[431:10D-654] Insurer conduct. (a) An insurer shall perform a comparison of its insureds' in-force policies, contracts, and retained asset accounts against a death master file, on at least a semi-annual basis, by using the full death master file once and thereafter using the death master file update files for future comparisons to identify potential matches of its insureds. For those potential matches identified as a result of a death master file match:

(1) The insurer shall, within ninety days of a death master file match:

(A) Complete a good faith effort, which shall be documented by the insurer, to confirm the death of the insured or retained asset account holder against other available records and information;

(B) Determine whether benefits are due in accordance with the applicable policy or contract; provided that if benefits are due in accordance with the applicable policy or contract:

(i) Use good faith efforts, which shall be documented by the insurer, to locate the beneficiary or beneficiaries; and

(ii) Provide the appropriate claims forms or instructions to the beneficiary or beneficiaries to make a claim, including the need to provide an official death certificate, if applicable under the policy or contract;

(2) With respect to group life insurance, insurers shall confirm the possible death of an insured when the insurers maintain at least the following information of those covered under a policy or certificate:

(A) Social security number or name and date of birth;

(B) Beneficiary designation information;

(C) Coverage eligibility;

(D) Benefit amount; and

(E) Premium payment status;

(3) Every insurer shall implement procedures to account for the following:

(A) Common nicknames, initials used in lieu of a first or middle name, use of a middle name, compound first and middle names, and interchanged first and middle names;

(B) Compound last names, maiden or married names, and hyphens, blank spaces, or apostrophes in last names;

(C) Transposition of the month and date portions of the date of birth; and

(D) Incomplete social security number;

(4) To the extent permitted by law, the insurer may disclose minimum necessary personal information about the insured or beneficiary to a person who the insurer reasonably believes may be able to assist the insurer with locating the beneficiary or a person otherwise entitled to payment of the claim proceeds; and

(5) The insurer comparison of in-force policies, contracts, and retained asset accounts shall be conducted first to the extent that such records are available electronically and then using the most easily accessible insurer records for records that are not available electronically.

Nothing in this subsection shall limit the insurer from requesting a valid death certificate as part of any claims validation process.

(b) An insurer or its service provider shall not charge any beneficiary or other authorized representative for any fees or costs associated with a death master file search or verification of a death master file match conducted pursuant to this section.

(c) The benefits from a policy, contract, or retained asset account, plus any applicable accrued contractual interest, shall first be payable to the designated beneficiaries or owners and in the event said beneficiaries or owners cannot be found, shall escheat to the State as unclaimed property pursuant to chapter 523A. Interest payable under section 431:10-243 shall not be payable as unclaimed property under chapter 523A.

(d) An insurer shall notify the director of finance upon the expiration of the statutory time period for escheat that:

(1) A policy or contract beneficiary or retained asset account holder has not submitted a claim with the insurer; and

(2) The insurer has complied with subsection (a) and has been unable, after good faith efforts documented by the insurer, to contact the retained asset account holder, beneficiary, or beneficiaries.

(e) The commissioner may adopt such rules and regulations as may be reasonably necessary to implement the provisions of this section.

(f) The commissioner may, in the commissioner's reasonable discretion, make an order:

(1) Limiting an insurer's death master file comparisons required under subsection (a) to the insurer's electronic searchable files or approving a plan and timeline for conversion of the insurer's files to electronic searchable files;

(2) Exempting an insurer from the death master file comparisons required under subsection (a) or permitting an insurer to perform such comparisons less frequently than semi-annually upon a demonstration of hardship by the insurer; or

(3) Phasing-in compliance with this section according to a plan and timeline approved by the commissioner.

(g) Failure to meet any requirement of this section with such frequency as to constitute a general business practice shall constitute an unfair or deceptive act or practice under article 13. Nothing in this section shall be construed to create or imply a private cause of action for a violation of this section. [L 2018, c 202, pt of 1]

 

 

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