New York S 5353: Relates to prohibiting the Metropolitan Transportation Authority from listing a gender on commuter tickets

Bill Text

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S05353 Summary:

BILL NOS05353 

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SAME ASNo Same As

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SPONSORCOMRIE

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COSPNSR

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MLTSPNSR

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Amd §§5106, 5109, 5102, 3420 & 5202, Ins L

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Enacts the "Automobile Insurance Fraud Prevention Act"; relates to claims and medical treatment arising out of motor vehicle accidents.

Go to top S05353 Actions:

BILL NOS05353 

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02/20/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS05353 Committee&nbspVotes:

Go to topS05353 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS05353 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5353

 2025-2026 Regular Sessions

 IN SENATE

 February 20, 2025
 ___________

 Introduced by Sen. COMRIE -- read twice and ordered printed, and when
 printed to be committed to the Committee on Insurance

 AN ACT to amend the insurance law, in relation to enacting the "automo-
 bile insurance fraud prevention act of 2025"

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. This act shall be known and may be cited as the "automobile
 2 insurance fraud prevention act of 2025".
 3 § 2. Section 5106 of the insurance law, subsection (b) as amended by
 4 chapter 452 of the laws of 2005, subsection (d) as amended by section 8
 5 of part AAA of chapter 59 of the laws of 2017, paragraph 2 of subsection
 6 (d) as amended by chapter 129 of the laws of 2022, and subsection (e) as
 7 added by chapter 766 of the laws of 2023, is amended to read as follows:
 8 § 5106. Fair claims settlement. (a) (1) Payments of first party bene-
 9 fits and additional first party benefits shall be made as the loss is
 10 incurred. Such benefits are overdue if not paid within thirty days
 11 after the claimant supplies proof of the fact and amount of loss
 12 sustained. If proof is not supplied as to the entire claim, the amount
 13 which is supported by proof is overdue if not paid within thirty days
 14 after such proof is supplied. All overdue payments shall bear interest
 15 at the rate of two percent per month. If a valid claim or portion was
 16 overdue, the claimant shall also be entitled to recover [his] their
 17 attorney's reasonable fee, for services necessarily performed in
 18 connection with securing payment of the overdue claim, subject to limi-
 19 tations promulgated by the superintendent in regulations.
 20 (2) The failure to issue a denial of a claim within thirty days shall
 21 not preclude the insurer or self-insurer from presenting evidence to
 22 establish that (A) the services or items billed for in a claim were not
 23 provided; (B) certain portions of the charges for services in a claim
 24 exceed, by more than ten percent, the charges permissible under sched-
 25 ules prepared and established pursuant to subsections (a) and (b) of

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09492-01-5

 S. 5353 2

 1 section five thousand one hundred eight of this article; or (C) the
 2 event from which the claim arose was based upon an intent to defraud an
 3 insurer or self-insurer. Nothing contained in this paragraph shall
 4 preclude an insurer from contesting the existence of applicable insur-
 5 ance coverage for the loss claimed.
 6 (3) An insurer may deny a claim on the basis of lack of medical neces-
 7 sity not later than sixty days after the date upon which the claim
 8 became overdue. Any denial of a claim which is based upon a lack of
 9 medical necessity shall be based upon review by a licensed provider who
 10 typically diagnoses and provides treatment for the condition under
 11 review, or typically provides the health care service or treatment under
 12 review. Copies of all reports prepared by a health care provider who
 13 examines a claimant at the request of an insurer or reviews a claim for
 14 medical benefits at the request of an insurer shall be provided to the
 15 claimant, the claimant's attorney and the claimant's treating health
 16 care provider within thirty business days of such examination or review.
 17 (b) [Every insurer shall provide a] (1) A claimant [with] shall have
 18 the option of submitting any dispute involving the insurer's liability
 19