Section 4224. Life, accident and health insurance; discrimination and rebating; prohibited inducements and interdependent sales  


Latest version.
  • (a)  No  life  insurance  company  doing  business  in  this  state  and no savings and
      insurance bank shall:
        (1) make or permit any unfair discrimination  between  individuals  of
      the  same  class  and  of  equal  expectation  of life, in the amount or
      payment or return of premiums, or rates charged  for  policies  of  life
      insurance  or  annuity  contracts, or in the dividends or other benefits
      payable thereon, or in any of the terms and conditions thereof;
        (2) refuse to insure, refuse  to  continue  to  insure  or  limit  the
      amount, extent or kind of coverage available to an individual, or charge
      a different rate for the same coverage solely because of the physical or
      mental  disability,  impairment or disease, or prior history thereof, of
      the insured or potential insured, except where the  refusal,  limitation
      or  rate  differential is permitted by law or regulation and is based on
      sound actuarial  principles  or  is  related  to  actual  or  reasonably
      anticipated  experience,  in  which  case  the  insurer,  subject to the
      limitations contained in  section  twenty-six  hundred  eleven  of  this
      chapter,  shall  notify the insured or potential insured of the right to
      receive, or to designate a medical professional to receive, the specific
      reason or reasons for such refusal, limitation or rate differential;
        (3) knowingly permit, and no agent thereof and no  licensed  insurance
      broker  shall  offer  to  make  or make, any policy of life insurance or
      annuity contract or agreement as to such policy or contract  other  than
      as plainly expressed in the policy or contract.
        (b) No insurer doing in this state the business of accident and health
      insurance,  as specified in paragraph three of subsection (a) of section
      one thousand one hundred thirteen of this chapter,  and  no  officer  or
      agent  of such insurer and no licensed insurance broker, and no employee
      or other representative of such insurer, agent or broker shall:
        (1) make or permit any unfair discrimination  between  individuals  of
      the  same class in the amount of premiums, policy fees, or rates charged
      for any policy of accident and health  insurance,  or  in  the  benefits
      payable  thereon, or in any of the terms or conditions of such policies,
      or in any other manner whatsoever;
        (2) refuse to insure, refuse  to  continue  to  insure  or  limit  the
      amount, extent or kind of coverage available to an individual, or charge
      a different rate for the same coverage solely because of the physical or
      mental  disability,  impairment or disease, or prior history thereof, of
      the insured or potential insured, except where the  refusal,  limitation
      or  rate  differential is permitted by law or regulation and is based on
      sound actuarial  principles  or  is  related  to  actual  or  reasonably
      anticipated  experience,  in  which  case  the  insurer,  subject to the
      limitations contained in  section  twenty-six  hundred  eleven  of  this
      chapter  shall  notify  the insured or potential insured of the right to
      receive, or to designate a medical professional to receive, the specific
      reason or reasons for such refusal, limitation or rate differential;
        (3) knowingly permit or offer to make or make, any policy of  accident
      and health insurance, other than as plainly expressed in the policy.
        (c)  Except  as  permitted  by  section  three  thousand  two  hundred
      thirty-nine of this chapter, no such life insurance company and no  such
      savings   and  insurance  bank  and  no  officer,  agent,  solicitor  or
      representative thereof and no such  insurer  doing  in  this  state  the
      business  of  accident  and  health  insurance  and  no  officer, agent,
      solicitor or representative thereof, and no  licensed  insurance  broker
      and  no  employee  or other representative of any such insurer, agent or
      broker, shall pay, allow or give,  or  offer  to  pay,  allow  or  give,
      directly  or  indirectly,  as  an inducement to any person to insure, or
    
      shall give, sell or purchase, or offer to give,  sell  or  purchase,  as
      such  inducement, or interdependent with any policy of life insurance or
      annuity contract or policy of accident and health insurance, any stocks,
      bonds,  or  other securities, or any dividends or profits accruing or to
      accrue thereon, or any valuable consideration or inducement whatever not
      specified in such policy or contract; nor shall any person in this state
      knowingly receive as such inducement, any rebate of  premium  or  policy
      fee or any special favor or advantage in the dividends or other benefits
      to  accrue on any such policy or contract, or knowingly receive any paid
      employment or contract  for  services  of  any  kind,  or  any  valuable
      consideration  or  inducement  whatever  which  is not specified in such
      policy or contract.
        (d) (1) No insurer authorized to do  one  or  more  of  the  kinds  of
      insurance   business  specified  in  paragraph  one,  two  or  three  of
      subsection (a) of section one thousand  one  hundred  thirteen  of  this
      chapter  or authorized to do the kind of insurance business specified in
      section three thousand two hundred  twenty-two  of  this  chapter  shall
      directly  or  indirectly, or by any of its agents or representatives, or
      by any broker or brokers, participate in any plan to offer or effect any
      kind or kinds of such insurance business in this state as an  inducement
      to,  or  interdependent  with,  the purchase by the public of any goods,
      securities,  commodities,  housing,   services   or   subscriptions   to
      periodicals,  except  as  provided  by  subsection  (e) of section three
      thousand four hundred thirty-six, paragraph three of subsection  (b)  of
      section   four   thousand  two  hundred  sixteen  of  this  article,  by
      subparagraph (E) of paragraph one of  subsection  (c)  of  section  four
      thousand two hundred thirty-five of this article or by article forty-six
      of the public health law.
        (2)  This  subsection  shall  not  prohibit  payment  plans  which are
      otherwise in compliance with this subsection and this chapter.
        (e) This section shall not prohibit the giving by any company, in  its
      discretion,  of  medical  examinations  and  diagnoses  and  of  nursing
      services to all or any part of its policyholders, under reasonable rules
      and regulations.