New York Claims Compliance
Key regulatory requirements, correspondence deadlines, and mandated forms for New York (NY).
Catastrophe-Specific Rules Apply
New York has catastrophe-specific rules that may modify standard deadlines and require additional consumer notices during declared emergency periods. Check the Disclosures tab for details.
Quick Reference
Key Deadlines
Requirements
- Mandated Forms
- Catastrophe Rules
- Separate P&C / Life & Health
- Fraud Warning
- Depreciation Notice
- E-Delivery (yes)
Regulatory Authority
New York State Department of Financial Services (DFS)
Phone: (800) 342-3736; Website: https://www.dfs.ny.gov; Address: Consumer Assistance Unit, New York State Department of Financial Services, One State Street, New York, NY 10004 or One Commerce Plaza, Albany, NY 12257
Bad Faith: N.Y. Ins. Law § 2601
Lines of Business
Key Statutes
- N.Y. Ins. Law § 2601
- 11 NYCRR 216.0 et seq. (Insurance Regulation 64)
- N.Y. Ins. Law § 3404
- N.Y. Ins. Law § 3407
New York has highly procedural claim correspondence requirements, particularly for no-fault/PIP claims. The Department of Financial Services (DFS) publishes circular letters and claims-related guidance on timeliness and communications.
Acknowledgment
Insurers must acknowledge receipt of a claim within 15 business days. The acknowledgment must provide necessary claim forms and instructions.
No-Fault / PIP
No-fault denial of claim forms (NF-10) must be issued within 30 calendar days of the insurer's receipt of the completed verification. Strict adherence to the NF form series is required.
DFS Guidance
DFS circular letters provide supplemental guidance on confirmation or denial of coverage in motor vehicle contexts and other claim-handling standards.
LOB-Specific Requirements
Regulatory requirements for New York, grouped by line of business. Select a chip to filter.
- Appraisal Process DetailsStatutory
- If either party makes a written demand for appraisal, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within 20 days of such demand (N.Y. Ins. Law § 3404(e))
- DOI Contact In Letters Required
- Yes
- Unfair Claims Practices Act RefStatutory
- N.Y. Ins. Law § 2601
- Prompt Payment Statute Ref
- 11 NYCRR 216.6
- HO Specific RequirementsStatutory
- Standard Fire Policy (N.Y. Ins. Law § 3404); Property insurance proof of loss (N.Y. Ins. Law § 3407)
- Catastrophe Provisions
- Emergency Amendment 17 to Regulation 64 (11 NYCRR 216) regarding riot/civil commotion reduced the investigation commencement deadline from 15 business days to 6 business days, allowed photos/video for proof of loss, and permitted immediate property repairs for health and safety
- Proof Of Loss RequirementsStatutory
- Failure to furnish a proof of loss does not invalidate or diminish a claim unless the insurer, after the loss, gives written notice that it desires proof of loss and provides a suitable blank form. The insured then has 60 days after the receipt of such notice and form to furnish the proof of loss (N.Y. Ins. Law § 3407)
- Suit Limitation PeriodStatutory
- 24 months next after the inception of the loss (N.Y. Ins. Law § 3404(e))
New York Case Law
Published decisions that shape claim-handling and correspondence practice in New York. Pair these with the statutory deadlines above.
- Case Law
Great Lakes Insurance SE v. Raiders Retreat Realty Co., LLC
601 U.S. 65 (2024)
Status UpdatesInland / Ocean MarineThe U.S. Supreme Court held that choice-of-law provisions in maritime contracts (which frequently select New York law) are presumptively enforceable under federal maritime law.
- Case Law
Liang v. Progressive Cas. Ins. Co
172 A.D.3d 696 (2019)
Bad FaithInland / Ocean MarineStudicata / Justia / CaseMine, Pavia v. State Farm Mutual Automobile Insurance Co., 82 N.Y.2d 445 (1993).
- Case LawDiminished ValueAutoCommercial Auto
the court recognized that applying the strict Johnson rule to an appreciating asset (in that case, a rare Ford GT sports car) would fail to make the plaintiff whole . Thus, if a vehicle appreciates in market value from the time of its acquisition, a third-party recovery of both repair costs and proven diminished value is permitted .
- Case Law
Elacqua v. Physicians' Reciprocal Insurers
21 A.D.3d 702 (2005)
Duty to DefendReservation of RightsCommercial AutoProfessional LiabilityAn insurer has an affirmative obligation to inform the insured of their right to select independent counsel at the insurer's expense when a conflict of interest exists.
- Closing LettersProfessional Liability
the Appellate Division, Second Department held that a violation of 11 NYCRR 216.6(c) does not estop an insurer from relying on a policy exclusion to disclaim coverage .
- Case LawClosing LettersProfessional Liability
the court held that the insurer's failure to promptly disclaim coverage in writing, in violation of 11 NYCRR 216.6(c), precluded the insurer from denying coverage .
Show 9 more cases
- Case LawDiminished ValueAuto
the measure of damages for injury to property is strictly the difference in market value immediately before and immediately after the accident, or the reasonable cost of repairs necessary to restore it to its former condition, whichever amount is lesser .
- Case LawClosing LettersProfessional Liability
. The state's highest court confirmed that while failing to send a proper written rejection or closing notice within the timeframes set by Regulation 64 is a regulatory violation, it is not a sufficient basis, standing alone, to preclude the insurer from asserting its policy exclusions in a breach of contract suit .
- Case LawStatus UpdatesCommercial Auto
Established the "gross disregard" standard for failing to protect the insured's interests.
- Case LawStatus UpdatesWorkers' Comp
decisively ruled that "the law of this State does not currently recognize a private cause of action under Insurance Law § 2601" . The power to punish insurers for failing to communicate or provide status updates rests exclusively with the Superintendent of the New York Department of Financial Services (NYDFS) and the Workers' Compensation Board .
- Case LawBad FaithStatus UpdatesCommercial AutoCyber
the court found bad faith where the insurer deliberately delayed issuing coverage decisions and refused to participate in settlements, hoping to limit its own financial exposure while the insured bled capital defending the claims .
- Case LawStatus UpdatesCommercial Auto
Made failure to communicate settlement negotiations a specific factor in bad faith liability.
- Case LawDuty to DefendProfessional Liability
the Second Department held that an insurer did not have an affirmative duty to advise the insured of the right to retain independent counsel, dismissing a bad faith and conflict of interest counterclaim predicated on that failure . Practitioners must be aware of this geographical split within New York's appellate divisions when assessing notification requirements.
- Case LawDuty to DefendProfessional Liability
A notice of disclaimer under § 3420(d)(2) must apprise the claimant with a "high degree of specificity" of the grounds on which the disclaimer is predicated. Current Status: Valid and heavily relied upon for assessing the required content of a disclaimer.
- Case LawReservation of RightsGeneral Liability
Historical court cases are for reference only and may be superseded, distinguished, or abrogated.
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