual policy or the identifiable charge to the debtor, if any, under a group policy, separate from any other charges;

(4) the amount and term of the coverage provided which, in the case of group insurance, may be by description rather than by stated amount and term;

(5) a brief description of the coverage provided;

(6) a brief description of any limitations, reductions or exceptions, such as an actively at work requirement; and

(7) a description of the eligibility requirements for the insurance, as referred to in subdivision (b) of this section (this requirement may be provided in the credit insurance disclosure statement or equivalent form) shall be delivered to the debtor at the time such indebtedness is incurred. Such application for an individual policy or notice of proposed group insurance shall include a statement that, if the insurance is declined by the insurer or otherwise does not become effective, any premium or identifiable charge will be refunded or credited to the debtor pursuant to the provisions of section 187.7 of this Part. The copy of the application for an individual policy and the notice of proposed group insurance shall refer exclusively to insurance coverage, and shall be separate and apart from the loan, sale or other credit statement of account, instrument or agreement, unless set forth therein in a separate provision with an appropriate and prominent caption on the face or reverse thereof in bold face type at least equal in size to the type used for the other provisions thereof. The application for credit unemployment insurance must clearly and conspicuously disclose to the debtor:

(i) that the credit unemployment insurance is not required by the creditor, and

(ii) the cost of the credit unemployment insurance.

The insurer shall be responsible for establishment of procedures for delivery of the individual policy or certificate of group insurance to the debtor upon the insurance becoming effective, or within 30 days of the date upon which the indebtedness is incurred. Said application or notice of proposed group insurance shall provide that, upon acceptance by the insurer, the insurance coverage provided shall become effective as specified in section 187.6(c) of this Part, unless the insurer has theretofore demonstrated to the satisfaction of the Superintendent of Insurance that in deferring the effective date of the insurance the contract conforms to the standards of section 3201(b)(1) and (c)(7) of the Insurance Law.

(e) A policy of unemployment insurance may contain a provision excluding or denying a claim for unemployment resulting from:

(1) voluntary forfeiture of salary, wages or employment income, without good cause;

(2) resignation;

(3) retirement;

(4) loss of income due to disability caused by accident, sickness, disease or pregnancy;

(5) loss of income due to termination as the result of willful misconduct (a transgression of some established and definite rule of action, a forbidden act, a dereliction of duty, willful in character, improper or wrong behavior, but not negligence or carelessness), criminal misconduct or unlawful behavior as determined in judicial or administrative proceedings;

(6) strikes, lockouts and illegal walkouts;

(7) unemployment as the result of military discharge;

(8) normal or routine scheduled layoff or plant closing where the employee is expected to be rehired; and

(9) other reasons as approved by the Superintendent of Insurance.

(f) A credit unemployment insurance policy may exclude from the classes eligible for insurance:

(1) Classes of debtors determined by age, provided that no age for ineligibility shall be less than:

(i) age 65 at date of indebtedness; or

(ii) age 66 at maturity date.

(2) Class of debtor determined by employment status, provided that if an actively at work requirement in excess of three months is used, then periods of unemployment totaling less than 30 days shall not render the debtor ineligible for credit unemployment insurance, however in no event shall an actively at work requirement in excess of 12 months be used. A definition of actively at work not more restrictive then requiring the debtor be working 30 hours a week for wages may be used.

(g) A credit unemployment insurance policy may impose conditions under which an insured debtor becomes reeligible for credit unemployment benefits after a period of receiving benefits. If reeligibility conditions are required for full benefits for a subsequent period of unemployment such conditions may not be more stringent than the initial eligibility conditions and in no event shall require that the insured be actively at work for more than six months. If an insured debtor has not satisfied the reeligibility requirement at the time of a subsequent unemployment, such unemployment shall be considered a continuation of the prior unemployment with no waiting period, and with a maximum benefit period equal to the unused portion of the maximum benefit period for the prior unemployment.

(h) A credit unemployment insurance policy may call for the termination of coverage upon the attainment of a specified age. Such age may not be less than age 66.

(i) A group credit unemployment insurance policy which provides for payment of single premiums or of advance premiums to the insurer shall contain a provision that, in the event of termination of such policy by the insurer or creditor, insurance coverage with respect to any debtor insured under such policy shall be continued for the entire period for which a single premium or advance premium has been paid for such debtor, except as otherwise provided in section 187.5(c) of this Part, unless such coverage is immediately assumed by the same or another insurer. A group credit unemployment insurance policy under which premiums are paid to the insurer monthly on outstanding balances shall contain a provision that, in the event of termination of such policy by the insurer or creditor, 31 days' notice of such termination shall be given to any debtor insured under the policy by the insurer where practicable, otherwise by the creditor, unless there is immediate replacement of the coverage by the same or another insurer.

(j) A group credit unemployment insurance policy issued to a trustee, trustees or agent designated by two or more creditors shall set forth:

(1) the duties and obligations pertaining to the service and administration of said group policy of the trustee, trustees or agent;

(2) the class or classes of creditors that may be included in the group policy and the condition for eligibility of any such class or classes;

(3) the method of computation and manner of charging and collecting premiums for each class or classes of creditors;

(4) the insurer's method and manner of computing and crediting dividends or experience rate adjustments if different for any class or classes of creditors or debtors;

(5) the class or classes of debtors to be insured under said group policy; and

(6) the method of computation and manner of charging and collecting premiums or identifiable charges for each class or classes of debtors; provided, however, that paragraph (1) of this subdivision need not be set forth in the group policy if such paragraph is set forth in the trust or agency agreement and any amendments thereto. No such policy shall be issued until after the trust or agency agreement has been filed with the Superintendent of Insurance and found unobjectionable by him.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 187.4