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Bill

A 11164

Provides for the issuance of pet insurance

2025 Regular Session Introduced by Pamela Hunter

Establishes a comprehensive, transparent framework for pet insurance in New York, including definitions, consumer disclosures, underwriting rules, wellness program separation, and

REFERRED TO INSURANCE
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WeVote Research Nonpartisan
Bill Summary · A 11164

Overview

A11164 proposes a framework for pet insurance in New York, clarifying definitions, consumer disclosures, policy terms, and training for producers. The bill treats pet insurance as inland marine insurance and sets consumer-protection requirements, underwriting rules, and supervisory authority to regulate pet insurance products sold in the state. It would take effect 180 days after becoming law and apply to policies entered into or renewed on or after that date.

Main purpose and intent

  • Establish a clear statutory structure for pet insurance in New York.
  • Ensure transparency, consistency, and protections for consumers purchasing pet insurance.
  • Distinguish pet insurance from wellness programs and other non-insurance offerings.
  • Require proper licensing, training, and regulatory oversight of insurers and producers.

Key provisions and changes

  • Definition changes and inclusions

    • Pet insurance is defined as a property insurance policy covering accidents and illnesses of pets.
    • Clarifies that “animal insurance” generally covers loss/damage to animals but excludes pet insurance.

  • New statutory section: Pet Insurance (Section 3463)

    • Definitions introduced for terms including chronic condition, congenital anomaly, hereditary disorder, orthopedic, preexisting condition, renewal, veterinarian, veterinary expenses, waiting period, and wellness program.
    • Preexisting condition treatment: a condition for which coverage may be excluded initially can be excluded, but coverage for that condition on renewal is not considered preexisting.
    • Waiting periods: up to 30 days for illnesses (including orthopedic conditions) not resulting from an accident; waiting periods for accidents are prohibited. An option for waiving waiting periods via a medical exam is allowed (at the policyholder’s cost unless stated otherwise).
    • Wellness programs: defined as separate from insurance; if marketed, they must be clearly separated from pet insurance and subject to consumer protections if they have insurance-like features.

  • Consumer disclosures and transparency (subsection (c))

    • Insurers must disclose:
    • Exclusions (preexisting, hereditary, congenital, chronic) and other exclusions with a general notice to review exclusions.
    • Policy provisions that limit coverage via waiting periods, deductibles, coinsurance, or annual/lifetime limits.
    • Possible premium changes due to claims history, pet age, or geographic location.
    • Whether underwriting company differs from the brand name.
    • “Free look” period: applicants have 30 days to review and return the policy for a full premium refund, with a detailed model notice.
    • Summary of policy provisions must be provided in a document titled “Insurer Disclosure of Important Policy Provisions,” and a link to these provisions must be on the insurer’s main website.
    • Clear disclosure of how claim payments are determined (basis/formula) before issuance, and, for schedules or usual/customary fee bases, explicit disclosures and schedules (via policy and website link).
    • Explanations of required veterinary examinations prior to coverage, and potential impact on preexisting-condition exclusions.
    • Required disclosures must accompany policy delivery, including contact information for the insurer, agent/broker, and the department.

  • Underwriting and policy structure (subsection (d))

    • Insurers may exclude coverage for preexisting conditions with proper disclosure.
    • Waiting periods may be imposed (up to 30 days for illnesses/orthopedic conditions; not for accidents). Examinations can waive waiting periods, with policyholder paying the exam unless the policy states otherwise.
    • Renewal does not require a veterinary exam.
    • If wellness or non-insurance benefits are included, they become part of the contract and subject to all applicable laws.
    • Eligibility to purchase cannot depend on participation in a wellness program.

  • Wellness programs (section (e))

    • Wellness programs cannot be marketed as pet insurance.
    • If offered, they must be separate from pet insurance, with costs, terms, and products clearly distinct.
    • Non-insurance wellness benefits must be clearly labeled as not insurance, with department contact information and insurer/producer details provided.

  • Producer licensing and training (section (f))

    • Pet insurance producers must be licensed and complete specified training before selling.
    • Training must cover preexisting conditions, waiting periods, differences between pet insurance and wellness programs, hereditary/congenital/chronically conditions interactions, and underwriting/renewal topics.
    • Substantial equivalence training from another state can satisfy New York requirements.

  • Regulation and supremacy (section (h))

    • The superintendent will promulgate rules for implementing the act.
    • The act’s provisions supersede general pet-insurance provisions in conflict with these specific rules.

Who/what is affected

  • Pet insurance insurers and program administrators operating in New York.
  • Insurance producers and brokers selling pet insurance in New York.
  • Pet owners purchasing pet insurance policies for their companion animals.
  • Veterinarians and veterinary examiners involved in examinations related to waiting periods.
  • The New York Department of Financial Services (superintendent) responsible for rulemaking and enforcement.

Procedural and timeline aspects

  • Effective date: 180 days after becoming law.
  • Application: Applies to policies entered into, renewed, modified, or amended on or after the effective date.
  • Technical implementation: Immediate authority for rulemaking to align with the act’s requirements.

Notable clarifications and protections

  • Explicit separation of wellness programs from pet insurance, with clear consumer disclosures for both.
  • Free-look rights for policyholders, with a model notice and 30-day review period.
  • If a policy uses a standard or usual-and-customary fee basis, the insurer must disclose how these amounts are determined.
  • Requirements to provide essential contact information and department resources to consumers upon policy issuance.

This bill aims to create a comprehensive, transparent framework for pet insurance in New York, balancing consumer protections with insurer flexibility in pricing and coverage.

Compiled from official sources — confirm details with the bill’s official record.

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