§ 2612 — Discrimination based on being a victim of domestic violence

New York § 2612

• Jurisdiction: New York
• Law ISC: Insurance
• Art. 26: Unfair Claim Settlement Practices; Other Misconduct; Discrimination

Text

§ 2612. Discrimination based on being a victim of domestic violence.\n(a) No individual, insurer or entity subject to the supervision of the\nsuperintendent shall solely because a person is or has been a victim of\ndomestic violence:\n (1) refuse to issue or renew, deny or cancel any insurance policy or\ncontract;\n (2) demand or require a greater premium or payment from any person;\n (3) designate domestic violence as a preexisting condition, for which\ncoverage will be denied or reduced;\n (4) fix any lower rate or discriminate in the fees or commissions of\nagents or brokers for writing or renewing such a policy.\n (b) The fact that a person is or has been a victim of domestic\nviolence is not a permitted underwriting criterion.\n (c) For the purposes of this section, the following terms shall be\ndefined as:\n (1) "victim of domestic violence" shall be as defined by subdivision\none of section four hundred fifty-nine-a of the social services law.\n (2) "insurer" shall mean an insurer, a corporation organized pursuant\nto article forty-three of this chapter, a municipal cooperative health\nbenefit plan established pursuant to article forty-seven of this\nchapter, a health maintenance organization certified pursuant to article\nforty-four of the public health law or a provider issued a special\ncertificate of authority pursuant to section four thousand four hundred\nthree-a of such law, or an agent, representative or designee thereof\nregulated pursuant to this chapter.\n (3) "policy" shall mean a policy of insurance issued pursuant to this\nchapter, a child health insurance plan issued pursuant to title one-A of\narticle twenty-five of the public health law or medical assistance or\nhealth care services provided pursuant to title eleven or eleven-D of\narticle five of the social services law.\n (d) The prohibitions contained in subsection (a) of this section shall\nnot preclude an insurer from taking any of the actions described in\nsubsection (a) of this section so long as such insurer relies on\nunderwriting criteria reasonably related to the physical or mental\ncondition of a person, their property or claim history and the decision\nwas based on sound underwriting and actuarial principles reasonably\nrelated to actual or anticipated loss experience. In such case the\nselection criteria permitted must be based on such principles. The\ninsurer shall notify the insured of its specific reason or reasons for\nsuch decision.\n (e) An insurer that complies with subsections (a), (f) and (g) of this\nsection and acts reasonably and in good faith shall not be subject to\ncivil or criminal liability on account of compliance with such\nsubsections.\n (f) If any person covered by an insurance policy issued to another\nperson as the policyholder delivers to the insurer that issued the\npolicy, at its home office, a valid order of protection against the\npolicyholder, issued by a court of competent jurisdiction in this state,\nor, except where the insurance policy was issued by a health insurer as\ndefined in subparagraph (B) of paragraph (1) of subsection (h) of this\nsection, a request to designate an alternative mailing address,\ntelephone number or method of contact for the purpose of receiving claim\nrelated information if the person states that disclosure of all or part\nof the claim related information could endanger the person, the insurer\nshall be prohibited for the duration of the order, or until the request\ndesignating an alternative mailing address, telephone number or other\nmethod of contact is cancelled by the requesting person in writing, from\ndisclosing to the policyholder the address, telephone number or other\nmethod of contact for the insured, or for any person or entity providing\ncovered services to the insured, any personally identifying information\nof the insured, or the nature of the covered services provided to the\ninsured, or from mailing, delivering, or otherwise providing claim\nrelated information to any mailing address, telephone number, or other\nmethod of contact other than as designated by the requesting person\npursuant to this subsection. If a child is the covered person, the right\nestablished by this subsection may be asserted by, and shall also extend\nto, the parent or guardian of the child. An insurer may require a person\nmaking a request to designate an alternative mailing address, telephone\nnumber or other method of contact pursuant to this subsection to: make\nthe request in writing; include in the request a statement that\ndisclosure of all or part of the claim related information to which the\nrequest pertains could endanger the person or child; and specify an\nalternative mailing address, telephone number, or other method of\ncontact. For the purpose of this subsection, "claim related information"\nmeans all claim or billing information relating specifically to an\ninsured or person covered by an insurance policy issued by an insurer\nother than a health insurer as defined in subparagraph (B) of paragraph\n(1) of subsection (h) of this section. The superintendent, in\nconsultation with the commissioner of health and the office of children\nand family services and the office for the prevention of domestic\nviolence, shall promulgate rules to guide and enable insurers to guard\nagainst the disclosure of the address and location of an insured who is\na victim of domestic violence.\n (g) If any person covered by a group insurance policy delivers to the\ninsurer that issued the policy, at its home office, (i) a valid order of\nprotection against another person covered by the group policy, issued by\na court of competent jurisdiction in this state, or, except where the\ninsurance policy was issued by a health insurer as defined in\nsubparagraph (B) of paragraph (1) of subsection (h) of this section, a\nrequest to designate an alternative mailing address, telephone number or\nother method of contact for the purpose of receiving claim related\ninformation if the person states that disclosure of all or part of the\nclaim related information could endanger the person, the insurer shall\nbe prohibited for the duration of the order, or until the request\ndesignating an alternative mailing address, telephone number or other\nmethod of contact is cancelled by the requesting person in writing, from\ndisclosing to the person against whom a valid order of protection was\nissued the address, telephone number or other method of contact for the\ninsured person covered by the order of protection or for any person or\nentity providing covered services to the insured person covered by the\norder of protection, any personally identifying information of the\ninsured, or the nature of the covered services provided to the insured,\nor from mailing, delivering, or otherwise providing claim related\ninformation to any mailing address, telephone number, or other method of\ncontact other than as designated by the requesting person pursuant to\nthis subsection. If a child is the covered person, the right established\nby this subsection may be asserted by, and shall also extend to, the\nparent or guardian of the child. An insurer may require a person making\na request to designate an alternative mailing address, telephone number\nor other method of contact pursuant to this subsection to: make the\nrequest in writing; include in the request a statement that disclosure\nof all or part of the claim related information to which the request\npertains could endanger the person or child; and specify an alternative\nmailing address, telephone number, or other method of contact. For the\npurpose of this subsection, "claim related information" means all claim\nor billing information relating specifically to an insured or person\ncovered by an insurance policy issued by an insurer other than a health\ninsurer as defined in subparagraph (B) of paragraph (1) of subsection\n(h) of this section. The superintendent, in consultation with the\ncommissioner of health, the office of children and family services and\nthe office for the prevention of domestic violence, shall promulgate\nrules to guide and enable insurers to guard against the disclosure of\nthe address and location of an insured who is a victim of domestic\nviolence.\n (h)(1) For purposes of this subsection:\n (A) "Claim related information" means all claim or billing information\nrelating specifically to an insured, subscriber or person covered by an\ninsurance policy or contract issued by the health insurer.\n (B) "Health insurer" means an insurer licensed to write accident and\nhealth insurance or salary protection insurance in this state, a\ncorporation organized pursuant to article forty-three of this chapter, a\nmunicipal cooperative health benefit plan established pursuant to\narticle forty-seven of this chapter, a health maintenance organization\ncertified pursuant to article forty-four of the public health law or a\nprovider issued a special certificate of authority pursuant to section\nfour thousand four hundred three-a of such law, or an agent,\nrepresentative or designee thereof regulated pursuant to this chapter.\n (2)(A) A health insurer shall accommodate a reasonable request by a\nperson covered by an insurance policy or contract issued by the health\ninsurer to receive communications of claim related information from the\nhealth insurer by alternative means or at alternative locations if the\nperson clearly states that disclosure of all or part of the information\ncould endanger the person.\n (B) If a child is covered by an insurance policy or contract issued by\nthe health insurer, then the child's parent or guardian may make a\nrequest to the health insurer pursuant to subparagraph (A) of this\nparagraph.\n (3) A health insurer may require: a person to make a request pursuant\nto paragraph two of this subsection in writing; the request to contain a\nstatement that disclosure of all or part of the claim related\ninformation to which the request pertains could endanger the person or\nchild; and the specification of an alternative address, telephone number\nor other method of contact.\n (4) With respect to an insurer authorized to write accident and health\ninsurance in this state, this subsection shall apply only to a policy of\naccident and health insurance or a policy of salary protection\ninsurance, as defined in subsection (a) of section one thousand one\nhundred thirteen of this chapter.\n (5) Nothing in this subsection shall prevent, hinder, or otherwise\naffect the entry of an appropriate order made in the best interests of a\nchild by a court of competent jurisdiction adjudicating disputed issues\nof child welfare or custody.\n (6) Except with the express consent of the person making a request\npursuant to subparagraph (A) of paragraph two of this subsection, a\nhealth insurer shall not disclose to the policyholder (i) the address,\ntelephone number, or any other personally identifying information of the\nperson who made the request or child for whose benefit a request was\nmade; (ii) the nature of the health care services provided; or (iii) the\nname or address of the provider of the covered services.\n (7) A health insurer that makes reasonable and good faith efforts to\ncomply with this subsection shall not be subject to civil or criminal\nliability on the ground of non-compliance with this subsection.\n (8) The superintendent, in consultation with the commissioner of\nhealth, the office of children and family services and the office for\nthe prevention of domestic violence, shall promulgate rules to guide\nhealth insurers in guarding against the disclosure of the information\nprotected pursuant to this subsection.\n