Sec. 210.7. Denial of benefits

(a) If the benefit provider is an insurance company, then the claimant shall appeal the denial to the insurance company. If the insurance company denies the claimant’s appeal, then a claimant may bring an action at law or in equity to recover on the insurance policy. However, a claimant shall not bring an action at law or in equity to recover on the insurance policy prior to the expiration of 60 days after the claim was filed pursuant to section 210.6 of this Part and a claimant shall not bring such an action after the expiration of 2 years following the time the claimant was required to file the claim pursuant to section 210.6(a)(1) of this Part.

(b) Except where the benefit provider is an insurance company, as provided in this Part, any denial of benefit of enhanced cancer disability benefits shall be considered a final and binding agency determination within the meaning of the New York State Civil Practice Law and Rules.