ยง 3224-c. Coordination of benefits. An insurer or organization or
corporation licensed or certified pursuant to article forty-three or
forty-seven of this chapter or article forty-four of the public health
law shall not deny a claim, either in whole or in part, on the basis
that it is coordinating benefits and another insurer or organization or
corporation or other entity is liable for the payment of the claim,
unless it has a reasonable basis to believe that the insured has other
health insurance coverage which is primary for that benefit. If an
insurer or organization or corporation does not have current information
from the insured regarding other coverage, and requests such information
in accordance with subsection (b) of section three thousand two hundred
twenty-four-a of this article, and no information is received within
forty-five days, the claim shall be adjudicated provided, however, the
claim shall not be denied based on the insurer, or organization or
corporation not having received such information.
Structure 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.
3202 - Withdrawal of Approval of Policy Forms.
3205 - Insurable Interest in the Person; Consent Required; Exceptions.
3206 - Policies Which Provide for an Adjustable Maximum Rate of Interest on Policy Loans.
3208 - Antedating of Life Insurance Policies and Burial Agreements Prohibited.
3209 - Life Insurance, Annuities and Funding Agreements Disclosure Requirements.
3210 - Incontestability After Reinstatement.
3212 - Exemption of Proceeds and Avails of Certain Insurance and Annuity Contracts.
3214 - Interest Upon Proceeds of Life Insurance Policies and Annuity Contracts.
3215 - Disability Benefits in Connection With Life Insurance and Annuities.
3216 - Individual Accident and Health Insurance Policy Provisions.
3217-A - Disclosure of Information.
3217-C - Primary and Preventive Obstetric and Gynecologic Care.
3217-D - Grievance Procedure and Access to Specialty Care.
3217-E - Choice of Health Care Provider.
3217-F - Prohibition on Lifetime and Annual Limits.
3217-G - Maternal Depression Screenings.
3217-H - Telehealth Delivery of Services.
3217-I - Essential Health Benefits Package and Limit on Cost-Sharing.
3217-J - Utilization Review Determinations for Medically Fragile Children.
3218 - Medicare Supplemental Insurance Policies.
3220 - Group Life Insurance Policies; Standard Provisions.
3221 - Group or Blanket Accident and Health Insurance Policies; Standard Provisions.
3224 - Standard Claim Forms; Accident and Health Insurance.
3224-B - Rules Relating to the Processing of Health Claims and Overpayments to Physicians.
3224-C - Coordination of Benefits.
3224-D - Prescription Synchronization.
3225 - Eligibility for Health Insurance in Cases of Exposure to Des.
3226 - Reinsurance Contracts Excepted.
3227 - Interest Upon Surrenders, Policy Loans and Other Funds.
3228 - Individual Accident and Health Insurance Policies; Premium Refund at Death of Insured.
3229 - Minimum Benefit Standards for Certain Long Term Care Plans.
3231 - Rating of Individual and Small Group Health Insurance Policies; Approval of Superintendent.
3231*2 - Health Insurance Policies and Subscriber Contracts; Prohibited Claims.
3232 - Pre-Existing Condition Provisions in Health Policies.
3232-A - Certification of Creditable Coverage.
3233 - Stabilization of Health Insurance Markets and Premium Rates.
3234 - Pre-Existing Condition Provisions in Group and Blanket Disability Policies.
3234*2 - Limitations on Administrative Services and Stop-Loss Coverage.
3236 - Public Health Law Assessments.
3237 - Health Insurance Coverage for Full-Time Students on Medical Leaves of Absence.
3238 - Pre-Authorization of Health Care Services.
3240*2 - Student Accident and Health Insurance.
3242 - Prescription Drug Coverage.
3245 - Liability to Providers in the Event of an Insolvency.