§ 226 — The insurance contract

§ 226. The insurance contract. 1. Every policy of insurance providing\nthe benefits required to be paid under this article shall contain a\nprovision setting forth the right of the chairman to enforce in the name\nof the people of the state of New York for the benefit of the person\nentitled to the benefits insured by the policy, either by filing a\nseparate application or by making the insurance carrier a party to the\noriginal application, the liability of the insurance carrier in whole or\nin part for the payment of such benefits; provided, however, that\npayment in whole or in part of such benefits by either the employer or\nthe insurance carrier shall to the extent thereof be a bar to the\nrecovery against the other of the amount so paid.\n 2. Every such policy shall contain a provision that, as between the\nemployee and the insurance carrier, the notice to or knowledge of the\noccurrence of the injury or sickness on the part of the employer shall\nbe deemed notice or knowledge as the case may be, on the part of the\ninsurance carrier; that jurisdiction of the employer shall, for the\npurpose of this chapter, be jurisdiction of the insurance carrier and\nthat the insurance carrier shall in all things be bound by and subject\nto the orders, findings or decisions rendered in connection with the\npayment of benefits under the provisions of this article.\n 3. Every such policy shall contain a provision to the effect that the\ninsolvency or bankruptcy of the employer shall not relieve the insurance\ncarrier from the payment of benefits for disability suffered by an\nemployee during the life of such policy.\n 4. Every policy of insurance issued to meet the requirements of\nsection two hundred eleven shall contain a provision reciting in effect\nthat notwithstanding any other provision of the policy, benefits shall\nbe paid at least to the extent and in the manner and subject to the\nconditions required by the terms of the insured's provision of benefits\nunder this article.\n 5. No contract of insurance issued by an insurance carrier providing\nthe benefits to be paid under this article shall be cancelled within the\ntime limited in such contract for its expiration unless notice is given\nas required by this section. When cancellation is due to non-payment of\npremiums such cancellation shall not be effective until at least ten\ndays after a notice of cancellation of such contract, on a date\nspecified in such notice, shall be filed in the office of the chair and\nalso served on the employer. When cancellation is due to any reason\nother than non-payment of premiums such cancellation shall not be\neffective until at least thirty days after a notice of cancellation of\nsuch contract, on a date specified in such notice, shall be filed in the\noffice of the chair and also served on the employer; provided, however,\nin either case that if insurance with another insurance carrier has been\nobtained which becomes effective prior to the expiration of the time\nstated in such notice, the cancellation shall be effective as of the\ndate of such other coverage. Such notice shall be served on the employer\nas prescribed by the chair, including delivering it to him or her by\nelectronic means; provided that, if the employer be a partnership, then\nsuch notice may be given to any one of the partners, and if the employer\nbe a corporation then the notice may be given to any agent or officer of\nthe corporation upon whom legal process may be served, provided,\nhowever, the right to cancellation of a policy of insurance in the state\nfund shall be exercised only for nonpayment of premiums or as provided\nin section ninety-four of this chapter.\n 6. (a) Any insurance carrier or the state insurance fund who issues,\nreinstates, amends or endorses any contract of insurance or rider\nthereto providing the benefits required to be paid under this article\nshall file notification in the office of the chair within thirty days\nafter such issuance, reinstatement, amendment or endorsement of the\ncontract. Such notice shall be filed in the manner and form prescribed\nby the chair.\n (b) In the event notice required under this subdivision or subdivision\nfive of this section is not filed with the chair within the thirty-day\ntime period, the chair may impose a penalty of up to one hundred dollars\nfor each ten-day period the insurance carrier or state insurance fund\nfailed to file the notification. All penalties collected pursuant to\nthis subdivision shall be deposited in the uninsured employers' fund.\n 7. The chair may require by regulation that every policy of family\nleave insurance contain a provision requiring that all disputes be\nresolved by designated alternative dispute resolution process in\naccordance with such regulations.\n 8. Premiums for policies providing disability or family leave benefits\nin accordance with this article shall be calculated in accordance with\napplicable provisions of the insurance law, including subsection (n) of\nsection four thousand two hundred thirty-five of such law.\n 9. Except as set forth in subdivision eight of section two hundred\neleven of this article, every policy of insurance issued pursuant to\nthis article must offer coverage for both disability and family leave\nbenefits.\n