MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Insurance

By: Senator(s) Carlton

AN ACT TO PROHIBIT DISCRIMINATION BY INSURANCE COMPANIES AGAINST VICTIMS OF ABUSE; TO DEFINE CERTAIN TERMS USED IN THE ACT; TO PROHIBIT CERTAIN ACTS BY INSURERS WHEN BASED UPON THE APPLICANT'S ABUSE STATUS OR ON THE BASIS OF A PROPERTY'S USE IN THE OPERATION OF A SHELTER FOR SUBJECTS OF ABUSE; TO PROHIBIT CERTAIN ACTS AS UNFAIR PRACTICES; TO REQUIRE INSURERS TO ADHERE TO WRITTEN PROCEDURES, DEVELOPED AND FILED WITH THE COMMISSIONER OF INSURANCE, TO ENSURE THE PRIVACY OF THE SUBJECT OF ABUSE; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. (1) For purposes of this section, the following definitions apply:

(a) "Abuse" means the occurrence of one or more of the following acts by a current or former family member, household member, or caretaker:

(i) Attempting to cause or intentionally, knowingly, or recklessly causing another person, bodily injury or emotional distress;

(ii) Knowingly engaging in a course of conduct or repeatedly committing acts toward another person, including stalking under Section 97-3-107, Mississippi Code of 1972, under circumstances that place the person in reasonable fear of bodily injury;

(iii) Subjecting another person to false imprisonment; or

(iv) Attempting to cause, or intentionally, knowingly, or recklessly causing, damage to property so as to intimidate or attempt to control the behavior of another person.

(b) "Abuse status" means the fact or perception that a person is, has been, or may be a subject of abuse or abuse-related claims, regardless of whether the person has sustained abuse-related medical conditions or has incurred abuse-related claims.

(c) "Confidential abuse information" means information about acts of abuse or abuse status of a subject of abuse, the address and telephone number of a subject of abuse or the status of an applicant insured as a family member, associate of, or a person in a relationship with, a subject of abuse.

(d) "Insured" means a party named on a policy or certificate, or an individual with legal rights to the benefits provided by such policy.

(e) "Insurer" means a person engaged in the business of insurance, a health care service contractor, a health maintenance organization, including producers and agents to the extent that they perform underwriting or claims activities delegated by an insurer, or possess confidential abuse information.

(2) The following acts are prohibited when based upon the applicant's, insured's, or enrolled participant's abuse status or on the basis of a property's use in the operation of a shelter for subjects of abuse:

(a) Refusing to issue, renew or reissue an insurance policy or health benefit plan;

(b) Canceling or otherwise terminating an insurance policy or health benefit plan;

(c) Restricting or excluding coverage or adding a premium differential to an insurance policy or health benefit plan;

(d) Denying or limiting payment for a covered loss or denying a covered claim;

(e) Failing to pay losses to an innocent claimant when the loss is caused by the intentional act of a coinsured; and

(f) Using other exclusions or limitations on coverage which the commissioner has determined to unreasonably restrict the ability of subjects of abuse or shelters to be indemnified for losses.

(3) The following acts are prohibited as unfair practices:

(a) Requesting information relating to acts of abuse or an applicant's or insured's abuse status or making use of such information, however obtained, except for the limited purpose of complying with legal obligations or verifying a person's claim; and

(b) Disclosure or transfer of confidential abuse information by a person employed by or contracting with an insurer for any purpose or to any person, except where required by the Commissioner of Insurance, a court of competent jurisdiction, abuse reporting laws, or as otherwise required by law.

(4) Nothing in this section prohibits a life insurer from declining to issue a life insurance policy if the applicant or prospective owner of the policy is or would be designated as a beneficiary of the policy, and if:

(a) The applicant or prospective owner of the policy lacks an insurable interest in the insured;

(b) The applicant or prospective owner of the policy is known, on the basis of police or court records, to have committed an act of abuse against a prospective insured; or

(c) The insured or prospective insured is a subject of abuse, and that person, or a person who has assumed the care of that person if a minor or an incapacitated adult, has objected to the issuance of the policy in good faith and with probable cause on the grounds that the policy would be issued to or for the direct or indirect benefit of the abuser.

(5) Any insurer that takes an action, not prohibited by this section, that adversely affects an applicant or insured on the basis of an abuse-related medical condition or an abuse-related claim, shall upon written request, directly notify in writing the applicant, insured, or enrolled participant, of the reason for the action and must be able to demonstrate that the action, and any applicable policy provision:

(a) Does not have the purpose or effect of treating abuse status as a medical condition or underwriting criterion;

(b) Is not based upon any actual or perceived correlation between a medical condition or a type of property and casualty claim and abuse;

(c) Is otherwise permissible by law and applies in the same manner and to the same extent to all applicants and insureds with a similar medical condition or property and casualty claim without regard to whether the condition or claim is abuse-related; and

(d) Is based on a determination, made in conformance with sound actuarial principles and supported by reasonable statistical evidence, that there is a correlation between the type of property and casualty claim and a material increase in insurance risk.

(6) Insurers shall adhere to written procedures, developed and filed with the Commissioner of Insurance, to be followed by employees, contractors, producers, agents, and brokers to ensure the privacy of the subject of abuse when taking an application, investigating a claim, pursuing subrogation, or taking any other action relating to a policy or claim involving a subject of abuse. Insurers shall distribute their written procedures to employees, contractors, adjusters, producers, agents and brokers.

SECTION 2. Section 1 of this act shall be codified as a separate section within Chapter 5 of Title 83, Mississippi Code of 1972.

SECTION 3. This act shall take effect and be in force from and after July 1, 1999.