New York Regulation 64: What Your Insurer Must Do on an Auto Claim

Most people going through a collision claim in New York assume the insurer sets the rules. It does not. There is a regulation that tells the insurer what it must do, how quickly it must do it, and what has to appear on the estimate it hands you. It is called Regulation 64, and it lives at Part 216 of Title 11 of the New York Codes, Rules and Regulations.

Almost nobody reads it, which is exactly why it is worth understanding. Nearly every frustrating moment in a claim — the estimate that took three weeks, the adjuster who stopped replying, the mystery deduction, the aftermarket part that appeared without explanation — maps onto a provision of Regulation 64 that says something specific about how that was supposed to go.

Here is the plain-English version.

What Regulation 64 actually is

Its full title is Unfair Claims Settlement Practices and Claim Cost Control Measures. It is a regulation of the New York State Department of Financial Services, and it binds insurers — not you, and not your repair shop. It sets minimum standards for how a claim must be acknowledged, investigated, estimated, settled and paid.

One definition matters throughout: a business day means a day other than Saturday, Sunday or a New York State legal holiday. Some of the deadlines below are in business days and some are in calendar days, and the difference is frequently the difference between an insurer being late and being on time.

The deadlines

These are the ones worth knowing by heart.

• 15 business days — to acknowledge receipt of your claim.
• 15 business days — to begin investigating, and to tell you every form, statement and item it believes it will need from you. You should not be discovering new requirements one at a time in week four.
• Six business days — to inspect your damaged vehicle after receiving notice of the claim, and to make a good faith offer of settlement within that same period. The regulation describes that offer as one sufficient to repair the vehicle to the condition it was in immediately before the loss.
• 15 business days — to reply to any other pertinent communication from you. An adjuster going quiet is not a neutral event.
• 15 business days after a properly executed proof of loss — to advise you in writing whether the claim is accepted or rejected.
• Five business days — to pay any amount finally agreed in settlement, running from receipt of the agreement or from when you have done whatever the agreement required of you, whichever is later.
• Every 90 days — if the investigation is still running, you are entitled to an updated letter explaining why.
• 30 calendar days — if payment on a physical damage claim takes longer than this, the insurer owes you a written explanation of the specific reasons for the delay, and another one every 30 days after that.

The six-business-day inspection window is the one that surprises people most, because it is short and because it comes with teeth.

If they miss the inspection window

This provision is worth reading twice. If the insurer fails to inspect the damaged vehicle within that six-business-day period, it forfeits its right to inspect the vehicle before repairs.

In practice that means a car cannot be held hostage indefinitely waiting for an appraiser who never comes. If the window passes, the repair can proceed. We document the date notice was given and the date an appraiser actually appeared on every file, precisely because this comes up.

What the estimate itself has to contain

At the inspection, the insurer must furnish a copy of its estimate showing, at minimum, the extent of known damages and the manner of repair. Where the estimate is processed electronically it may be delivered within 24 hours of the inspection instead — but either way, you or your designated representative must receive the insurer’s detailed written estimate within the six business days.

“Manner of repair” is doing real work in that sentence. An estimate that lists a price without stating how the damage is to be repaired is not a complete document.

One small line item that is often missing: the estimate must separately include the reasonable cost of properly disposing of waste material generated by painting the vehicle or the crash part.

Aftermarket parts: what the insurer is required to disclose

This is the section that matters most to anyone driving something worth repairing properly, and it is the one most often honored loosely.

Where an insurer specifies non-OEM crash parts — aftermarket panels, bumpers, reinforcements and the like — Regulation 64 requires all of the following:

• The estimate must specify the non-OEM part and its supplier. Not a vague abbreviation buried in a parts column. The part and who makes it.
• No more than three different non-OEM suppliers may be specified for any one repair without the consent of the insured or their designated representative.
• The part must equal or exceed the comparable OEM part in fit, form, finish, quality and performance. That is the standard the regulation sets, in those words.
• The part must be warranted by the non-OEM manufacturer at least to the same extent and duration as the comparable original part.

Two practical consequences follow. First, if aftermarket parts appear on your estimate with no supplier identified, the estimate does not meet the disclosure standard — and you are entitled to ask for one that does. Second, “equal or exceed in fit, form, finish, quality and performance” is a substantive claim about a specific part on a specific car, not a box to tick. On a component that a radar or camera mounts to, or one engineered to deform in a defined sequence, it is a claim that frequently does not survive contact with the manufacturer’s own repair procedure.

We wrote separately about how that argument actually plays out in OEM vs aftermarket parts in a New York claim.

Betterment and depreciation

Deductions for betterment or depreciation are permitted only for parts normally subject to repair and replacement during the useful life of the vehicle — tires, batteries, exhaust components and their equivalents. Not structure. Not a door skin.

Where a deduction is permitted, it is capped at the lesser of two figures: the proportion of the part’s normal useful life that had already expired, or the amount by which the repair or replacement actually increases the vehicle’s resale value.

And critically: the calculations must be in the insurer’s claim file. A betterment deduction is not a number an adjuster is entitled to pick. If you are told a deduction applies, you can ask how it was calculated, and there is supposed to be an answer on file.

Disputes over one item should not hold up the rest

Where there is no dispute as to one or more elements of a claim, payment for those elements must be made regardless of disputes over the others.

This is one of the most useful and least known provisions in the whole regulation. A disagreement about a bumper reinforcement does not justify freezing payment on the eleven items nobody is arguing about.

When you and the insurer cannot agree on price

This happens, and the regulation contemplates it.

If no agreed price is reached, the insurer must furnish you with a prescribed Notice of Rights letter setting out your options. And if you ask for it, the insurer must give you the name and address of a New York State registered repair shop that will do the work at the insurer’s estimated cost — within a distance the regulation specifies, and closer in urban areas than elsewhere.

Read that carefully, because it is regularly presented backwards. The insurer naming a shop that will work to its number is the insurer meeting an obligation to you. It is not an instruction. Under New York Insurance Law § 2610 the choice of repair facility remains yours, and nothing in Regulation 64 changes that.

One more: if the insurer requires you to obtain estimates of the damage, the reasonable cost of obtaining them is the insurer’s to bear, not yours.

Total loss: how the number is supposed to be built

If the car is totalled, the value is not a figure someone chooses. Regulation 64 permits three methods:

1. The average of retail values for a substantially similar vehicle, taken from two valuation manuals current at the date of loss and approved by the Department.
2. A quotation from a qualified dealer reasonably convenient to you. The comparable vehicle quoted must remain available for you to purchase for three calendar days after you receive notice — so a comparable that has already sold is not a valid basis for the offer.
3. A quotation from an approved computerized database producing statistically valid fair market values for a substantially similar vehicle in your local market area.

There is one significant limitation. If you bought the vehicle within the 180 calendar days before the loss, and one of those methods would produce an offer higher than what you paid plus substantiated improvements, the insurer may limit the offer to that purchase price plus those improvements.

More on the wider picture in total loss claims in New York.

If the insurer is not following it

Regulation 64 is enforced by the New York State Department of Financial Services, and you can file a complaint. It costs nothing.

Worth knowing: when DFS makes an inquiry, the insurer must furnish the requested information within 10 business days. That is a considerably shorter leash than the one you get as a policyholder, and it tends to focus attention.

Before you file, gather the dates. When notice of the claim was given. When an appraiser actually inspected. When you received the detailed written estimate. When you last had a reply. Dates are what a complaint turns on, which is why documenting them from day one matters more than being right in the abstract.

Where we come into it

We write repair plans from the manufacturer’s published procedure and we fit new original parts from the dealer, which means most of the provisions above get tested on our files as a matter of routine rather than as a special event. We track the dates, we ask for the disclosures the regulation requires, and we deal with the adjuster directly instead of relaying messages through you.

That is not adversarial and it is not unusual. It is simply what the regulation already says is supposed to happen.

Common questions

Does Regulation 64 apply to a claim against the other driver’s insurer?

Part 216 covers both first-party and third-party claims, though some provisions are written specifically for one or the other and the practical experience differs. Your own policy language also governs your own claim. If you are unsure which rules are being applied to you, that is a fair question to put to the adjuster in writing.

The adjuster has not called me back in three weeks. Is that a violation?

The regulation requires an appropriate reply to pertinent communications within 15 business days. Three weeks of silence is at or past that line depending on the calendar. Put the next request in writing and note the date.

My estimate shows aftermarket parts but does not say who makes them.

The estimate is required to specify the non-OEM part and its supplier. Ask for a corrected estimate that does.

Can the insurer make me use its shop?

No. It may give you a shop that will work to its estimated figure — which is an obligation it owes you, not a direction. The choice is yours under § 2610.

They deducted for betterment on a body panel. Is that allowed?

Betterment deductions are permitted only for parts normally subject to repair and replacement during the vehicle’s useful life. Ask for the calculation; it is required to be in the claim file.

How long can they take to pay once we have agreed a number?

Five business days from receipt of the agreement, or from when you have done whatever the agreement required, whichever is later.

Where can I read the regulation myself?

Part 216 is published in full. Section 11 NYCRR 216.7 is the one dealing specifically with motor vehicle physical damage claims, and it is the section most of this article draws on.

This article is general information about New York Insurance Regulation 64 and is not legal advice. Regulations are amended from time to time and your own policy language governs your claim. Where a dispute matters, read the current text or speak to someone qualified to advise you on it.

Enthusiast Auto Works, 55B Plain Ave, New Rochelle, NY 10801. Certified for auto body with Land Rover, Jaguar, Rivian, Genesis, Infiniti, Nissan, Kia and Stellantis, equipped for every other premium marque, serving Westchester, the Bronx and lower Fairfield County. Call (914) 630-1668 or send us the details below.