State RegulationsNY specificDifficulty 1/5
A New York long-term care insured writes to her insurer asking how her benefits were calculated. Under Reg 62, the insurer must answer this information request within:
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under Reg 62 (11 NYCRR Part 52), a New York long-term care insurer must answer an insured's request for information within 15 business days. If the response requires supplemental materials that must be gathered from beyond the insurer's own records, the insurer gets more time, up to 45 days. The rule keeps policyholders from being stonewalled about how their own benefits are being determined.
Why the other options are wrong
- A) Five business days is a shorter turnaround than the rule requires; the regulation allows the insurer more than a week.
- C) Forty-five is the outer window when supplemental materials are needed, not the ordinary deadline for answering the request.
- D) Sixty days is the deadline for deciding a benefit appeal, not for responding to an information request.
Memory hook
Information in 15 business days; appeals decided in 60.