New York Insurance Code § 3215

Disability benefits in connection with life insurance and annuities
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§ 3215. Disability benefits in connection with life insurance and\nannuities.  (a) No policy of life insurance or contract of deferred\nannuity, which provides benefits by reason of the disability of the\ninsured, including waiver of premium, shall be delivered or issued for\ndelivery in this state unless it contains in substance the following\nprovisions or provisions which in the opinion of the superintendent are\nmore favorable to policyholders:\n  (1) That disability benefits be paid or allowed only in case of total\ndisability and defining total disability in either of the following\nforms:\n  (A) Total disability is incapacity of the insured, resulting from\ninjury or disease, to engage in any occupation for remuneration or\nprofit. Such a policy shall be known and described as a "total\ndisability" policy or contract.\n  (B) Total disability, shall exist whenever the insured's average\nmonthly earned income for a period of four months next preceding has, as\na result of the insured's injury or disease, not exceeded one-fourth of\nhis former earned income averaged monthly for a period (next preceding\nsaid four months) which shall be prescribed in the policy and shall be\nnot less than twelve months.  Such a policy shall be known and described\nas an "earned income disability" policy or contract.\n  (2) That disability benefits will be paid or allowed only in case such\ntotal disability is also permanent as defined in either of the following\nforms:\n  (A) If such policy is a total disability policy, as defined in\nparagraph one hereof, a provision that total disability which has been\ncontinuous for a period specified in the contract, and which shall be\nnot less than four months nor more than one year, shall be deemed to be\npermanent only with respect to determining the commencement of\ndisability benefits.\n  (B) If such policy is an earned income disability policy, as defined\nin paragraph one hereof, a provision that total disability shall be\ndeemed to continue as long as the insured's earned monthly income shall,\nas a result of injury or disease, not exceed one-fourth of his average\nmonthly earned income as determined at the commencement of total\ndisability.\n  (3) That written notice of claim be given to the insurer during the\nlifetime of the insured and during the period of total disability.\nFailure to give such notice shall not invalidate or reduce any claim if\nit shall be shown not to have been reasonably possible to give such\nnotice and that notice was given as soon as was reasonably possible.\n  (4) That there be reasonable requirements as to the time, method and\nform of proof of disability and as to the continuance of disability,\nincluding an examination of the insured by the insurer at reasonable\nintervals. Failure to furnish proof of disability within the time\nrequired shall not invalidate or reduce any claim if it was not\nreasonably possible to give proof within such time, provided such proof\nis furnished as soon as reasonably possible and in no event, except in\nthe absence of legal capacity, later than one year from the time proof\nis otherwise required.\n  (5) That the contract of disability insurance shall be incontestable\nafter it shall have been in force, during the lifetime of the insured\nand without the occurrence of total disability of the insured, for a\nperiod of three years from date of issue, except for nonpayment of\npremiums and except for the conditions of the contract relating to\nmilitary or naval service.\n  (b) Any provision in such policy or contract that total disability\nresulting from any specified cause shall be excluded from coverage,\nshall contain only the following exclusions:\n  (1) (A) a provision terminating disability coverage when the insured\nbecomes a member of the military, naval or air forces of any country at\nwar, declared or undeclared; or\n  (B) a provision terminating disability coverage when the insured\nbecomes a member of any auxiliary or civi

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