Connecticut 2020 Regular Session

Connecticut House Bill HB05255 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
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2	2
3	3	LCO No. 1241 1 of 14
4	4
5	5	General Assembly Raised Bill No. 5255
6	6	February Session, 2020
7	7	LCO No. 1241
8	8
9	9
10	10	Referred to Committee on INSURANCE AND REAL ESTATE
11	11
12	12
13	13	Introduced by:
14	14	(INS)
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16	16
17	17
18	18
19	19	AN ACT CONCERNING LI VING ORGAN DONOR INS URANCE
20	20	DISCRIMINATION.
21	21	Be it enacted by the Senate and House of Representatives in General
22	22	Assembly convened:
23	23
24	24	Section 1. Section 38a-1 of the general statutes is repealed and the 1
25	25	following is substituted in lieu thereof (Effective January 1, 2021): 2
26	26	Terms used in this title and section 2 of this act, unless it appears from 3
27	27	the context to the contrary, shall have a scope and meaning as set forth 4
28	28	in this section. 5
29	29	(1) "Affiliate" or "affiliated" means a person that directly, or indirectly 6
30	30	through one or more intermediaries, controls, is controlled by or is 7
31	31	under common control with another person. 8
32	32	(2) "Alien insurer" means any insurer that has been chartered by or 9
33	33	organized or constituted within or under the laws of any jurisdiction or 10
34	34	country without the United States. 11
35	35	(3) "Annuities" means all agreements to make periodical payments 12
36	36	where the making or continuance of all or some of the series of the 13 Raised Bill No. 5255
37	37
38	38
39	39
40	40	LCO No. 1241 2 of 14
41	41
42	42	payments, or the amount of the payment, is dependent upon the 14
43	43	continuance of human life or is for a specified term of years. This 15
44	44	definition does not apply to payments made under a policy of life 16
45	45	insurance. 17
46	46	(4) "Commissioner" means the Insurance Commissioner. 18
47	47	(5) "Control", "controlled by" or "under common control with" means 19
48	48	the possession, direct or indirect, of the power to direct or cause the 20
49	49	direction of the management and policies of a person, whether through 21
50	50	the ownership of voting securities, by contract other than a commercial 22
51	51	contract for goods or nonmanagement services, or otherwise, unless the 23
52	52	power is the result of an official position with the person. 24
53	53	(6) "Domestic insurer" means any insurer that has been chartered by, 25
54	54	incorporated, organized or constituted within or under the laws of this 26
55	55	state. 27
56	56	(7) "Domestic surplus lines insurer" means any domestic insurer that 28
57	57	has been authorized by the commissioner to write surplus lines 29
58	58	insurance. 30
59	59	(8) "Foreign country" means any jurisdiction not in any state, district 31
60	60	or territory of the United States. 32
61	61	(9) "Foreign insurer" means any insurer that has been chartered by or 33
62	62	organized or constituted within or under the laws of another state or a 34
63	63	territory of the United States. 35
64	64	(10) "Insolvency" or "insolvent" means, for any insurer, that it is 36
65	65	unable to pay its obligations when they are due, or when its admitted 37
66	66	assets do not exceed its liabilities plus the greater of: (A) Capital and 38
67	67	surplus required by law for its organization and continued operation; 39
68	68	or (B) the total par or stated value of its authorized and issued capital 40
69	69	stock. For purposes of this subdivision "liabilities" shall include but not 41
70	70	be limited to reserves required by statute or by regulations adopted by 42
71	71	the commissioner in accordance with the provisions of chapter 54 or 43 Raised Bill No. 5255
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73	73
74	74
75	75	LCO No. 1241 3 of 14
76	76
77	77	specific requirements imposed by the commissioner upon a subject 44
78	78	company at the time of admission or subsequent thereto. 45
79	79	(11) "Insurance" means any agreement to pay a sum of money, 46
80	80	provide services or any other thing of value on the happening of a 47
81	81	particular event or contingency or to provide indemnity for loss in 48
82	82	respect to a specified subject by specified perils in return for a 49
83	83	consideration. In any contract of insurance, an insured shall have an 50
84	84	interest which is subject to a risk of loss through destruction or 51
85	85	impairment of that interest, which risk is assumed by the insurer and 52
86	86	such assumption shall be part of a general scheme to distribute losses 53
87	87	among a large group of persons bearing similar risks in return for a 54
88	88	ratable contribution or other consideration. 55
89	89	(12) "Insurer" or "insurance company" includes any person or 56
90	90	combination of persons doing any kind or form of insurance business 57
91	91	other than a fraternal benefit society, and shall include a receiver of any 58
92	92	insurer when the context reasonably permits. 59
93	93	(13) "Insured" means a person to whom or for whose benefit an 60
94	94	insurer makes a promise in an insurance policy. The term includes 61
95	95	policyholders, subscribers, members and beneficiaries. This definition 62
96	96	applies only to the provisions of this title and does not define the 63
97	97	meaning of this word as used in insurance policies or certificates. 64
98	98	(14) "Life insurance" means insurance on human lives and insurances 65
99	99	pertaining to or connected with human life. The business of life 66
100	100	insurance includes granting endowment benefits, granting additional 67
101	101	benefits in the event of death by accident or accidental means, granting 68
102	102	additional benefits in the event of the total and permanent disability of 69
103	103	the insured, and providing optional methods of settlement of proceeds. 70
104	104	Life insurance includes burial contracts to the extent provided by 71
105	105	section 38a-464. 72
106	106	(15) "Mutual insurer" means any insurer without capital stock, the 73
107	107	managing directors or officers of which are elected by its members. 74 Raised Bill No. 5255
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109	109
110	110
111	111	LCO No. 1241 4 of 14
112	112
113	113	(16) "Person" means an individual, a corporation, a partnership, a 75
114	114	limited liability company, an association, a joint stock company, a 76
115	115	business trust, an unincorporated organization or other legal entity. 77
116	116	(17) "Policy" means any document, including attached endorsements 78
117	117	and riders, purporting to be an enforceable contract, which 79
118	118	memorializes in writing some or all of the terms of an insurance 80
119	119	contract. 81
120	120	(18) "State" means any state, district, or territory of the United States. 82
121	121	(19) "Subsidiary" of a specified person means an affiliate controlled 83
122	122	by the person directly, or indirectly through one or more intermediaries. 84
123	123	(20) "Unauthorized insurer" or "nonadmitted insurer" means an 85
124	124	insurer that has not been granted a certificate of authority by the 86
125	125	commissioner to transact the business of insurance in this state or an 87
126	126	insurer transacting business not authorized by a valid certificate. 88
127	127	(21) "United States" means the United States of America, its territories 89
128	128	and possessions, the Commonwealth of Puerto Rico and the District of 90
129	129	Columbia. 91
130	130	Sec. 2. (NEW) (Effective January 1, 2021) (a) No insurer delivering, 92
131	131	issuing for delivery, renewing, amending or continuing a life insurance 93
132	132	policy, long-term care insurance policy or a policy providing disability 94
133	133	income protection coverage in this state on or after January 1, 2021, shall 95
134	134	make any distinction or discriminate against an individual in delivering, 96
135	135	issuing for delivery, renewing, amending, continuing, offering, 97
136	136	withholding or cancelling such policy, or in the terms of such policy, 98
137	137	solely because such individual is a living organ donor. 99
138	138	(b) Any violation of this section shall be deemed an unfair method of 100
139	139	competition and unfair and deceptive act or practice in the business of 101
140	140	insurance under section 38a-816 of the general statutes, as amended by 102
141	141	this act. 103
142	142	Sec. 3. Section 38a-816 of the 2020 supplement to the general statutes 104 Raised Bill No. 5255
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144	144
145	145
146	146	LCO No. 1241 5 of 14
147	147
148	148	is repealed and the following is substituted in lieu thereof (Effective 105
149	149	January 1, 2021): 106
150	150	The following are defined as unfair methods of competition and 107
151	151	unfair and deceptive acts or practices in the business of insurance: 108
152	152	(1) Misrepresentations and false advertising of insurance policies. 109
153	153	Making, issuing or circulating, or causing to be made, issued or 110
154	154	circulated, any estimate, illustration, circular or statement, sales 111
155	155	presentation, omission or comparison which: (A) Misrepresents the 112
156	156	benefits, advantages, conditions or terms of any insurance policy; (B) 113
157	157	misrepresents the dividends or share of the surplus to be received, on 114
158	158	any insurance policy; (C) makes any false or misleading statements as 115
159	159	to the dividends or share of surplus previously paid on any insurance 116
160	160	policy; (D) is misleading or is a misrepresentation as to the financial 117
161	161	condition of any person, or as to the legal reserve system upon which 118
162	162	any life insurer operates; (E) uses any name or title of any insurance 119
163	163	policy or class of insurance policies misrepresenting the true nature 120
164	164	thereof; (F) is a misrepresentation, including, but not limited to, an 121
165	165	intentional misquote of a premium rate, for the purpose of inducing or 122
166	166	tending to induce to the purchase, lapse, forfeiture, exchange, 123
167	167	conversion or surrender of any insurance policy; (G) is a 124
168	168	misrepresentation for the purpose of effecting a pledge or assignment of 125
169	169	or effecting a loan against any insurance policy; or (H) misrepresents 126
170	170	any insurance policy as being shares of stock. 127
171	171	(2) False information and advertising generally. Making, publishing, 128
172	172	disseminating, circulating or placing before the public, or causing, 129
173	173	directly or indirectly, to be made, published, disseminated, circulated or 130
174	174	placed before the public, in a newspaper, magazine or other publication, 131
175	175	or in the form of a notice, circular, pamphlet, letter or poster, or over any 132
176	176	radio or television station, or in any other way, an advertisement, 133
177	177	announcement or statement containing any assertion, representation or 134
178	178	statement with respect to the business of insurance or with respect to 135
179	179	any person in the conduct of his insurance business, which is untrue, 136
180	180	deceptive or misleading. 137 Raised Bill No. 5255
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182	182
183	183
184	184	LCO No. 1241 6 of 14
185	185
186	186	(3) Defamation. Making, publishing, disseminating or circulating, 138
187	187	directly or indirectly, or aiding, abetting or encouraging the making, 139
188	188	publishing, disseminating or circulating of, any oral or written 140
189	189	statement or any pamphlet, circular, article or literature which is false 141
190	190	or maliciously critical of or derogatory to the financial condition of an 142
191	191	insurer, and which is calculated to injure any person engaged in the 143
192	192	business of insurance. 144
193	193	(4) Boycott, coercion and intimidation. Entering into any agreement 145
194	194	to commit, or by any concerted action committing, any act of boycott, 146
195	195	coercion or intimidation resulting in or tending to result in unreasonable 147
196	196	restraint of, or monopoly in, the business of insurance. 148
197	197	(5) False financial statements. Filing with any supervisory or other 149
198	198	public official, or making, publishing, disseminating, circulating or 150
199	199	delivering to any person, or placing before the public, or causing, 151
200	200	directly or indirectly, to be made, published, disseminated, circulated or 152
201	201	delivered to any person, or placed before the public, any false statement 153
202	202	of financial condition of an insurer with intent to deceive; or making any 154
203	203	false entry in any book, report or statement of any insurer with intent to 155
204	204	deceive any agent or examiner lawfully appointed to examine into its 156
205	205	condition or into any of its affairs, or any public official to whom such 157
206	206	insurer is required by law to report, or who has authority by law to 158
207	207	examine into its condition or into any of its affairs, or, with like intent, 159
208	208	wilfully omitting to make a true entry of any material fact pertaining to 160
209	209	the business of such insurer in any book, report or statement of such 161
210	210	insurer. 162
211	211	(6) Unfair claim settlement practices. Committing or performing with 163
212	212	such frequency as to indicate a general business practice any of the 164
213	213	following: (A) Misrepresenting pertinent facts or insurance policy 165
214	214	provisions relating to coverages at issue; (B) failing to acknowledge and 166
215	215	act with reasonable promptness upon communications with respect to 167
216	216	claims arising under insurance policies; (C) failing to adopt and 168
217	217	implement reasonable standards for the prompt investigation of claims 169
218	218	arising under insurance policies; (D) refusing to pay claims without 170 Raised Bill No. 5255
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220	220
221	221
222	222	LCO No. 1241 7 of 14
223	223
224	224	conducting a reasonable investigation based upon all available 171
225	225	information; (E) failing to affirm or deny coverage of claims within a 172
226	226	reasonable time after proof of loss statements have been completed; (F) 173
227	227	not attempting in good faith to effectuate prompt, fair and equitable 174
228	228	settlements of claims in which liability has become reasonably clear; (G) 175
229	229	compelling insureds to institute litigation to recover amounts due under 176
230	230	an insurance policy by offering substantially less than the amounts 177
231	231	ultimately recovered in actions brought by such insureds; (H) 178
232	232	attempting to settle a claim for less than the amount to which a 179
233	233	reasonable man would have believed he was entitled by reference to 180
234	234	written or printed advertising material accompanying or made part of 181
235	235	an application; (I) attempting to settle claims on the basis of an 182
236	236	application which was altered without notice to, or knowledge or 183
237	237	consent of the insured; (J) making claims payments to insureds or 184
238	238	beneficiaries not accompanied by statements setting forth the coverage 185
239	239	under which the payments are being made; (K) making known to 186
240	240	insureds or claimants a policy of appealing from arbitration awards in 187
241	241	favor of insureds or claimants for the purpose of compelling them to 188
242	242	accept settlements or compromises less than the amount awarded in 189
243	243	arbitration; (L) delaying the investigation or payment of claims by 190
244	244	requiring an insured, claimant, or the physician of either to submit a 191
245	245	preliminary claim report and then requiring the subsequent submission 192
246	246	of formal proof of loss forms, both of which submissions contain 193
247	247	substantially the same information; (M) failing to promptly settle claims, 194
248	248	where liability has become reasonably clear, under one portion of the 195
249	249	insurance policy coverage in order to influence settlements under other 196
250	250	portions of the insurance policy coverage; (N) failing to promptly 197
251	251	provide a reasonable explanation of the basis in the insurance policy in 198
252	252	relation to the facts or applicable law for denial of a claim or for the offer 199
253	253	of a compromise settlement; (O) using as a basis for cash settlement with 200
254	254	a first party automobile insurance claimant an amount which is less than 201
255	255	the amount which the insurer would pay if repairs were made unless 202
256	256	such amount is agreed to by the insured or provided for by the 203
257	257	insurance policy. 204 Raised Bill No. 5255
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259	259
260	260
261	261	LCO No. 1241 8 of 14
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263	263	(7) Failure to maintain complaint handling procedures. Failure of any 205
264	264	person to maintain complete record of all the complaints which it has 206
265	265	received since the date of its last examination. This record shall indicate 207
266	266	the total number of complaints, their classification by line of insurance, 208
267	267	the nature of each complaint, the disposition of these complaints, and 209
268	268	the time it took to process each complaint. For purposes of this 210
269	269	subsection "complaint" means any written communication primarily 211
270	270	expressing a grievance. 212
271	271	(8) Misrepresentation in insurance applications. Making false or 213
272	272	fraudulent statements or representations on or relative to an application 214
273	273	for an insurance policy for the purpose of obtaining a fee, commission, 215
274	274	money or other benefit from any insurer, producer or individual. 216
275	275	(9) Any violation of any one of sections 38a-358, 38a-446, 38a-447, 38a-217
276	276	488, 38a-825, 38a-826, 38a-828 and 38a-829. None of the following 218
277	277	practices shall be considered discrimination within the meaning of 219
278	278	section 38a-446 or 38a-488 or a rebate within the meaning of section 38a-220
279	279	825: (A) Paying bonuses to policyholders or otherwise abating their 221
280	280	premiums in whole or in part out of surplus accumulated from 222
281	281	nonparticipating insurance, provided any such bonuses or abatement of 223
282	282	premiums shall be fair and equitable to policyholders and for the best 224
283	283	interests of the company and its policyholders; (B) in the case of policies 225
284	284	issued on the industrial debit plan, making allowance to policyholders 226
285	285	who have continuously for a specified period made premium payments 227
286	286	directly to an office of the insurer in an amount which fairly represents 228
287	287	the saving in collection expense; (C) readjustment of the rate of premium 229
288	288	for a group insurance policy based on loss or expense experience, or 230
289	289	both, at the end of the first or any subsequent policy year, which may be 231
290	290	made retroactive for such policy year. 232
291	291	(10) Notwithstanding any provision of any policy of insurance, 233
292	292	certificate or service contract, whenever such insurance policy or 234
293	293	certificate or service contract provides for reimbursement for any 235
294	294	services which may be legally performed by any practitioner of the 236
295	295	healing arts licensed to practice in this state, reimbursement under such 237 Raised Bill No. 5255
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297	297
298	298
299	299	LCO No. 1241 9 of 14
300	300
301	301	insurance policy, certificate or service contract shall not be denied 238
302	302	because of race, color or creed nor shall any insurer make or permit any 239
303	303	unfair discrimination against particular individuals or persons so 240
304	304	licensed. 241
305	305	(11) Favored agent or insurer: Coercion of debtors. (A) No person 242
306	306	may (i) require, as a condition precedent to the lending of money or 243
307	307	extension of credit, or any renewal thereof, that the person to whom 244
308	308	such money or credit is extended or whose obligation the creditor is to 245
309	309	acquire or finance, negotiate any policy or contract of insurance through 246
310	310	a particular insurer or group of insurers or producer or group of 247
311	311	producers; (ii) unreasonably disapprove the insurance policy provided 248
312	312	by a borrower for the protection of the property securing the credit or 249
313	313	lien; (iii) require directly or indirectly that any borrower, mortgagor, 250
314	314	purchaser, insurer or producer pay a separate charge, in connection 251
315	315	with the handling of any insurance policy required as security for a loan 252
316	316	on real estate or pay a separate charge to substitute the insurance policy 253
317	317	of one insurer for that of another; or (iv) use or disclose information 254
318	318	resulting from a requirement that a borrower, mortgagor or purchaser 255
319	319	furnish insurance of any kind on real property being conveyed or used 256
320	320	as collateral security to a loan, when such information is to the 257
321	321	advantage of the mortgagee, vendor or lender, or is to the detriment of 258
322	322	the borrower, mortgagor, purchaser, insurer or the producer complying 259
323	323	with such a requirement. 260
324	324	(B) (i) Subparagraph (A)(iii) of this subdivision shall not include the 261
325	325	interest which may be charged on premium loans or premium 262
326	326	advancements in accordance with the security instrument. (ii) For 263
327	327	purposes of subparagraph (A)(ii) of this subdivision, such disapproval 264
328	328	shall be deemed unreasonable if it is not based solely on reasonable 265
329	329	standards uniformly applied, relating to the extent of coverage required 266
330	330	and the financial soundness and the services of an insurer. Such 267
331	331	standards shall not discriminate against any particular type of insurer, 268
332	332	nor shall such standards call for the disapproval of an insurance policy 269
333	333	because such policy contains coverage in addition to that required. (iii) 270
334	334	The commissioner may investigate the affairs of any person to whom 271 Raised Bill No. 5255
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336	336
337	337
338	338	LCO No. 1241 10 of 14
339	339
340	340	this subdivision applies to determine whether such person has violated 272
341	341	this subdivision. If a violation of this subdivision is found, the person in 273
342	342	violation shall be subject to the same procedures and penalties as are 274
343	343	applicable to other provisions of section 38a-815, subsections (b) and (e) 275
344	344	of section 38a-817 and this section. (iv) For purposes of this section, 276
345	345	"person" includes any individual, corporation, limited liability 277
346	346	company, association, partnership or other legal entity. 278
347	347	(12) Refusing to insure, refusing to continue to insure or limiting the 279
348	348	amount, extent or kind of coverage available to an individual or 280
349	349	charging an individual a different rate for the same coverage because of 281
350	350	physical disability, mental or nervous condition as set forth in section 282
351	351	38a-488a or intellectual disability, except where the refusal, limitation or 283
352	352	rate differential is based on sound actuarial principles or is related to 284
353	353	actual or reasonably anticipated experience. 285
354	354	(13) Refusing to insure, refusing to continue to insure or limiting the 286
355	355	amount, extent or kind of coverage available to an individual or 287
356	356	charging an individual a different rate for the same coverage solely 288
357	357	because of blindness or partial blindness. For purposes of this 289
358	358	subdivision, "refusal to insure" includes the denial by an insurer of 290
359	359	disability insurance coverage on the grounds that the policy defines 291
360	360	"disability" as being presumed in the event that the insured is blind or 292
361	361	partially blind, except that an insurer may exclude from coverage any 293
362	362	disability, consisting solely of blindness or partial blindness, when such 294
363	363	condition existed at the time the policy was issued. Any individual who 295
364	364	is blind or partially blind shall be subject to the same standards of sound 296
365	365	actuarial principles or actual or reasonably anticipated experience as are 297
366	366	sighted persons with respect to all other conditions, including the 298
367	367	underlying cause of the blindness or partial blindness. 299
368	368	(14) Refusing to insure, refusing to continue to insure or limiting the 300
369	369	amount, extent or kind of coverage available to an individual or 301
370	370	charging an individual a different rate for the same coverage because of 302
371	371	exposure to diethylstilbestrol through the female parent. 303 Raised Bill No. 5255
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373	373
374	374
375	375	LCO No. 1241 11 of 14
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377	377	(15) (A) Failure by an insurer, or any other entity responsible for 304
378	378	providing payment to a health care provider pursuant to an insurance 305
379	379	policy, to pay accident and health claims, including, but not limited to, 306
380	380	claims for payment or reimbursement to health care providers, within 307
381	381	the time periods set forth in subparagraph (B) of this subdivision, unless 308
382	382	the Insurance Commissioner determines that a legitimate dispute exists 309
383	383	as to coverage, liability or damages or that the claimant has fraudulently 310
384	384	caused or contributed to the loss. Any insurer, or any other entity 311
385	385	responsible for providing payment to a health care provider pursuant 312
386	386	to an insurance policy, who fails to pay such a claim or request within 313
387	387	the time periods set forth in subparagraph (B) of this subdivision shall 314
388	388	pay the claimant or health care provider the amount of such claim plus 315
389	389	interest at the rate of fifteen per cent per annum, in addition to any other 316
390	390	penalties which may be imposed pursuant to sections 38a-11, 38a-25, 317
391	391	38a-41 to 38a-53, inclusive, 38a-57 to 38a-60, inclusive, 38a-62 to 38a-64, 318
392	392	inclusive, 38a-76, 38a-83, 38a-84, 38a-117 to 38a-124, inclusive, 38a-129 319
393	393	to 38a-140, inclusive, 38a-146 to 38a-155, inclusive, 38a-283, 38a-288 to 320
394	394	38a-290, inclusive, 38a-319, 38a-320, 38a-459, 38a-464, 38a-815 to 38a-819, 321
395	395	inclusive, 38a-824 to 38a-826, inclusive, and 38a-828 to 38a-830, 322
396	396	inclusive. Whenever the interest due a claimant or health care provider 323
397	397	pursuant to this section is less than one dollar, the insurer shall deposit 324
398	398	such amount in a separate interest-bearing account in which all such 325
399	399	amounts shall be deposited. At the end of each calendar year each such 326
400	400	insurer shall donate such amount to The University of Connecticut 327
401	401	Health Center. 328
402	402	(B) Each insurer or other entity responsible for providing payment to 329
403	403	a health care provider pursuant to an insurance policy subject to this 330
404	404	section, shall pay claims not later than: 331
405	405	(i) For claims filed in paper format, sixty days after receipt by the 332
406	406	insurer of the claimant's proof of loss form or the health care provider's 333
407	407	request for payment filed in accordance with the insurer's practices or 334
408	408	procedures, except that when there is a deficiency in the information 335
409	409	needed for processing a claim, as determined in accordance with section 336
410	410	38a-477, the insurer shall (I) send written notice to the claimant or health 337 Raised Bill No. 5255
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412	412
413	413
414	414	LCO No. 1241 12 of 14
415	415
416	416	care provider, as the case may be, of all alleged deficiencies in 338
417	417	information needed for processing a claim not later than thirty days 339
418	418	after the insurer receives a claim for payment or reimbursement under 340
419	419	the contract, and (II) pay claims for payment or reimbursement under 341
420	420	the contract not later than thirty days after the insurer receives the 342
421	421	information requested; and 343
422	422	(ii) For claims filed in electronic format, twenty days after receipt by 344
423	423	the insurer of the claimant's proof of loss form or the health care 345
424	424	provider's request for payment filed in accordance with the insurer's 346
425	425	practices or procedures, except that when there is a deficiency in the 347
426	426	information needed for processing a claim, as determined in accordance 348
427	427	with section 38a-477, the insurer shall (I) notify the claimant or health 349
428	428	care provider, as the case may be, of all alleged deficiencies in 350
429	429	information needed for processing a claim not later than ten days after 351
430	430	the insurer receives a claim for payment or reimbursement under the 352
431	431	contract, and (II) pay claims for payment or reimbursement under the 353
432	432	contract not later than ten days after the insurer receives the information 354
433	433	requested. 355
434	434	(C) As used in this subdivision, "health care provider" means a person 356
435	435	licensed to provide health care services under chapter 368d, chapter 357
436	436	368v, chapters 370 to 373, inclusive, 375 to 383c, inclusive, 384a to 384c, 358
437	437	inclusive, or chapter 400j. 359
438	438	(16) Failure to pay, as part of any claim for a damaged motor vehicle 360
439	439	under any automobile insurance policy where the vehicle has been 361
440	440	declared to be a constructive total loss, an amount equal to the sum of 362
441	441	(A) the settlement amount on such vehicle plus, whenever the insurer 363
442	442	takes title to such vehicle, (B) an amount determined by multiplying 364
443	443	such settlement amount by a percentage equivalent to the current sales 365
444	444	tax rate established in section 12-408. For purposes of this subdivision, 366
445	445	"constructive total loss" means the cost to repair or salvage damaged 367
446	446	property, or the cost to both repair and salvage such property, equals or 368
447	447	exceeds the total value of the property at the time of the loss. 369 Raised Bill No. 5255
448	448
449	449
450	450
451	451	LCO No. 1241 13 of 14
452	452
453	453	(17) Any violation of section 42-260, by an extended warranty 370
454	454	provider subject to the provisions of said section, including, but not 371
455	455	limited to: (A) Failure to include all statements required in subsections 372
456	456	(c) and (f) of section 42-260 in an issued extended warranty; (B) offering 373
457	457	an extended warranty without being (i) insured under an adequate 374
458	458	extended warranty reimbursement insurance policy or (ii) able to 375
459	459	demonstrate that reserves for claims contained in the provider's 376
460	460	financial statements are not in excess of one-half the provider's audited 377
461	461	net worth; (C) failure to submit a copy of an issued extended warranty 378
462	462	form or a copy of such provider's extended warranty reimbursement 379
463	463	policy form to the Insurance Commissioner. 380
464	464	(18) With respect to an insurance company, hospital service 381
465	465	corporation, health care center or fraternal benefit society providing 382
466	466	individual or group health insurance coverage of the types specified in 383
467	467	subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469, 384
468	468	refusing to insure, refusing to continue to insure or limiting the amount, 385
469	469	extent or kind of coverage available to an individual or charging an 386
470	470	individual a different rate for the same coverage because such 387
471	471	individual has been a victim of family violence. 388
472	472	(19) With respect to an insurance company, hospital service 389
473	473	corporation, health care center or fraternal benefit society providing 390
474	474	individual or group health insurance coverage of the types specified in 391
475	475	subdivisions (1), (2), (3), (4), (6), (9), (10), (11) and (12) of section 38a-469, 392
476	476	refusing to insure, refusing to continue to insure or limiting the amount, 393
477	477	extent or kind of coverage available to an individual or charging an 394
478	478	individual a different rate for the same coverage because of genetic 395
479	479	information. Genetic information indicating a predisposition to a 396
480	480	disease or condition shall not be deemed a preexisting condition in the 397
481	481	absence of a diagnosis of such disease or condition that is based on other 398
482	482	medical information. An insurance company, hospital service 399
483	483	corporation, health care center or fraternal benefit society providing 400
484	484	individual health coverage of the types specified in subdivisions (1), (2), 401
485	485	(3), (4), (6), (9), (10), (11) and (12) of section 38a-469, shall not be 402
486	486	prohibited from refusing to insure or applying a preexisting condition 403 Raised Bill No. 5255
487	487
488	488
489	489
490	490	LCO No. 1241 14 of 14
491	491
492	492	limitation, to the extent permitted by law, to an individual who has been 404
493	493	diagnosed with a disease or condition based on medical information 405
494	494	other than genetic information and has exhibited symptoms of such 406
495	495	disease or condition. For the purposes of this subsection, "genetic 407
496	496	information" means the information about genes, gene products or 408
497	497	inherited characteristics that may derive from an individual or family 409
498	498	member. 410
499	499	(20) Any violation of sections 38a-465 to 38a-465q, inclusive. 411
500	500	(21) With respect to a managed care organization, as defined in 412
501	501	section 38a-478, failing to establish a confidentiality procedure for 413
502	502	medical record information, as required by section 38a-999. 414
503	503	(22) Any violation of sections 38a-591d to 38a-591f, inclusive. 415
504	504	(23) Any violation of section 38a-472j. 416
505	505	(24) Any violation of section 2 of this act. 417
506	506	This act shall take effect as follows and shall amend the following
507	507	sections:
508	508
509	509	Section 1 January 1, 2021 38a-1
510	510	Sec. 2 January 1, 2021 New section
511	511	Sec. 3 January 1, 2021 38a-816
512	512
513	513	Statement of Purpose:
514	514	To (1) prohibit certain insurers from discriminating against any
515	515	individual solely because such individual is a living organ donor, and
516	516	(2) provide that such discrimination constitutes a violation of the
517	517	Connecticut Unfair Insurance Practices Act.
518	518	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
519	519	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
520	520	underlined.]
521	521