§ 3216. Individual accident and health insurance policy provisions.\n(a) In this section the term:\n (1) "Policy of accident and health insurance" includes any individual\npolicy or contract covering the kind or kinds of insurance described in\nparagraph three of subsection (a) of section one thousand one hundred\nthirteen of this chapter.\n (2) "Indemnity" means benefits promised.\n (3) "Family" may include the policyholder's spouse, or dependent\nchildren, or any other person dependent upon the policyholder.\n (4) "Dependent children" (A) shall include any children under a\nspecified age which shall not exceed age nineteen except:\n (i) Any unmarried dependent child, regardless of age, who is incapable\nof self-sustaining employment by reason of mental illness, or\ndevelopmental disability as defined in the mental hygiene law, or\nphysical handicap and who became so incapable prior to the age at which\ndependent coverage would otherwise terminate, shall be included in\ncoverage subject to any pre-existing conditions limitation applicable to\nother dependents; or\n (ii) Any unmarried student at an accredited institution of learning\nmay be considered a dependent child until attaining age twenty-three for\na policy other than hospital, medical, surgical, or prescription drug\nexpense insurance; or\n (iii) Any married or unmarried child shall be considered a dependent\nchild until attaining age twenty-six without regard to financial\ndependence, residency with the policyholder, student status, or\nemployment, for a policy of hospital, medical, surgical, or prescription\ndrug expense insurance.\n (B) may include, at the option of the insurer, any unmarried child\nuntil attaining age twenty-five for a policy other than hospital,\nmedical, surgical, or prescription drug expense insurance.\n (C) In addition to the requirements of subparagraphs (A) and (B) of\nthis paragraph, every insurer issuing a policy of hospital, medical, or\nsurgical expense insurance pursuant to this section that provides\ncoverage for dependent children must make available and, if requested by\nthe policyholder, extend coverage under the policy to an unmarried child\nthrough age twenty-nine, without regard to financial dependence who is\nnot insured by or eligible for coverage under an employer health benefit\nplan as an employee or member, whether insured or self-insured, and who\nlives, works or resides in New York state or the service area of the\ninsurer. Such coverage shall be made available at the inception of all\nnew policies. Written notice of the availability of such coverage shall\nbe delivered to the policyholder thirty days prior to the inception of\nsuch policy.\n (b) No policy of accident and health insurance, including\nnon-cancellable disability insurance, except as provided in subsection\n(h) hereof, shall be delivered or issued for delivery in this state\nuntil the rate manual showing rates, rules and classifications of risks\nfor use in connection with such accident and health insurance policies\nor with riders or endorsements thereon, has been filed with the\nsuperintendent.\n (c) No policy of accident and health insurance shall be delivered or\nissued for delivery to any person in this state unless:\n (1) The entire money and other considerations therefor are expressed\ntherein.\n (2) The time at which the insurance takes effect and terminates is\nexpressed therein.\n (3) It purports to insure only one person, except that a policy may\ninsure, originally or by subsequent amendment, members of a family, as\ndefined herein, upon the application of an adult member of the family\nwho shall be deemed the policyholder.\n (4) (A) Coverage of an unmarried dependent child who is incapable of\nself-sustaining employment by reason of mental illness, developmental\ndisability, as defined in the mental hygiene law, or physical handicap\nand who became so incapable prior to attainment of the age at which\ndependent coverage would othe
‹ Prev All New York sections Next ›
Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.