§ 27-61-5 — § 27-61-5. Justification of adverse insurance decisions.

§ 27-61-5. Justification of adverse insurance decisions.

An insurer of an individual or group policy that takes an underwriting action that adversely affects a subject of abuse on the basis of a medical condition that the insurer knows is abuse-related shall explain the reason for its action to the applicant or insured in writing and shall be able to demonstrate that its action:

(1) Does not treat abuse status as a medical condition;

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

(3) Is based on a determination, made in conformance with sound actuarial principles or related actual or reasonably anticipated experience, that there is a correlation between the medical condition and a material increase in insurance risk.

Legislative History

P.L. 1997, ch. 163, § 1; P.L. 2023, ch. 395, art. 1, § 20, effective December 31, 2023.