OGC Opinion No. 06-11-24

The Office of General Counsel issued the following opinion on November 29, 2006, representing the position of the New York State Insurance Department.

Re: Medical Examination for Life Insurance Application

 Question Presented:

Does the New York Insurance Law, or the regulations promulgated thereunder, prohibit an insurer from accepting the results of a medical examination performed outside New York on an applicant of a life insurance policy to be delivered or issued for delivery in New York?

Conclusion:

No, neither the New York Insurance Law nor the regulations promulgated thereunder prohibit an insurer from accepting the results of a medical examination performed outside New York on an applicant of a life insurance policy to be delivered or issued for delivery in New York.

Facts:

A licensed life insurance agent in New York and New Jersey stated that a New Jersey resident applied for life insurance at his New York office. The applicant underwent a medical examination in New Jersey and provided a copy of the report as part of his application. The agent attempted to place coverage with a life insurer in New York but was advised by the insurer that it does not accept reports of medical examinations conducted in a state outside New York on an applicant who applies for coverage in New York. The insurer advised that this practice is required by regulators and new compliance rules.

Analysis:

Neither the New York Insurance Law nor the regulations promulgated thereunder prohibit an insurer in New York from accepting the results of a medical examination performed outside New York on an applicant of a life insurance policy to be delivered or issued for delivery in New York. The insurer may have been referring to its internal business practices, such as its underwriting guidelines.

For further information you may contact Associate Attorney Sally A. Geisel at the New York City Office.