N.Y. ISC. LAW § 5106 : NY Code - Section 5106: Fair claims settlement

Search N.Y. ISC. LAW § 5106 : NY Code - Section 5106: Fair claims settlement

(a) Payments of first party benefits
  and additional first party  benefits  shall  be  made  as  the  loss  is
  incurred.    Such  benefits  are  overdue if not paid within thirty days
  after the claimant supplies  proof  of  the  fact  and  amount  of  loss
  sustained.  If  proof is not supplied as to the entire claim, the amount
  which is supported by proof is overdue if not paid  within  thirty  days
  after  such  proof is supplied. All overdue payments shall bear interest
  at the rate of two percent per month. If a valid claim  or  portion  was
  overdue,  the  claimant shall also be entitled to recover his attorney's
  reasonable fee, for services necessarily performed  in  connection  with
  securing   payment   of   the  overdue  claim,  subject  to  limitations
  promulgated by the superintendent in regulations.
    (b) Every  insurer  shall  provide  a  claimant  with  the  option  of
  submitting  any  dispute  involving the insurer's liability to pay first
  party benefits, or additional first party benefits, the  amount  thereof
  or  any  other matter which may arise pursuant to subsection (a) of this
  section  to  arbitration  pursuant  to  simplified  procedures   to   be
  promulgated   or   approved   by  the  superintendent.  Such  simplified
  procedures shall include an expedited eligibility hearing  option,  when
  required,  to designate the insurer for first party benefits pursuant to
  subsection (d) of this section. The expedited eligibility hearing option
  shall be a forum for eligibility disputes only, and  shall  not  include
  the submission of any particular bill, payment or claim for any specific
  benefit  for  adjudication,  nor  shall it consider any other defense to
  payment.
    (c) An award by an arbitrator shall be binding except where vacated or
  modified by a master arbitrator in accordance with simplified procedures
  to be promulgated or approved by the  superintendent.  The  grounds  for
  vacating or modifying an arbitrator's award by a master arbitrator shall
  not  be  limited  to  those  grounds  for  review  set  forth in article
  seventy-five of the civil practice law and rules. The award of a  master
  arbitrator  shall be binding except for the grounds for review set forth
  in article seventy-five  of  the  civil  practice  law  and  rules,  and
  provided further that where the amount of such master arbitrator's award
  is   five  thousand  dollars  or  greater,  exclusive  of  interest  and
  attorney's fees, the insurer or  the  claimant  may  institute  a  court
  action to adjudicate the dispute de novo.
    (d)  Where  there  is reasonable belief more than one insurer would be
  the source of  first  party  benefits,  the  insurers  may  agree  among
  themselves,  if  there  is a valid basis therefor, that one of them will
  accept and pay the claim initially. If there is no such agreement,  then
  the  first insurer to whom notice of claim is given shall be responsible
  for payment. Any such dispute shall be resolved in accordance  with  the
  arbitration procedures established pursuant to section five thousand one
  hundred  five  of  this  article  and  regulation  as promulgated by the
  superintendent, and any insurer paying  first-party  benefits  shall  be
  reimbursed  by other insurers for their proportionate share of the costs
  of the claim and the allocated expenses  of  processing  the  claim,  in
  accordance  with  the  provisions entitled "other coverage" contained in
  regulation and the provisions entitled  "other  sources  of  first-party
  benefits"  contained  in regulation. If there is no such insurer and the
  motor vehicle accident occurs in this state, then an applicant who is  a
  qualified  person  as defined in article fifty-two of this chapter shall
  institute the  claim  against  motor  vehicle  accident  indemnification
  corporation.