New York Laws
Article 32 - Insurance Contracts - Life, Accident and Health, Annuities
3201 - Approval of Life, Accident and Health, Credit Unemployment, and Annuity Policy Forms.

(b) (1) No policy form shall be delivered or issued for delivery in
this state unless it has been filed with and approved by the
superintendent as conforming to the requirements of this chapter and not
inconsistent with law. A group life, group accident, group health, group
accident and health or blanket accident and health insurance certificate
evidencing insurance coverage on a resident of this state shall be
deemed to have been delivered in this state, regardless of the place of
actual delivery, unless the insured group is of the type described in:
(A) section four thousand two hundred sixteen, except paragraph four
where the group policy is issued to a trustee or trustees of a fund
established or participated in by two or more employers not in the same
industry with respect to an employer principally located within the
state, paragraph twelve, thirteen or fourteen of subsection (b) thereof;
(B) section four thousand two hundred thirty-five except subparagraph
(D) where the group policy is issued to a trustee or trustees of a fund
established or participated in by two or more employers not in the same
industry with respect to an employer principally located within the
state, subparagraph (K), (L) or (M) of paragraph one of subsection (c)
thereof; or (C) section four thousand two hundred thirty-seven (except
subparagraph (F) of paragraph three of subsection (a) thereof; of this
chapter; and where the master policies or contracts were lawfully issued
without this state in a jurisdiction where the insurer was authorized to
do an insurance business. With regard to any certificate deemed to have
been delivered in this state by virtue of this paragraph, the
superintendent shall (i) require that the premiums charged be reasonable
in relation to the benefits provided, except in cases where the
policyholder pays the entire premium; (ii) have power to issue
regulations prescribing the required, optional and prohibited provisions
in such certificates; (iii) establish an accelerated certificate form
approval procedure available to an insurer which includes a statement in
its policy form submission letter that it is the company's opinion that
the certificate form or forms comply with applicable New York law and
regulations. The superintendent, upon receipt of such a filing letter,
shall grant conditional approval of such certificate form or forms in
reliance on the aforementioned statement by the company upon the
condition that the company will retroactively modify such certificate
form or forms, to the extent necessary, if it is found by the
superintendent that the certificate form fails to comply with applicable
New York laws and regulations. The superintendent may, with regard to
the approval of any certificate deemed to have been delivered in this
state by virtue of this paragraph, approve such certificate if the
superintendent finds that the certificate affords insureds protections
substantially similar to those which have been provided by certificates
delivered in this state. Any regulations issued by the superintendent

pursuant to this paragraph may not impose stricter requirements than
those applicable to similar policies and certificates actually delivered
in this state.
(2) No unallocated group annuity contract or funding agreement, or
policy form for accident and health insurance or any other policy form
specified by the superintendent pursuant to regulation shall be issued
by a domestic insurer or fraternal benefit society for delivery outside
this state unless it has been filed with the superintendent.
(3) In exercising the authority granted by this subsection and by
subsection (c) hereof, with respect to a policy or certificate form
under which additional amounts may be credited pursuant to subsection
(b) of section four thousand two hundred thirty-two or section four
thousand five hundred eighteen of this chapter, the superintendent shall
take into account the tax aspects of the policy form as they relate to
all parties concerned.
(4) (A) No credit insurance or credit unemployment insurance policy
form shall be issued unless it and its premium rates have been filed
with and approved by the superintendent. In this section "credit
insurance" and "credit unemployment insurance" mean insurance on a
debtor, including an intended borrower, pursuant to a program as defined
in paragraph three of subsection (b) of section four thousand two
hundred sixteen of this chapter for defraying the costs of attendance of
a student at a college or university, in connection with a specified
loan or other credit transaction to provide payment to the creditor in
the event of the death of the debtor or indemnity to the creditor for
the installment payments on the indebtedness becoming due while the
debtor is disabled as defined in the policy, or payment to the creditor
for the installment payments on the indebtedness becoming due while the
debtor is unemployed as set forth in section three thousand four hundred
thirty-six of this chapter.
(B) The superintendent shall from time to time prescribe regulations
which, among other things, shall require that, in the event of the
termination of the insurance prior to the scheduled maturity date of the
indebtedness or the last maturing instalment thereof, there shall be an
appropriate refund by the insurer to the policyholder of any amount
collected from or charged to the policyholder for such terminated
insurance, and an appropriate refund or credit by the policyholder or
creditor to the debtor of an amount collected from or charged to the
debtor for such terminated insurance, if such refund amounts to one
dollar or more.
(5) Notwithstanding the other provisions of this section, on and after
June first, nineteen hundred eighty no policy form of industrial life
insurance, industrial accident insurance or industrial health insurance
shall be approved by the superintendent for delivery or issuance for
delivery in this state.
(6) (A) As an alternative procedure to the policy form filing
requirements of paragraph (1) of this subsection, an insurer has the
option to file an expedited policy form approval application with the
superintendent pursuant to this paragraph. If this option is elected,
the filing shall include the proposed policy form, including rates as
required, and all necessary supporting material requested by the
superintendent pursuant to rule, and a certification signed by an
officer of the insurer, who is knowledgeable with respect to the law and
regulation applicable to the type of policy form, that such form is in
compliance with the applicable law and regulations to the best of his or
her knowledge and belief.
Within ninety days of receipt of a filing, the superintendent shall,
in writing, either approve, submit a detailed list to the insurer

requesting all additional information necessary to make a determination
on the filing, or deny such filing, otherwise, such filing shall be
deemed approved. Any denial issued by the superintendent shall state the
reasons for such disapproval. If an insurer does not provide the
additional information requested by the superintendent, or respond to
the superintendent's objections within forty-five days of receipt of
such request or denial, then such filing shall be deemed denied and such
filing may not be resubmitted for a period not to exceed ninety days
from the date that such information or response was due. The forty-five
day limit for providing such additional information or response may be
extended at the option of the superintendent.
In the event that an insurer properly submits the additional
information or response, then such filing shall be deemed approved
forty-five days after receipt of such information or response by the
superintendent, unless the insurer is notified in writing prior to such
date that the filing has been denied. Such denial shall state the
reasons for such disapproval and cannot be based on any objection not
specified in the superintendent's initial review of the filing, unless
the objection arises from a modification of the policy forms made by the
insurer in addressing the objections or new material submitted by the
insurer. Notwithstanding anything to the contrary contained in this
section, the superintendent may, at any time, before the filing is
either deemed approved, affirmatively approved, or denied, raise
objections to the policy form that is based on the explicit requirements
of this chapter and any applicable regulations.
The superintendent shall, as soon as practicable, but no later than
sixty days after receipt of the filing, notify the insurer if its filing
is incomplete or fails to comply with applicable statutory or regulatory
requirements. Such notice shall indicate that the filing is being
returned with no action by the superintendent and that the period for
the superintendent's substantive review has not commenced.
(B) Nothing contained in this paragraph shall prohibit the
superintendent from requiring an insurer to retroactively modify or
withdraw a form approved pursuant to the expedited filing procedure if
such form is found to fail to conform with the requirements of this
chapter, provided that the order to withdraw or modify such form is
issued in accordance with the provisions of section three thousand one
hundred ten or section three thousand two hundred two of this chapter.
(C) In addition to any penalties for violations contained in this
chapter, any insurer which receives approval under this subsection for a
form which is found to fail to comply with the provisions of this
chapter shall be ineligible to apply for an expedited review under this
subsection for a period not to exceed one year.
(7) Notwithstanding any other provision of this section, an approved
policy form that has been revised may continue to be delivered or issued
for delivery in this state without further approval from the
superintendent, provided that the policy form is revised solely to
reflect:
(A) a change in the investment options of a separate account offered
under the policy form, in accordance with an amended statement as to the
methods of operation of the separate account approved by the
superintendent pursuant to subsection (e) of section four thousand two
hundred forty of this chapter, and further provided that an
informational filing, in a form acceptable to the superintendent,
identifying the policy forms that have been revised and the investment
options offered in each policy form, is submitted to the superintendent
no later than sixty days after the amended statement as to the methods
of operation of the separate account has been approved; or
(B) any other type of change to a class or classes of policy forms for
which the superintendent waives or otherwise modifies the filing and
approval requirements of this section provided, however, that such
determination to waive or otherwise modify shall be published in written
guidance issued by the superintendent after such determination has been
made.
(c) (1) The superintendent may disapprove any policy form for delivery
or issuance for delivery in this state if he finds that the same
contains any provision or has any title, heading, backing or other
indication of the contents of any or all of its provisions, which is
likely to mislead the policyholder, contract holder or certificate
holder.
(2) The superintendent may disapprove any life insurance policy form,
or any form of annuity contract or group annuity certificate, or any
form of funding agreement for delivery or issuance for delivery in this
state, if its issuance would be prejudicial to the interests of
policyholders or members or it contains provisions which are unjust,
unfair or inequitable.
(3) The superintendent may disapprove any accident and health
insurance policy form for delivery or issuance for delivery in this
state if the benefits provided therein are unreasonable in relation to
the premium charged or any such form contains provisions which encourage
misrepresentation or are unjust, unfair, inequitable, misleading,
deceptive, or contrary to law or to the public policy of this state.
(4) The superintendent shall not approve any life insurance policy
form containing any war or travel exclusion or restriction, for delivery
or issuance for delivery in this state, unless such policy form shall
have printed or stamped across its face in red and in capital letters
not smaller than twelve point type, or in an equally prominent manner
established at the discretion of the superintendent and promulgated
through regulations, the following:
"Read your policy (certificate) carefully.
"Certain (war, travel) risks are not assumed.
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(5) The superintendent shall not approve any annuity or life insurance
policy form which is subject to the provisions of section four thousand
two hundred twenty, four thousand two hundred twenty-one or four
thousand five hundred eleven of this chapter, unless a detailed
statement of the method used by the insurer in calculating any cash
surrender value and any paid-up nonforfeiture benefit in the policy form
is stated therein or, in lieu thereof, a statement that such method of
computation has been filed with the insurance supervisory official of
the state in which the policy form is delivered, and unless a statement
of the method to be used in calculating the cash surrender value and
paid-up nonforfeiture benefit available on any anniversary beyond the
last anniversary for which such value and benefits are consecutively
shown in the policy form is included therein, and, with respect to
policy forms under which additional amounts may be credited pursuant to
subsection (b) of section four thousand two hundred thirty-two or
section four thousand five hundred eighteen of this chapter, the insurer
shall also furnish such further information to the superintendent as the
superintendent may require.
(6) (a) The superintendent may disapprove any policy form specified in
paragraph two of subsection (b) of this section issued by a domestic
life insurer or fraternal benefit society for delivery outside the state

if its issuance would be prejudicial to the interests of its
policyholders or members.
(b) Except for the policy forms specified in paragraph two of
subsection (b) of this section, every domestic life insurer and
fraternal benefit society shall file annually with the superintendent a
list identifying and describing the policy forms issued by the insurer
or fraternal benefit society for delivery outside the state in a form
prescribed by the superintendent. If the superintendent determines that
the issuance of a policy form has been or may be prejudicial to the
interests of policyholders or members, the superintendent may take any
action he or she deems appropriate, including issuing an order, after a
hearing, to cease and desist issuing the policy form.
(7) If any policy of individual accident and health insurance is
issued by an insurer domiciled in this state for delivery to a person
residing in another state, and if the official having responsibility for
the administration of the insurance laws of such other state shall have
advised the superintendent that any such policy form is not subject to
approval or disapproval by such official, the superintendent may by
ruling require that such policy form meet the standards set forth in
subsections (c) and (d) of section three thousand two hundred sixteen of
this article.
(8) Without limitation on his other powers and duties under this
section, the superintendent shall not approve any credit insurance or
credit unemployment insurance policy forms or premium rates if the
premium rates are unreasonable in relation to the benefits provided.
(9) Each insurer shall file with the superintendent of financial
services any change in the premium rates for policies authorized under
subparagraph (J) of paragraph one of subsection (c) of section four
thousand two hundred thirty-five of this chapter, and the same shall be
subject to his approval.
(10) The superintendent shall not approve any form of life insurance
policy that is subject to the provisions of section four thousand two
hundred twenty-one of this chapter or any form of annuity contract that
is subject to the provisions of section four thousand two hundred
twenty-three of this chapter if such form of policy or contract provides
for the adjustment of any cash surrender benefit or policy loan value in
accordance with a market-value adjustment formula, unless there shall
have been filed with the superintendent a memorandum, in form and
substance satisfactory to the superintendent, describing the
market-value adjustment formula and stating that, in the opinion of the
insurer, the formula provides reasonable equity to terminating and
continuing policy and contract holders and to the insurer and complies
with the nonforfeiture provisions of this chapter.
(11) (A) The superintendent shall not approve a life insurance policy
which provides for accelerated payment of death benefits or special
surrender values pursuant to subparagraph (B), (C), (D), (E) or (F) of
paragraph one of subsection (a) of section one thousand one hundred
thirteen of this chapter unless it also provides for such accelerated
payments or special surrender values pursuant to subparagraph (A) of
paragraph one of subsection (a) of such section.
(B) The superintendent shall promulgate a regulation establishing
rules for advertising, disclosure, benefit levels, benefit eligibility,
payment of long term care benefits, nonforfeiture, and reserves for
accelerated payment of death benefits or special surrender values
provided under a life insurance policy. The regulation shall establish
reasonable disclosure requirements concerning the percentage of the
death benefit payable when accelerated payment of the death benefit or
special surrender value occurs, the impact of accelerated payment of the

death benefit or special surrender value on eligibility for public
assistance (as determined by the commissioner of social services), the
prohibition that no health care facility as defined in section twenty of
the public health law can require any person to accelerate payment of a
death benefit or obtain a special surrender value as a condition of
admission, providing or continuing care, and notice of possible tax
obligations.
(12) The superintendent shall promulgate a regulation relating to
waiver of premium for unemployment as authorized by paragraph one of
subsection (a) of section one thousand one hundred thirteen of this
chapter establishing minimum standards for benefit levels, benefits
eligibility and exclusions. The premium charged shall be reasonable in
relation to the benefit provided.
(d) The superintendent shall, within a reasonable time after the
filing of any policy form requiring approval, notify the insurer filing
the form of his approval or disapproval of it.

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