NY A06465

Prohibits insurers from offsetting or reducing disability insurance benefits based on actual or estimated Social Security disability benefits unless specific conditions are satisfied

Requires insurers to have a reasonable, good faith belief that the insured is entitled to Social Security benefits and a means to reasonably estimate the amount before any offset

Mandates insurers notify the insured of potential Social Security benefit eligibility and advise them to pursue benefits through required administrative appeals

Obligates insurers to make good faith efforts to assist the insured in applying for Social Security disability benefits

Allows benefit offsets only if the insured fails to apply for or pursue Social Security benefits with reasonable diligence during the application or appeals process

Applies to both individual (Section 3216) and group (Section 3221) accident and health insurance policies providing disability coverage