The Office of General Counsel issued the following opinion on July 30, 2002, representing the position of the New York State Insurance Department.
Re: Record Retention Requirements
Question Presented:
Are there any regulations regarding the amount of time that a life insurance company must keep records of the payment of claims?
Conclusion:
Yes. Pursuant to N.Y. Comp. Codes R. & Regs. tit. 11, § 243.2(b)(4) (1996) (Regulation 152) an insurer must keep a claim file for six calendar years after all elements of the claim are resolved and the file is closed or until after the filing of the report on examination in which the claim file was subject to review, whichever is longer.
Facts:
The inquirer states that a life insurance company that she made a claim with for a past policy has stated that the claim was paid years ago and that they only keep records of the payment of claims for seven years. The company maintains that this is consistent with the regulations of the New York State Insurance Department. The inquirer would like to know whether there are any regulations regarding the amount of time that a life insurance company must keep records of the payment of claims.
Analysis:
N.Y. Comp. Codes R. and Regs. tit. 11, §§ 243.0-243.3 (1996) (Regulation 152), entitled "Standards of Records Retention by Insurance Companies", establishes the minimum requirements regarding the retention of records by insurance companies. Section 243.2 provides, in pertinent part, as follows:
(a) [E]very insurer shall maintain its claims, rating, underwriting, marketing, complaint, financial, and producer licensing records, and such other records subject to examination by the superintendent, in accordance with the provisions of this Part.
(b) Except as otherwise required by law or regulation, an insurer shall maintain:
. . .
(4) A claim file for six calendar years after all elements of the claim are resolved and the file is closed or until after the filing of the report on examination in which the claim file was subject to review, whichever is longer. A claim file shall show clearly the inception, handling and disposition of the claim, including the dates that forms and other documents were received. . . .
(8) Any other-record for six calendar years from its creation or until after the filing of a report on examination or the conclusion of an investigation in which the record was subject to review.
(c) If the superintendent is not required to conduct an examination of an insurer, the requirement that the record be maintained until after the filing of the report on examination shall not apply. However, if an examination in which the record is subject to review has begun, the insurer shall retain the record until after the filing fo the report on examination.
Accordingly, pursuant to N.Y. Comp. Codes R. & Regs. tit. 11, § 243.2(b)(4) (1996) (Regulation 152) an insurer must keep a claim file for six calendar years after all elements of the claim are resolved and the file is closed or until after the filing of the report on examination in which the claim file was subject to review, whichever is longer.
For further information, you may contact Attorney Pascale Joasil at the New York City office.