New York Insurance Law Section 2612 and Insurance Regulation 11 NYCRR 244
We will not discriminate against a person solely because they are or have been a victim of domestic violence. We will not refuse to issue, renew or cancel coverage; require a greater premium; designate domestic violence as a condition for which coverage will be denied or reduced; or discriminate in the fees or commissions of producers for writing or renewing such a policy.
We will accommodate a reasonable request made by a person to receive communications of claim related information by alternative means or at alternative locations if the person clearly states that disclosure of all or part of the information could endanger the person. If a child is covered by us, then the child's parent or guardian may make such a request.
Upon receipt of a written request or valid protective order, we will not disclose the following information to a policyholder or another insured under the same insurance policy, except with your consent: (1) the address, telephone number, or any other personally identifying information of the individual who made the request or child for whose benefit a request was made; (2) the nature of the health care services provided; or (3) the name or address of the provider of the health care services.
Making a Request
To make a request, please complete this form and submit it to the following address:
The Standard Life Insurance Company of New York
P.O. Box 5031
White Plains, NY 10602
Revoking a Request
A person may revoke this request by notifying us in writing. For identity verification, the person will be asked to provide us with the alternate address that was initially disclosed to us.
New York Domestic and Sexual Violence Hotline
For further information on domestic violence services in the state of New York, a person can contact the NYS Domestic and Sexual Violence Hotline. The contact information for the hotline is listed below. A person may also access the New York State Office for the Prevention of Domestic Violence website.
NYS Domestic and Sexual Violence Hotline: 1.800.942.6906
Spanish language: 1.800.942.6908
In NYC: 1.800.621.HOPE (4673) or dial 311