Connecticut 2021 Regular Session

Connecticut House Bill HB06387 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
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	4	+	HB.docx
	5	+	1 of 14
	6	+
	7	+	General Assembly Raised Bill No. 6387
	8	+	January Session, 2021
	9	+	LCO No. 2752
	10	+
	11	+
	12	+	Referred to Committee on INSURANCE AND REAL ESTATE
	13	+
	14	+
	15	+	Introduced by:
	16	+	(INS)
1	17
2	18
3	19
4		-	House Bill No. 6387
5		-
6		-	Public Act No. 21-156
7		-
8		-
9	20		AN ACT CONCERNING IN SURANCE DISCRIMINATION AGAINST
10		-	LIVING ORGAN DONORS AND ESTABLISHING A CHRONIC
11		-	KIDNEY DISEASE ADVISORY COMMITTEE.
	21	+	LIVING ORGAN DONORS.
12	22		Be it enacted by the Senate and House of Representatives in General
13	23		Assembly convened:
14	24
15		-	Section 1. Section 38a-1 of the general statutes is repealed and the
16		-	following is substituted in lieu thereof (Effective January 1, 2022):
17		-	Terms used in this title and section 2 of this act, unless it appears from
18		-	the context to the contrary, shall have a scope and meaning as set forth
19		-	in this section.
20		-	(1) "Affiliate" or "affiliated" means a person that directly, or indirectly
21		-	through one or more intermediaries, controls, is controlled by or is
22		-	under common control with another person.
23		-	(2) "Alien insurer" means any insurer that has been chartered by or
24		-	organized or constituted within or under the laws of any jurisdiction or
25		-	country without the United States.
26		-	(3) "Annuities" means all agreements to make periodical payments
27		-	where the making or continuance of all or some of the series of the
28		-	payments, or the amount of the payment, is dependent upon the
29		-	continuance of human life or is for a specified term of years. This House Bill No. 6387
	25	+	Section 1. Section 38a-1 of the general statutes is repealed and the 1
	26	+	following is substituted in lieu thereof (Effective January 1, 2022): 2
	27	+	Terms used in this title and section 2 of this act, unless it appears from 3
	28	+	the context to the contrary, shall have a scope and meaning as set forth 4
	29	+	in this section. 5
	30	+	(1) "Affiliate" or "affiliated" means a person that directly, or indirectly 6
	31	+	through one or more intermediaries, controls, is controlled by or is 7
	32	+	under common control with another person. 8
	33	+	(2) "Alien insurer" means any insurer that has been chartered by or 9
	34	+	organized or constituted within or under the laws of any jurisdiction or 10
	35	+	country without the United States. 11
	36	+	(3) "Annuities" means all agreements to make periodical payments 12
	37	+	where the making or continuance of all or some of the series of the 13 Raised Bill No. 6387
30	38
31		-	Public Act No. 21-156 2 of 19
32	39
33		-	definition does not apply to payments made under a policy of life
34		-	insurance.
35		-	(4) "Commissioner" means the Insurance Commissioner.
36		-	(5) "Control", "controlled by" or "under common control with" means
37		-	the possession, direct or indirect, of the power to direct or cause the
38		-	direction of the management and policies of a person, whether through
39		-	the ownership of voting securities, by contract other than a commercial
40		-	contract for goods or nonmanagement services, or otherwise, unless the
41		-	power is the result of an official position with the person.
42		-	(6) "Domestic insurer" means any insurer that has been chartered by,
43		-	incorporated, organized or constituted within or under the laws of this
44		-	state.
45		-	(7) "Domestic surplus lines insurer" means any domestic insurer that
46		-	has been authorized by the commissioner to write surplus lines
47		-	insurance.
48		-	(8) "Foreign country" means any jurisdiction not in any state, district
49		-	or territory of the United States.
50		-	(9) "Foreign insurer" means any insurer that has been chartered by or
51		-	organized or constituted within or under the laws of another state or a
52		-	territory of the United States.
53		-	(10) "Insolvency" or "insolvent" means, for any insurer, that it is
54		-	unable to pay its obligations when they are due, or when its admitted
55		-	assets do not exceed its liabilities plus the greater of: (A) Capital and
56		-	surplus required by law for its organization and continued operation;
57		-	or (B) the total par or stated value of its authorized and issued capital
58		-	stock. For purposes of this subdivision "liabilities" shall include but not
59		-	be limited to reserves required by statute or by regulations adopted by
60		-	the commissioner in accordance with the provisions of chapter 54 or House Bill No. 6387
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	42	+	2 of 14
61	43
62		-	Public Act No. 21-156 3 of 19
	44	+	payments, or the amount of the payment, is dependent upon the 14
	45	+	continuance of human life or is for a specified term of years. This 15
	46	+	definition does not apply to payments made under a policy of life 16
	47	+	insurance. 17
	48	+	(4) "Commissioner" means the Insurance Commissioner. 18
	49	+	(5) "Control", "controlled by" or "under common control with" means 19
	50	+	the possession, direct or indirect, of the power to direct or cause the 20
	51	+	direction of the management and policies of a person, whether through 21
	52	+	the ownership of voting securities, by contract other than a commercial 22
	53	+	contract for goods or nonmanagement services, or otherwise, unless the 23
	54	+	power is the result of an official position with the person. 24
	55	+	(6) "Domestic insurer" means any insurer that has been chartered by, 25
	56	+	incorporated, organized or constituted within or under the laws of this 26
	57	+	state. 27
	58	+	(7) "Domestic surplus lines insurer" means any domestic insurer that 28
	59	+	has been authorized by the commissioner to write surplus lines 29
	60	+	insurance. 30
	61	+	(8) "Foreign country" means any jurisdiction not in any state, district 31
	62	+	or territory of the United States. 32
	63	+	(9) "Foreign insurer" means any insurer that has been chartered by or 33
	64	+	organized or constituted within or under the laws of another state or a 34
	65	+	territory of the United States. 35
	66	+	(10) "Insolvency" or "insolvent" means, for any insurer, that it is 36
	67	+	unable to pay its obligations when they are due, or when its admitted 37
	68	+	assets do not exceed its liabilities plus the greater of: (A) Capital and 38
	69	+	surplus required by law for its organization and continued operation; 39
	70	+	or (B) the total par or stated value of its authorized and issued capital 40
	71	+	stock. For purposes of this subdivision "liabilities" shall include but not 41
	72	+	be limited to reserves required by statute or by regulations adopted by 42
	73	+	the commissioner in accordance with the provisions of chapter 54 or 43 Raised Bill No. 6387
63	74
64		-	specific requirements imposed by the commissioner upon a subject
65		-	company at the time of admission or subsequent thereto.
66		-	(11) "Insurance" means any agreement to pay a sum of money,
67		-	provide services or any other thing of value on the happening of a
68		-	particular event or contingency or to provide indemnity for loss in
69		-	respect to a specified subject by specified perils in return for a
70		-	consideration. In any contract of insurance, an insured shall have an
71		-	interest which is subject to a risk of loss through destruction or
72		-	impairment of that interest, which risk is assumed by the insurer and
73		-	such assumption shall be part of a general scheme to distribute losses
74		-	among a large group of persons bearing similar risks in return for a
75		-	ratable contribution or other consideration.
76		-	(12) "Insurer" or "insurance company" includes any person or
77		-	combination of persons doing any kind or form of insurance business
78		-	other than a fraternal benefit society, and shall include a receiver of any
79		-	insurer when the context reasonably permits.
80		-	(13) "Insured" means a person to whom or for whose benefit an
81		-	insurer makes a promise in an insurance policy. The term includes
82		-	policyholders, subscribers, members and beneficiaries. This definition
83		-	applies only to the provisions of this title and does not define the
84		-	meaning of this word as used in insurance policies or certificates.
85		-	(14) "Life insurance" means insurance on human lives and insurances
86		-	pertaining to or connected with human life. The business of life
87		-	insurance includes granting endowment benefits, granting additional
88		-	benefits in the event of death by accident or accidental means, granting
89		-	additional benefits in the event of the total and permanent disability of
90		-	the insured, and providing optional methods of settlement of proceeds.
91		-	Life insurance includes burial contracts to the extent provided by
92		-	section 38a-464. House Bill No. 6387
93	75
94		-	Public Act No. 21-156 4 of 19
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95	79
96		-	(15) "Mutual insurer" means any insurer without capital stock, the
97		-	managing directors or officers of which are elected by its members.
98		-	(16) "Person" means an individual, a corporation, a partnership, a
99		-	limited liability company, an association, a joint stock company, a
100		-	business trust, an unincorporated organization or other legal entity.
101		-	(17) "Policy" means any document, including attached endorsements
102		-	and riders, purporting to be an enforceable contract, which
103		-	memorializes in writing some or all of the terms of an insurance
104		-	contract.
105		-	(18) "State" means any state, district, or territory of the United States.
106		-	(19) "Subsidiary" of a specified person means an affiliate controlled
107		-	by the person directly, or indirectly through one or more intermediaries.
108		-	(20) "Unauthorized insurer" or "nonadmitted insurer" means an
109		-	insurer that has not been granted a certificate of authority by the
110		-	commissioner to transact the business of insurance in this state or an
111		-	insurer transacting business not authorized by a valid certificate.
112		-	(21) "United States" means the United States of America, its territories
113		-	and possessions, the Commonwealth of Puerto Rico and the District of
114		-	Columbia.
115		-	Sec. 2. (NEW) (Effective January 1, 2022) (a) Notwithstanding any
116		-	provision of the general statutes, no insurer delivering, issuing for
117		-	delivery or amending a life insurance policy, long-term care insurance
118		-	policy or a policy providing disability income protection coverage in
119		-	this state on or after January 1, 2022, shall, for any such policy issued on
120		-	or after said date:
121		-	(1) Decline to provide coverage, or limit the coverage provided, for
122		-	an individual under such policy solely because the individual is a living House Bill No. 6387
	80	+	specific requirements imposed by the commissioner upon a subject 44
	81	+	company at the time of admission or subsequent thereto. 45
	82	+	(11) "Insurance" means any agreement to pay a sum of money, 46
	83	+	provide services or any other thing of value on the happening of a 47
	84	+	particular event or contingency or to provide indemnity for loss in 48
	85	+	respect to a specified subject by specified perils in return for a 49
	86	+	consideration. In any contract of insurance, an insured shall have an 50
	87	+	interest which is subject to a risk of loss through destruction or 51
	88	+	impairment of that interest, which risk is assumed by the insurer and 52
	89	+	such assumption shall be part of a general scheme to distribute losses 53
	90	+	among a large group of persons bearing similar risks in return for a 54
	91	+	ratable contribution or other consideration. 55
	92	+	(12) "Insurer" or "insurance company" includes any person or 56
	93	+	combination of persons doing any kind or form of insurance business 57
	94	+	other than a fraternal benefit society, and shall include a receiver of any 58
	95	+	insurer when the context reasonably permits. 59
	96	+	(13) "Insured" means a person to whom or for whose benefit an 60
	97	+	insurer makes a promise in an insurance policy. The term includes 61
	98	+	policyholders, subscribers, members and beneficiaries. This definition 62
	99	+	applies only to the provisions of this title and does not define the 63
	100	+	meaning of this word as used in insurance policies or certificates. 64
	101	+	(14) "Life insurance" means insurance on human lives and insurances 65
	102	+	pertaining to or connected with human life. The business of life 66
	103	+	insurance includes granting endowment benefits, granting additional 67
	104	+	benefits in the event of death by accident or accidental means, granting 68
	105	+	additional benefits in the event of the total and permanent disability of 69
	106	+	the insured, and providing optional methods of settlement of proceeds. 70
	107	+	Life insurance includes burial contracts to the extent provided by 71
	108	+	section 38a-464. 72
	109	+	(15) "Mutual insurer" means any insurer without capital stock, the 73
	110	+	managing directors or officers of which are elected by its members. 74 Raised Bill No. 6387
123	111
124		-	Public Act No. 21-156 5 of 19
125	112
126		-	organ donor;
127		-	(2) Preclude an individual from donating all or part of an organ as a
128		-	condition to maintaining coverage under such policy; or
129		-	(3) Otherwise engage in discrimination in offering, issuing for
130		-	delivery, amending or cancelling, or in setting the amount, price or
131		-	conditions of, coverage for an individual under such policy solely
132		-	because the individual is a living organ donor.
133		-	(b) Any violation of this section shall be deemed an unfair method of
134		-	competition and unfair and deceptive act or practice in the business of
135		-	insurance under section 38a-816 of the general statutes, as amended by
136		-	this act.
137		-	Sec. 3. Section 38a-816 of the general statutes is repealed and the
138		-	following is substituted in lieu thereof (Effective January 1, 2022):
139		-	The following are defined as unfair methods of competition and
140		-	unfair and deceptive acts or practices in the business of insurance:
141		-	(1) Misrepresentations and false advertising of insurance policies.
142		-	Making, issuing or circulating, or causing to be made, issued or
143		-	circulated, any estimate, illustration, circular or statement, sales
144		-	presentation, omission or comparison which: (A) Misrepresents the
145		-	benefits, advantages, conditions or terms of any insurance policy; (B)
146		-	misrepresents the dividends or share of the surplus to be received, on
147		-	any insurance policy; (C) makes any false or misleading statements as
148		-	to the dividends or share of surplus previously paid on any insurance
149		-	policy; (D) is misleading or is a misrepresentation as to the financial
150		-	condition of any person, or as to the legal reserve system upon which
151		-	any life insurer operates; (E) uses any name or title of any insurance
152		-	policy or class of insurance policies misrepresenting the true nature
153		-	thereof; (F) is a misrepresentation, including, but not limited to, an
154		-	intentional misquote of a premium rate, for the purpose of inducing or House Bill No. 6387
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155	116
156		-	Public Act No. 21-156 6 of 19
	117	+	(16) "Person" means an individual, a corporation, a partnership, a 75
	118	+	limited liability company, an association, a joint stock company, a 76
	119	+	business trust, an unincorporated organization or other legal entity. 77
	120	+	(17) "Policy" means any document, including attached endorsements 78
	121	+	and riders, purporting to be an enforceable contract, which 79
	122	+	memorializes in writing some or all of the terms of an insurance 80
	123	+	contract. 81
	124	+	(18) "State" means any state, district, or territory of the United States. 82
	125	+	(19) "Subsidiary" of a specified person means an affiliate controlled 83
	126	+	by the person directly, or indirectly through one or more intermediaries. 84
	127	+	(20) "Unauthorized insurer" or "nonadmitted insurer" means an 85
	128	+	insurer that has not been granted a certificate of authority by the 86
	129	+	commissioner to transact the business of insurance in this state or an 87
	130	+	insurer transacting business not authorized by a valid certificate. 88
	131	+	(21) "United States" means the United States of America, its territories 89
	132	+	and possessions, the Commonwealth of Puerto Rico and the District of 90
	133	+	Columbia. 91
	134	+	Sec. 2. (NEW) (Effective January 1, 2022) (a) Notwithstanding any 92
	135	+	provision of the general statutes, no insurer delivering, issuing for 93
	136	+	delivery or amending a life insurance policy, long-term care insurance 94
	137	+	policy or a policy providing disability income protection coverage in 95
	138	+	this state on or after January 1, 2022, shall, for any such policy issued on 96
	139	+	or after said date: 97
	140	+	(1) Decline to provide coverage, or limit the coverage provided, for 98
	141	+	an individual under such policy solely because the individual is a living 99
	142	+	organ donor; 100
	143	+	(2) Preclude an individual from donating all or part of an organ as a 101
	144	+	condition to maintaining coverage under such policy; or 102 Raised Bill No. 6387
157	145
158		-	tending to induce to the purchase, lapse, forfeiture, exchange,
159		-	conversion or surrender of any insurance policy; (G) is a
160		-	misrepresentation for the purpose of effecting a pledge or assignment of
161		-	or effecting a loan against any insurance policy; or (H) misrepresents
162		-	any insurance policy as being shares of stock.
163		-	(2) False information and advertising generally. Making, publishing,
164		-	disseminating, circulating or placing before the public, or causing,
165		-	directly or indirectly, to be made, published, disseminated, circulated or
166		-	placed before the public, in a newspaper, magazine or other publication,
167		-	or in the form of a notice, circular, pamphlet, letter or poster, or over any
168		-	radio or television station, or in any other way, an advertisement,
169		-	announcement or statement containing any assertion, representation or
170		-	statement with respect to the business of insurance or with respect to
171		-	any person in the conduct of his insurance business, which is untrue,
172		-	deceptive or misleading.
173		-	(3) Defamation. Making, publishing, disseminating or circulating,
174		-	directly or indirectly, or aiding, abetting or encouraging the making,
175		-	publishing, disseminating or circulating of, any oral or written
176		-	statement or any pamphlet, circular, article or literature which is false
177		-	or maliciously critical of or derogatory to the financial condition of an
178		-	insurer, and which is calculated to injure any person engaged in the
179		-	business of insurance.
180		-	(4) Boycott, coercion and intimidation. Entering into any agreement
181		-	to commit, or by any concerted action committing, any act of boycott,
182		-	coercion or intimidation resulting in or tending to result in unreasonable
183		-	restraint of, or monopoly in, the business of insurance.
184		-	(5) False financial statements. Filing with any supervisory or other
185		-	public official, or making, publishing, disseminating, circulating or
186		-	delivering to any person, or placing before the public, or causing,
187		-	directly or indirectly, to be made, published, disseminated, circulated or House Bill No. 6387
188	146
189		-	Public Act No. 21-156 7 of 19
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190	150
191		-	delivered to any person, or placed before the public, any false statement
192		-	of financial condition of an insurer with intent to deceive; or making any
193		-	false entry in any book, report or statement of any insurer with intent to
194		-	deceive any agent or examiner lawfully appointed to examine into its
195		-	condition or into any of its affairs, or any public official to whom such
196		-	insurer is required by law to report, or who has authority by law to
197		-	examine into its condition or into any of its affairs, or, with like intent,
198		-	wilfully omitting to make a true entry of any material fact pertaining to
199		-	the business of such insurer in any book, report or statement of such
200		-	insurer.
201		-	(6) Unfair claim settlement practices. Committing or performing with
202		-	such frequency as to indicate a general business practice any of the
203		-	following: (A) Misrepresenting pertinent facts or insurance policy
204		-	provisions relating to coverages at issue; (B) failing to acknowledge and
205		-	act with reasonable promptness upon communications with respect to
206		-	claims arising under insurance policies; (C) failing to adopt and
207		-	implement reasonable standards for the prompt investigation of claims
208		-	arising under insurance policies; (D) refusing to pay claims without
209		-	conducting a reasonable investigation based upon all available
210		-	information; (E) failing to affirm or deny coverage of claims within a
211		-	reasonable time after proof of loss statements have been completed; (F)
212		-	not attempting in good faith to effectuate prompt, fair and equitable
213		-	settlements of claims in which liability has become reasonably clear; (G)
214		-	compelling insureds to institute litigation to recover amounts due under
215		-	an insurance policy by offering substantially less than the amounts
216		-	ultimately recovered in actions brought by such insureds; (H)
217		-	attempting to settle a claim for less than the amount to which a
218		-	reasonable man would have believed he was entitled by reference to
219		-	written or printed advertising material accompanying or made part of
220		-	an application; (I) attempting to settle claims on the basis of an
221		-	application which was altered without notice to, or knowledge or
222		-	consent of the insured; (J) making claims payments to insureds or House Bill No. 6387
	151	+	(3) Otherwise engage in discrimination in offering, issuing for 103
	152	+	delivery, amending or cancelling, or in setting the amount, price or 104
	153	+	conditions of, coverage for an individual under such policy solely 105
	154	+	because the individual is a living organ donor. 106
	155	+	(b) Any violation of this section shall be deemed an unfair method of 107
	156	+	competition and unfair and deceptive act or practice in the business of 108
	157	+	insurance under section 38a-816 of the general statutes, as amended by 109
	158	+	this act. 110
	159	+	Sec. 3. Section 38a-816 of the general statutes is repealed and the 111
	160	+	following is substituted in lieu thereof (Effective January 1, 2022): 112
	161	+	The following are defined as unfair methods of competition and 113
	162	+	unfair and deceptive acts or practices in the business of insurance: 114
	163	+	(1) Misrepresentations and false advertising of insurance policies. 115
	164	+	Making, issuing or circulating, or causing to be made, issued or 116
	165	+	circulated, any estimate, illustration, circular or statement, sales 117
	166	+	presentation, omission or comparison which: (A) Misrepresents the 118
	167	+	benefits, advantages, conditions or terms of any insurance policy; (B) 119
	168	+	misrepresents the dividends or share of the surplus to be received, on 120
	169	+	any insurance policy; (C) makes any false or misleading statements as 121
	170	+	to the dividends or share of surplus previously paid on any insurance 122
	171	+	policy; (D) is misleading or is a misrepresentation as to the financial 123
	172	+	condition of any person, or as to the legal reserve system upon which 124
	173	+	any life insurer operates; (E) uses any name or title of any insurance 125
	174	+	policy or class of insurance policies misrepresenting the true nature 126
	175	+	thereof; (F) is a misrepresentation, including, but not limited to, an 127
	176	+	intentional misquote of a premium rate, for the purpose of inducing or 128
	177	+	tending to induce to the purchase, lapse, forfeiture, exchange, 129
	178	+	conversion or surrender of any insurance policy; (G) is a 130
	179	+	misrepresentation for the purpose of effecting a pledge or assignment of 131
	180	+	or effecting a loan against any insurance policy; or (H) misrepresents 132
	181	+	any insurance policy as being shares of stock. 133 Raised Bill No. 6387
223	182
224		-	Public Act No. 21-156 8 of 19
225	183
226		-	beneficiaries not accompanied by statements setting forth the coverage
227		-	under which the payments are being made; (K) making known to
228		-	insureds or claimants a policy of appealing from arbitration awards in
229		-	favor of insureds or claimants for the purpose of compelling them to
230		-	accept settlements or compromises less than the amount awarded in
231		-	arbitration; (L) delaying the investigation or payment of claims by
232		-	requiring an insured, claimant, or the physician of either to submit a
233		-	preliminary claim report and then requiring the subsequent submission
234		-	of formal proof of loss forms, both of which submissions contain
235		-	substantially the same information; (M) failing to promptly settle claims,
236		-	where liability has become reasonably clear, under one portion of the
237		-	insurance policy coverage in order to influence settlements under other
238		-	portions of the insurance policy coverage; (N) failing to promptly
239		-	provide a reasonable explanation of the basis in the insurance policy in
240		-	relation to the facts or applicable law for denial of a claim or for the offer
241		-	of a compromise settlement; (O) using as a basis for cash settlement with
242		-	a first party automobile insurance claimant an amount which is less than
243		-	the amount which the insurer would pay if repairs were made unless
244		-	such amount is agreed to by the insured or provided for by the
245		-	insurance policy.
246		-	(7) Failure to maintain complaint handling procedures. Failure of any
247		-	person to maintain complete record of all the complaints which it has
248		-	received since the date of its last examination. This record shall indicate
249		-	the total number of complaints, their classification by line of insurance,
250		-	the nature of each complaint, the disposition of these complaints, and
251		-	the time it took to process each complaint. For purposes of this
252		-	subsection "complaint" means any written communication primarily
253		-	expressing a grievance.
254		-	(8) Misrepresentation in insurance applications. Making false or
255		-	fraudulent statements or representations on or relative to an application
256		-	for an insurance policy for the purpose of obtaining a fee, commission, House Bill No. 6387
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257	187
258		-	Public Act No. 21-156 9 of 19
	188	+	(2) False information and advertising generally. Making, publishing, 134
	189	+	disseminating, circulating or placing before the public, or causing, 135
	190	+	directly or indirectly, to be made, published, disseminated, circulated or 136
	191	+	placed before the public, in a newspaper, magazine or other publication, 137
	192	+	or in the form of a notice, circular, pamphlet, letter or poster, or over any 138
	193	+	radio or television station, or in any other way, an advertisement, 139
	194	+	announcement or statement containing any assertion, representation or 140
	195	+	statement with respect to the business of insurance or with respect to 141
	196	+	any person in the conduct of his insurance business, which is untrue, 142
	197	+	deceptive or misleading. 143
	198	+	(3) Defamation. Making, publishing, disseminating or circulating, 144
	199	+	directly or indirectly, or aiding, abetting or encouraging the making, 145
	200	+	publishing, disseminating or circulating of, any oral or written 146
	201	+	statement or any pamphlet, circular, article or literature which is false 147
	202	+	or maliciously critical of or derogatory to the financial condition of an 148
	203	+	insurer, and which is calculated to injure any person engaged in the 149
	204	+	business of insurance. 150
	205	+	(4) Boycott, coercion and intimidation. Entering into any agreement 151
	206	+	to commit, or by any concerted action committing, any act of boycott, 152
	207	+	coercion or intimidation resulting in or tending to result in unreasonable 153
	208	+	restraint of, or monopoly in, the business of insurance. 154
	209	+	(5) False financial statements. Filing with any supervisory or other 155
	210	+	public official, or making, publishing, disseminating, circulating or 156
	211	+	delivering to any person, or placing before the public, or causing, 157
	212	+	directly or indirectly, to be made, published, disseminated, circulated or 158
	213	+	delivered to any person, or placed before the public, any false statement 159
	214	+	of financial condition of an insurer with intent to deceive; or making any 160
	215	+	false entry in any book, report or statement of any insurer with intent to 161
	216	+	deceive any agent or examiner lawfully appointed to examine into its 162
	217	+	condition or into any of its affairs, or any public official to whom such 163
	218	+	insurer is required by law to report, or who has authority by law to 164
	219	+	examine into its condition or into any of its affairs, or, with like intent, 165
	220	+	wilfully omitting to make a true entry of any material fact pertaining to 166 Raised Bill No. 6387
259	221
260		-	money or other benefit from any insurer, producer or individual.
261		-	(9) Any violation of any one of sections 38a-358, 38a-446, 38a-447, 38a-
262		-	488, 38a-825, 38a-826, 38a-828 and 38a-829. None of the following
263		-	practices shall be considered discrimination within the meaning of
264		-	section 38a-446 or 38a-488 or a rebate within the meaning of section 38a-
265		-	825: (A) Paying bonuses to policyholders or otherwise abating their
266		-	premiums in whole or in part out of surplus accumulated from
267		-	nonparticipating insurance, provided any such bonuses or abatement of
268		-	premiums shall be fair and equitable to policyholders and for the best
269		-	interests of the company and its policyholders; (B) in the case of policies
270		-	issued on the industrial debit plan, making allowance to policyholders
271		-	who have continuously for a specified period made premium payments
272		-	directly to an office of the insurer in an amount which fairly represents
273		-	the saving in collection expense; (C) readjustment of the rate of premium
274		-	for a group insurance policy based on loss or expense experience, or
275		-	both, at the end of the first or any subsequent policy year, which may be
276		-	made retroactive for such policy year.
277		-	(10) Notwithstanding any provision of any policy of insurance,
278		-	certificate or service contract, whenever such insurance policy or
279		-	certificate or service contract provides for reimbursement for any
280		-	services which may be legally performed by any practitioner of the
281		-	healing arts licensed to practice in this state, reimbursement under such
282		-	insurance policy, certificate or service contract shall not be denied
283		-	because of race, color or creed nor shall any insurer make or permit any
284		-	unfair discrimination against particular individuals or persons so
285		-	licensed.
286		-	(11) Favored agent or insurer: Coercion of debtors. (A) No person
287		-	may (i) require, as a condition precedent to the lending of money or
288		-	extension of credit, or any renewal thereof, that the person to whom
289		-	such money or credit is extended or whose obligation the creditor is to
290		-	acquire or finance, negotiate any policy or contract of insurance through House Bill No. 6387
291	222
292		-	Public Act No. 21-156 10 of 19
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293	226
294		-	a particular insurer or group of insurers or producer or group of
295		-	producers; (ii) unreasonably disapprove the insurance policy provided
296		-	by a borrower for the protection of the property securing the credit or
297		-	lien; (iii) require directly or indirectly that any borrower, mortgagor,
298		-	purchaser, insurer or producer pay a separate charge, in connection
299		-	with the handling of any insurance policy required as security for a loan
300		-	on real estate or pay a separate charge to substitute the insurance policy
301		-	of one insurer for that of another; or (iv) use or disclose information
302		-	resulting from a requirement that a borrower, mortgagor or purchaser
303		-	furnish insurance of any kind on real property being conveyed or used
304		-	as collateral security to a loan, when such information is to the
305		-	advantage of the mortgagee, vendor or lender, or is to the detriment of
306		-	the borrower, mortgagor, purchaser, insurer or the producer complying
307		-	with such a requirement.
308		-	(B) (i) Subparagraph (A)(iii) of this subdivision shall not include the
309		-	interest which may be charged on premium loans or premium
310		-	advancements in accordance with the security instrument. (ii) For
311		-	purposes of subparagraph (A)(ii) of this subdivision, such disapproval
312		-	shall be deemed unreasonable if it is not based solely on reasonable
313		-	standards uniformly applied, relating to the extent of coverage required
314		-	and the financial soundness and the services of an insurer. Such
315		-	standards shall not discriminate against any particular type of insurer,
316		-	nor shall such standards call for the disapproval of an insurance policy
317		-	because such policy contains coverage in addition to that required. (iii)
318		-	The commissioner may investigate the affairs of any person to whom
319		-	this subdivision applies to determine whether such person has violated
320		-	this subdivision. If a violation of this subdivision is found, the person in
321		-	violation shall be subject to the same procedures and penalties as are
322		-	applicable to other provisions of section 38a-815, subsections (b) and (e)
323		-	of section 38a-817 and this section. (iv) For purposes of this section,
324		-	"person" includes any individual, corporation, limited liability
325		-	company, association, partnership or other legal entity. House Bill No. 6387
	227	+	the business of such insurer in any book, report or statement of such 167
	228	+	insurer. 168
	229	+	(6) Unfair claim settlement practices. Committing or performing with 169
	230	+	such frequency as to indicate a general business practice any of the 170
	231	+	following: (A) Misrepresenting pertinent facts or insurance policy 171
	232	+	provisions relating to coverages at issue; (B) failing to acknowledge and 172
	233	+	act with reasonable promptness upon communications with respect to 173
	234	+	claims arising under insurance policies; (C) failing to adopt and 174
	235	+	implement reasonable standards for the prompt investigation of claims 175
	236	+	arising under insurance policies; (D) refusing to pay claims without 176
	237	+	conducting a reasonable investigation based upon all available 177
	238	+	information; (E) failing to affirm or deny coverage of claims within a 178
	239	+	reasonable time after proof of loss statements have been completed; (F) 179
	240	+	not attempting in good faith to effectuate prompt, fair and equitable 180
	241	+	settlements of claims in which liability has become reasonably clear; (G) 181
	242	+	compelling insureds to institute litigation to recover amounts due under 182
	243	+	an insurance policy by offering substantially less than the amounts 183
	244	+	ultimately recovered in actions brought by such insureds; (H) 184
	245	+	attempting to settle a claim for less than the amount to which a 185
	246	+	reasonable man would have believed he was entitled by reference to 186
	247	+	written or printed advertising material accompanying or made part of 187
	248	+	an application; (I) attempting to settle claims on the basis of an 188
	249	+	application which was altered without notice to, or knowledge or 189
	250	+	consent of the insured; (J) making claims payments to insureds or 190
	251	+	beneficiaries not accompanied by statements setting forth the coverage 191
	252	+	under which the payments are being made; (K) making known to 192
	253	+	insureds or claimants a policy of appealing from arbitration awards in 193
	254	+	favor of insureds or claimants for the purpose of compelling them to 194
	255	+	accept settlements or compromises less than the amount awarded in 195
	256	+	arbitration; (L) delaying the investigation or payment of claims by 196
	257	+	requiring an insured, claimant, or the physician of either to submit a 197
	258	+	preliminary claim report and then requiring the subsequent submission 198
	259	+	of formal proof of loss forms, both of which submissions contain 199
	260	+	substantially the same information; (M) failing to promptly settle claims, 200 Raised Bill No. 6387
326	261
327		-	Public Act No. 21-156 11 of 19
328	262
329		-	(12) Refusing to insure, refusing to continue to insure or limiting the
330		-	amount, extent or kind of coverage available to an individual or
331		-	charging an individual a different rate for the same coverage because of
332		-	physical disability, mental or nervous condition as set forth in section
333		-	38a-488a or intellectual disability, except where the refusal, limitation or
334		-	rate differential is based on sound actuarial principles or is related to
335		-	actual or reasonably anticipated experience.
336		-	(13) Refusing to insure, refusing to continue to insure or limiting the
337		-	amount, extent or kind of coverage available to an individual or
338		-	charging an individual a different rate for the same coverage solely
339		-	because of blindness or partial blindness. For purposes of this
340		-	subdivision, "refusal to insure" includes the denial by an insurer of
341		-	disability insurance coverage on the grounds that the policy defines
342		-	"disability" as being presumed in the event that the insured is blind or
343		-	partially blind, except that an insurer may exclude from coverage any
344		-	disability, consisting solely of blindness or partial blindness, when such
345		-	condition existed at the time the policy was issued. Any individual who
346		-	is blind or partially blind shall be subject to the same standards of sound
347		-	actuarial principles or actual or reasonably anticipated experience as are
348		-	sighted persons with respect to all other conditions, including the
349		-	underlying cause of the blindness or partial blindness.
350		-	(14) Refusing to insure, refusing to continue to insure or limiting the
351		-	amount, extent or kind of coverage available to an individual or
352		-	charging an individual a different rate for the same coverage because of
353		-	exposure to diethylstilbestrol through the female parent.
354		-	(15) (A) Failure by an insurer, or any other entity responsible for
355		-	providing payment to a health care provider pursuant to an insurance
356		-	policy, to pay accident and health claims, including, but not limited to,
357		-	claims for payment or reimbursement to health care providers, within
358		-	the time periods set forth in subparagraph (B) of this subdivision, unless
359		-	the Insurance Commissioner determines that a legitimate dispute exists House Bill No. 6387
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360	266
361		-	Public Act No. 21-156 12 of 19
	267	+	where liability has become reasonably clear, under one portion of the 201
	268	+	insurance policy coverage in order to influence settlements under other 202
	269	+	portions of the insurance policy coverage; (N) failing to promptly 203
	270	+	provide a reasonable explanation of the basis in the insurance policy in 204
	271	+	relation to the facts or applicable law for denial of a claim or for the offer 205
	272	+	of a compromise settlement; (O) using as a basis for cash settlement with 206
	273	+	a first party automobile insurance claimant an amount which is less than 207
	274	+	the amount which the insurer would pay if repairs were made unless 208
	275	+	such amount is agreed to by the insured or provided for by the 209
	276	+	insurance policy. 210
	277	+	(7) Failure to maintain complaint handling procedures. Failure of any 211
	278	+	person to maintain complete record of all the complaints which it has 212
	279	+	received since the date of its last examination. This record shall indicate 213
	280	+	the total number of complaints, their classification by line of insurance, 214
	281	+	the nature of each complaint, the disposition of these complaints, and 215
	282	+	the time it took to process each complaint. For purposes of this 216
	283	+	subsection "complaint" means any written communication primarily 217
	284	+	expressing a grievance. 218
	285	+	(8) Misrepresentation in insurance applications. Making false or 219
	286	+	fraudulent statements or representations on or relative to an application 220
	287	+	for an insurance policy for the purpose of obtaining a fee, commission, 221
	288	+	money or other benefit from any insurer, producer or individual. 222
	289	+	(9) Any violation of any one of sections 38a-358, 38a-446, 38a-447, 38a-223
	290	+	488, 38a-825, 38a-826, 38a-828 and 38a-829. None of the following 224
	291	+	practices shall be considered discrimination within the meaning of 225
	292	+	section 38a-446 or 38a-488 or a rebate within the meaning of section 38a-226
	293	+	825: (A) Paying bonuses to policyholders or otherwise abating their 227
	294	+	premiums in whole or in part out of surplus accumulated from 228
	295	+	nonparticipating insurance, provided any such bonuses or abatement of 229
	296	+	premiums shall be fair and equitable to policyholders and for the best 230
	297	+	interests of the company and its policyholders; (B) in the case of policies 231
	298	+	issued on the industrial debit plan, making allowance to policyholders 232
	299	+	who have continuously for a specified period made premium payments 233 Raised Bill No. 6387
362	300
363		-	as to coverage, liability or damages or that the claimant has fraudulently
364		-	caused or contributed to the loss. Any insurer, or any other entity
365		-	responsible for providing payment to a health care provider pursuant
366		-	to an insurance policy, who fails to pay such a claim or request within
367		-	the time periods set forth in subparagraph (B) of this subdivision shall
368		-	pay the claimant or health care provider the amount of such claim plus
369		-	interest at the rate of fifteen per cent per annum, in addition to any other
370		-	penalties which may be imposed pursuant to sections 38a-11, 38a-25,
371		-	38a-41 to 38a-53, inclusive, 38a-57 to 38a-60, inclusive, 38a-62 to 38a-64,
372		-	inclusive, 38a-76, 38a-83, 38a-84, 38a-117 to 38a-124, inclusive, 38a-129
373		-	to 38a-140, inclusive, 38a-146 to 38a-155, inclusive, 38a-283, 38a-288 to
374		-	38a-290, inclusive, 38a-319, 38a-320, 38a-459, 38a-464, 38a-815 to 38a-819,
375		-	inclusive, 38a-824 to 38a-826, inclusive, and 38a-828 to 38a-830,
376		-	inclusive. Whenever the interest due a claimant or health care provider
377		-	pursuant to this section is less than one dollar, the insurer shall deposit
378		-	such amount in a separate interest-bearing account in which all such
379		-	amounts shall be deposited. At the end of each calendar year each such
380		-	insurer shall donate such amount to The University of Connecticut
381		-	Health Center.
382		-	(B) Each insurer or other entity responsible for providing payment to
383		-	a health care provider pursuant to an insurance policy subject to this
384		-	section, shall pay claims not later than:
385		-	(i) For claims filed in paper format, sixty days after receipt by the
386		-	insurer of the claimant's proof of loss form or the health care provider's
387		-	request for payment filed in accordance with the insurer's practices or
388		-	procedures, except that when there is a deficiency in the information
389		-	needed for processing a claim, as determined in accordance with section
390		-	38a-477, the insurer shall (I) send written notice to the claimant or health
391		-	care provider, as the case may be, of all alleged deficiencies in
392		-	information needed for processing a claim not later than thirty days
393		-	after the insurer receives a claim for payment or reimbursement under House Bill No. 6387
394	301
395		-	Public Act No. 21-156 13 of 19
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396	305
397		-	the contract, and (II) pay claims for payment or reimbursement under
398		-	the contract not later than thirty days after the insurer receives the
399		-	information requested; and
400		-	(ii) For claims filed in electronic format, twenty days after receipt by
401		-	the insurer of the claimant's proof of loss form or the health care
402		-	provider's request for payment filed in accordance with the insurer's
403		-	practices or procedures, except that when there is a deficiency in the
404		-	information needed for processing a claim, as determined in accordance
405		-	with section 38a-477, the insurer shall (I) notify the claimant or health
406		-	care provider, as the case may be, of all alleged deficiencies in
407		-	information needed for processing a claim not later than ten days after
408		-	the insurer receives a claim for payment or reimbursement under the
409		-	contract, and (II) pay claims for payment or reimbursement under the
410		-	contract not later than ten days after the insurer receives the information
411		-	requested.
412		-	(C) As used in this subdivision, "health care provider" means a person
413		-	licensed to provide health care services under chapter 368d, chapter
414		-	368v, chapters 370 to 373, inclusive, 375 to 383c, inclusive, 384a to 384c,
415		-	inclusive, or chapter 400j.
416		-	(16) Failure to pay, as part of any claim for a damaged motor vehicle
417		-	under any automobile insurance policy where the vehicle has been
418		-	declared to be a constructive total loss, an amount equal to the sum of
419		-	(A) the settlement amount on such vehicle plus, whenever the insurer
420		-	takes title to such vehicle, (B) an amount determined by multiplying
421		-	such settlement amount by a percentage equivalent to the current sales
422		-	tax rate established in section 12-408. For purposes of this subdivision,
423		-	"constructive total loss" means the cost to repair or salvage damaged
424		-	property, or the cost to both repair and salvage such property, equals or
425		-	exceeds the total value of the property at the time of the loss.
426		-	(17) Any violation of section 42-260, by an extended warranty House Bill No. 6387
	306	+	directly to an office of the insurer in an amount which fairly represents 234
	307	+	the saving in collection expense; (C) readjustment of the rate of premium 235
	308	+	for a group insurance policy based on loss or expense experience, or 236
	309	+	both, at the end of the first or any subsequent policy year, which may be 237
	310	+	made retroactive for such policy year. 238
	311	+	(10) Notwithstanding any provision of any policy of insurance, 239
	312	+	certificate or service contract, whenever such insurance policy or 240
	313	+	certificate or service contract provides for reimbursement for any 241
	314	+	services which may be legally performed by any practitioner of the 242
	315	+	healing arts licensed to practice in this state, reimbursement under such 243
	316	+	insurance policy, certificate or service contract shall not be denied 244
	317	+	because of race, color or creed nor shall any insurer make or permit any 245
	318	+	unfair discrimination against particular individuals or persons so 246
	319	+	licensed. 247
	320	+	(11) Favored agent or insurer: Coercion of debtors. (A) No person 248
	321	+	may (i) require, as a condition precedent to the lending of money or 249
	322	+	extension of credit, or any renewal thereof, that the person to whom 250
	323	+	such money or credit is extended or whose obligation the creditor is to 251
	324	+	acquire or finance, negotiate any policy or contract of insurance through 252
	325	+	a particular insurer or group of insurers or producer or group of 253
	326	+	producers; (ii) unreasonably disapprove the insurance policy provided 254
	327	+	by a borrower for the protection of the property securing the credit or 255
	328	+	lien; (iii) require directly or indirectly that any borrower, mortgagor, 256
	329	+	purchaser, insurer or producer pay a separate charge, in connection 257
	330	+	with the handling of any insurance policy required as security for a loan 258
	331	+	on real estate or pay a separate charge to substitute the insurance policy 259
	332	+	of one insurer for that of another; or (iv) use or disclose information 260
	333	+	resulting from a requirement that a borrower, mortgagor or purchaser 261
	334	+	furnish insurance of any kind on real property being conveyed or used 262
	335	+	as collateral security to a loan, when such information is to the 263
	336	+	advantage of the mortgagee, vendor or lender, or is to the detriment of 264
	337	+	the borrower, mortgagor, purchaser, insurer or the producer complying 265
	338	+	with such a requirement. 266 Raised Bill No. 6387
427	339
428		-	Public Act No. 21-156 14 of 19
429	340
430		-	provider subject to the provisions of said section, including, but not
431		-	limited to: (A) Failure to include all statements required in subsections
432		-	(c) and (f) of section 42-260 in an issued extended warranty; (B) offering
433		-	an extended warranty without being (i) insured under an adequate
434		-	extended warranty reimbursement insurance policy or (ii) able to
435		-	demonstrate that reserves for claims contained in the provider's
436		-	financial statements are not in excess of one-half the provider's audited
437		-	net worth; (C) failure to submit a copy of an issued extended warranty
438		-	form or a copy of such provider's extended warranty reimbursement
439		-	policy form to the Insurance Commissioner.
440		-	(18) With respect to an insurance company, hospital service
441		-	corporation, health care center or fraternal benefit society providing
442		-	individual or group health insurance coverage of the types specified in
443		-	subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469,
444		-	refusing to insure, refusing to continue to insure or limiting the amount,
445		-	extent or kind of coverage available to an individual or charging an
446		-	individual a different rate for the same coverage because such
447		-	individual has been a victim of family violence.
448		-	(19) With respect to an insurance company, hospital service
449		-	corporation, health care center or fraternal benefit society providing
450		-	individual or group health insurance coverage of the types specified in
451		-	subdivisions (1), (2), (3), (4), (6), (9), (10), (11) and (12) of section 38a-469,
452		-	refusing to insure, refusing to continue to insure or limiting the amount,
453		-	extent or kind of coverage available to an individual or charging an
454		-	individual a different rate for the same coverage because of genetic
455		-	information. Genetic information indicating a predisposition to a
456		-	disease or condition shall not be deemed a preexisting condition in the
457		-	absence of a diagnosis of such disease or condition that is based on other
458		-	medical information. An insurance company, hospital service
459		-	corporation, health care center or fraternal benefit society providing
460		-	individual health coverage of the types specified in subdivisions (1), (2), House Bill No. 6387
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462		-	Public Act No. 21-156 15 of 19
	345	+	(B) (i) Subparagraph (A)(iii) of this subdivision shall not include the 267
	346	+	interest which may be charged on premium loans or premium 268
	347	+	advancements in accordance with the security instrument. (ii) For 269
	348	+	purposes of subparagraph (A)(ii) of this subdivision, such disapproval 270
	349	+	shall be deemed unreasonable if it is not based solely on reasonable 271
	350	+	standards uniformly applied, relating to the extent of coverage required 272
	351	+	and the financial soundness and the services of an insurer. Such 273
	352	+	standards shall not discriminate against any particular type of insurer, 274
	353	+	nor shall such standards call for the disapproval of an insurance policy 275
	354	+	because such policy contains coverage in addition to that required. (iii) 276
	355	+	The commissioner may investigate the affairs of any person to whom 277
	356	+	this subdivision applies to determine whether such person has violated 278
	357	+	this subdivision. If a violation of this subdivision is found, the person in 279
	358	+	violation shall be subject to the same procedures and penalties as are 280
	359	+	applicable to other provisions of section 38a-815, subsections (b) and (e) 281
	360	+	of section 38a-817 and this section. (iv) For purposes of this section, 282
	361	+	"person" includes any individual, corporation, limited liability 283
	362	+	company, association, partnership or other legal entity. 284
	363	+	(12) Refusing to insure, refusing to continue to insure or limiting the 285
	364	+	amount, extent or kind of coverage available to an individual or 286
	365	+	charging an individual a different rate for the same coverage because of 287
	366	+	physical disability, mental or nervous condition as set forth in section 288
	367	+	38a-488a or intellectual disability, except where the refusal, limitation or 289
	368	+	rate differential is based on sound actuarial principles or is related to 290
	369	+	actual or reasonably anticipated experience. 291
	370	+	(13) Refusing to insure, refusing to continue to insure or limiting the 292
	371	+	amount, extent or kind of coverage available to an individual or 293
	372	+	charging an individual a different rate for the same coverage solely 294
	373	+	because of blindness or partial blindness. For purposes of this 295
	374	+	subdivision, "refusal to insure" includes the denial by an insurer of 296
	375	+	disability insurance coverage on the grounds that the policy defines 297
	376	+	"disability" as being presumed in the event that the insured is blind or 298
	377	+	partially blind, except that an insurer may exclude from coverage any 299 Raised Bill No. 6387
463	378
464		-	(3), (4), (6), (9), (10), (11) and (12) of section 38a-469, shall not be
465		-	prohibited from refusing to insure or applying a preexisting condition
466		-	limitation, to the extent permitted by law, to an individual who has been
467		-	diagnosed with a disease or condition based on medical information
468		-	other than genetic information and has exhibited symptoms of such
469		-	disease or condition. For the purposes of this subsection, "genetic
470		-	information" means the information about genes, gene products or
471		-	inherited characteristics that may derive from an individual or family
472		-	member.
473		-	(20) Any violation of sections 38a-465 to 38a-465q, inclusive.
474		-	(21) With respect to a managed care organization, as defined in
475		-	section 38a-478, failing to establish a confidentiality procedure for
476		-	medical record information, as required by section 38a-999.
477		-	(22) Any violation of sections 38a-591d to 38a-591f, inclusive.
478		-	(23) Any violation of section 38a-472j.
479		-	(24) Any violation of section 2 of this act.
480		-	Sec. 4. (NEW) (Effective from passage) (a) There is established a chronic
481		-	kidney disease advisory committee. The advisory committee shall:
482		-	(1) Work directly with policymakers, public health organizations and
483		-	educational institutions to:
484		-	(A) Increase awareness of chronic kidney disease in this state; and
485		-	(B) Develop health education programs that:
486		-	(i) Are intended to reduce the burden of kidney disease throughout
487		-	this state;
488		-	(ii) Include an ongoing health and wellness campaign that is based House Bill No. 6387
489	379
490		-	Public Act No. 21-156 16 of 19
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491	383
492		-	on relevant research;
493		-	(iii) Promote preventive screenings; and
494		-	(iv) Are promoted through social media and public relations
495		-	campaigns;
496		-	(2) Examine chronic kidney disease, kidney transplantation,
497		-	including, but not limited to, kidney transplantation as a preferred
498		-	treatment for chronic kidney disease, living and deceased kidney
499		-	donation and racial disparities in the rates of individuals afflicted with
500		-	chronic kidney disease;
501		-	(3) Examine methods to reduce the occurrence of chronic kidney
502		-	disease by controlling the most common risk factors, diabetes and
503		-	hypertension, through early detection and preventive efforts at the
504		-	community level and disease management efforts in the primary care
505		-	setting;
506		-	(4) Identify the barriers to the adoption of best practices and the
507		-	policies available to address such barriers;
508		-	(5) Develop an equitable, sustainable, cost-effective plan to raise
509		-	awareness about the importance of early detection, screening, diagnosis
510		-	and treatment of chronic kidney disease and prevention; and
511		-	(6) Examine the potential for an opt-out organ or kidney donor
512		-	registry.
513		-	(b) The advisory committee shall consist of the following members:
514		-	(1) The chairpersons and ranking members of the joint standing
515		-	committee of the General Assembly having cognizance of matters
516		-	relating to public health, or their designees;
517		-	(2) One appointed by the Senate chairperson of the joint standing House Bill No. 6387
	384	+	disability, consisting solely of blindness or partial blindness, when such 300
	385	+	condition existed at the time the policy was issued. Any individual who 301
	386	+	is blind or partially blind shall be subject to the same standards of sound 302
	387	+	actuarial principles or actual or reasonably anticipated experience as are 303
	388	+	sighted persons with respect to all other conditions, including the 304
	389	+	underlying cause of the blindness or partial blindness. 305
	390	+	(14) Refusing to insure, refusing to continue to insure or limiting the 306
	391	+	amount, extent or kind of coverage available to an individual or 307
	392	+	charging an individual a different rate for the same coverage because of 308
	393	+	exposure to diethylstilbestrol through the female parent. 309
	394	+	(15) (A) Failure by an insurer, or any other entity responsible for 310
	395	+	providing payment to a health care provider pursuant to an insurance 311
	396	+	policy, to pay accident and health claims, including, but not limited to, 312
	397	+	claims for payment or reimbursement to health care providers, within 313
	398	+	the time periods set forth in subparagraph (B) of this subdivision, unless 314
	399	+	the Insurance Commissioner determines that a legitimate dispute exists 315
	400	+	as to coverage, liability or damages or that the claimant has fraudulently 316
	401	+	caused or contributed to the loss. Any insurer, or any other entity 317
	402	+	responsible for providing payment to a health care provider pursuant 318
	403	+	to an insurance policy, who fails to pay such a claim or request within 319
	404	+	the time periods set forth in subparagraph (B) of this subdivision shall 320
	405	+	pay the claimant or health care provider the amount of such claim plus 321
	406	+	interest at the rate of fifteen per cent per annum, in addition to any other 322
	407	+	penalties which may be imposed pursuant to sections 38a-11, 38a-25, 323
	408	+	38a-41 to 38a-53, inclusive, 38a-57 to 38a-60, inclusive, 38a-62 to 38a-64, 324
	409	+	inclusive, 38a-76, 38a-83, 38a-84, 38a-117 to 38a-124, inclusive, 38a-129 325
	410	+	to 38a-140, inclusive, 38a-146 to 38a-155, inclusive, 38a-283, 38a-288 to 326
	411	+	38a-290, inclusive, 38a-319, 38a-320, 38a-459, 38a-464, 38a-815 to 38a-819, 327
	412	+	inclusive, 38a-824 to 38a-826, inclusive, and 38a-828 to 38a-830, 328
	413	+	inclusive. Whenever the interest due a claimant or health care provider 329
	414	+	pursuant to this section is less than one dollar, the insurer shall deposit 330
	415	+	such amount in a separate interest-bearing account in which all such 331
	416	+	amounts shall be deposited. At the end of each calendar year each such 332 Raised Bill No. 6387
518	417
519		-	Public Act No. 21-156 17 of 19
520	418
521		-	committee of the General Assembly having cognizance of matters
522		-	relating to public health;
523		-	(3) One appointed by the House chairperson of the joint standing
524		-	committee of the General Assembly having cognizance of matters
525		-	relating to public health;
526		-	(4) One appointed by the Senate ranking member of the joint standing
527		-	committee of the General Assembly having cognizance of matters
528		-	relating to public health;
529		-	(5) One appointed by the House ranking member of the joint standing
530		-	committee of the General Assembly having cognizance of matters
531		-	relating to public health;
532		-	(6) One appointed by the speaker of the House of Representatives,
533		-	who shall represent the renal provider community;
534		-	(7) One appointed by the president pro tempore of the Senate, who
535		-	shall represent a medical center with a kidney-related program;
536		-	(8) One appointed by the majority leader of the House of
537		-	Representatives;
538		-	(9) One appointed by the majority leader of the Senate;
539		-	(10) One appointed by the minority leader of the House of
540		-	Representatives;
541		-	(11) One appointed by the minority leader of the Senate;
542		-	(12) One appointed by the Governor;
543		-	(13) The Commissioner of Public Health, or the commissioner's
544		-	designee;
545		-	(14) One appointed by the chief executive officer of the National House Bill No. 6387
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546	422
547		-	Public Act No. 21-156 18 of 19
	423	+	insurer shall donate such amount to The University of Connecticut 333
	424	+	Health Center. 334
	425	+	(B) Each insurer or other entity responsible for providing payment to 335
	426	+	a health care provider pursuant to an insurance policy subject to this 336
	427	+	section, shall pay claims not later than: 337
	428	+	(i) For claims filed in paper format, sixty days after receipt by the 338
	429	+	insurer of the claimant's proof of loss form or the health care provider's 339
	430	+	request for payment filed in accordance with the insurer's practices or 340
	431	+	procedures, except that when there is a deficiency in the information 341
	432	+	needed for processing a claim, as determined in accordance with section 342
	433	+	38a-477, the insurer shall (I) send written notice to the claimant or health 343
	434	+	care provider, as the case may be, of all alleged deficiencies in 344
	435	+	information needed for processing a claim not later than thirty days 345
	436	+	after the insurer receives a claim for payment or reimbursement under 346
	437	+	the contract, and (II) pay claims for payment or reimbursement under 347
	438	+	the contract not later than thirty days after the insurer receives the 348
	439	+	information requested; and 349
	440	+	(ii) For claims filed in electronic format, twenty days after receipt by 350
	441	+	the insurer of the claimant's proof of loss form or the health care 351
	442	+	provider's request for payment filed in accordance with the insurer's 352
	443	+	practices or procedures, except that when there is a deficiency in the 353
	444	+	information needed for processing a claim, as determined in accordance 354
	445	+	with section 38a-477, the insurer shall (I) notify the claimant or health 355
	446	+	care provider, as the case may be, of all alleged deficiencies in 356
	447	+	information needed for processing a claim not later than ten days after 357
	448	+	the insurer receives a claim for payment or reimbursement under the 358
	449	+	contract, and (II) pay claims for payment or reimbursement under the 359
	450	+	contract not later than ten days after the insurer receives the information 360
	451	+	requested. 361
	452	+	(C) As used in this subdivision, "health care provider" means a person 362
	453	+	licensed to provide health care services under chapter 368d, chapter 363
	454	+	368v, chapters 370 to 373, inclusive, 375 to 383c, inclusive, 384a to 384c, 364 Raised Bill No. 6387
548	455
549		-	Kidney Foundation;
550		-	(15) One appointed by the chief executive officer of the American
551		-	Kidney Fund; and
552		-	(16) At least three additional members appointed by the chairpersons
553		-	of the joint standing committee of the General Assembly having
554		-	cognizance of matters relating to public health, one of whom shall
555		-	represent the kidney physician community, one of whom sha ll
556		-	represent a nonprofit organ procurement organization, one of whom
557		-	shall represent the kidney patient community in this state and such
558		-	other members that such chairpersons, in their discretion, agree are
559		-	necessary to represent public health clinics, community health centers,
560		-	minority health organizations and health insurers.
561		-	(c) Any member of the advisory committee appointed under
562		-	subdivision (1), (2), (3), (4), (5), (6), (7), (8), (9), (10), (11) or (16) of
563		-	subsection (b) of this section may be a member of the General Assembly.
564		-	(d) All initial appointments to the advisory committee shall be made
565		-	not later than thirty days after the effective date of this section. Any
566		-	vacancy shall be filled by the appointing authority.
567		-	(e) The speaker of the House of Representatives and the president pro
568		-	tempore of the Senate shall select the chairpersons of the advisory
569		-	committee from among the members of the advisory committee. Such
570		-	chairpersons shall schedule the first meeting of the advisory committee,
571		-	which shall be held not later than sixty days after the effective date of
572		-	this section. Meetings of the advisory committee may, at the discretion
573		-	of the chairpersons of the advisory committee, be conducted on a virtual
574		-	platform.
575		-	(f) The administrative staff of the advisory committee shall be
576		-	selected by the Office of Legislative Management in consultation with
577		-	the chairpersons of the advisory committee. House Bill No. 6387
578	456
579		-	Public Act No. 21-156 19 of 19
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580	460
581		-	(g) Not later than January 1, 2022, and annually thereafter, the
582		-	advisory committee shall submit a report on its findings and
583		-	recommendations to the joint standing committee of the General
584		-	Assembly having cognizance of matters relating to public health in
585		-	accordance with the provisions of section 11-4a of the general statutes.
	461	+	inclusive, or chapter 400j. 365
	462	+	(16) Failure to pay, as part of any claim for a damaged motor vehicle 366
	463	+	under any automobile insurance policy where the vehicle has been 367
	464	+	declared to be a constructive total loss, an amount equal to the sum of 368
	465	+	(A) the settlement amount on such vehicle plus, whenever the insurer 369
	466	+	takes title to such vehicle, (B) an amount determined by multiplying 370
	467	+	such settlement amount by a percentage equivalent to the current sales 371
	468	+	tax rate established in section 12-408. For purposes of this subdivision, 372
	469	+	"constructive total loss" means the cost to repair or salvage damaged 373
	470	+	property, or the cost to both repair and salvage such property, equals or 374
	471	+	exceeds the total value of the property at the time of the loss. 375
	472	+	(17) Any violation of section 42-260, by an extended warranty 376
	473	+	provider subject to the provisions of said section, including, but not 377
	474	+	limited to: (A) Failure to include all statements required in subsections 378
	475	+	(c) and (f) of section 42-260 in an issued extended warranty; (B) offering 379
	476	+	an extended warranty without being (i) insured under an adequate 380
	477	+	extended warranty reimbursement insurance policy or (ii) able to 381
	478	+	demonstrate that reserves for claims contained in the provider's 382
	479	+	financial statements are not in excess of one-half the provider's audited 383
	480	+	net worth; (C) failure to submit a copy of an issued extended warranty 384
	481	+	form or a copy of such provider's extended warranty reimbursement 385
	482	+	policy form to the Insurance Commissioner. 386
	483	+	(18) With respect to an insurance company, hospital service 387
	484	+	corporation, health care center or fraternal benefit society providing 388
	485	+	individual or group health insurance coverage of the types specified in 389
	486	+	subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469, 390
	487	+	refusing to insure, refusing to continue to insure or limiting the amount, 391
	488	+	extent or kind of coverage available to an individual or charging an 392
	489	+	individual a different rate for the same coverage because such 393
	490	+	individual has been a victim of family violence. 394
	491	+	(19) With respect to an insurance company, hospital service 395
	492	+	corporation, health care center or fraternal benefit society providing 396 Raised Bill No. 6387
586	493
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	498	+
	499	+	individual or group health insurance coverage of the types specified in 397
	500	+	subdivisions (1), (2), (3), (4), (6), (9), (10), (11) and (12) of section 38a-469, 398
	501	+	refusing to insure, refusing to continue to insure or limiting the amount, 399
	502	+	extent or kind of coverage available to an individual or charging an 400
	503	+	individual a different rate for the same coverage because of genetic 401
	504	+	information. Genetic information indicating a predisposition to a 402
	505	+	disease or condition shall not be deemed a preexisting condition in the 403
	506	+	absence of a diagnosis of such disease or condition that is based on other 404
	507	+	medical information. An insurance company, hospital service 405
	508	+	corporation, health care center or fraternal benefit society providing 406
	509	+	individual health coverage of the types specified in subdivisions (1), (2), 407
	510	+	(3), (4), (6), (9), (10), (11) and (12) of section 38a-469, shall not be 408
	511	+	prohibited from refusing to insure or applying a preexisting condition 409
	512	+	limitation, to the extent permitted by law, to an individual who has been 410
	513	+	diagnosed with a disease or condition based on medical information 411
	514	+	other than genetic information and has exhibited symptoms of such 412
	515	+	disease or condition. For the purposes of this subsection, "genetic 413
	516	+	information" means the information about genes, gene products or 414
	517	+	inherited characteristics that may derive from an individual or family 415
	518	+	member. 416
	519	+	(20) Any violation of sections 38a-465 to 38a-465q, inclusive. 417
	520	+	(21) With respect to a managed care organization, as defined in 418
	521	+	section 38a-478, failing to establish a confidentiality procedure for 419
	522	+	medical record information, as required by section 38a-999. 420
	523	+	(22) Any violation of sections 38a-591d to 38a-591f, inclusive. 421
	524	+	(23) Any violation of section 38a-472j. 422
	525	+	(24) Any violation of section 2 of this act. 423
	526	+	This act shall take effect as follows and shall amend the following
	527	+	sections:
	528	+
	529	+	Section 1 January 1, 2022 38a-1 Raised Bill No. 6387
	530	+
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	535	+
	536	+	Sec. 2 January 1, 2022 New section
	537	+	Sec. 3 January 1, 2022 38a-816
	538	+
	539	+	INS Joint Favorable
587	540