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This entry was published on 2014-09-22
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SECTION 2612
Discrimination based on being a victim of domestic violence
Insurance (ISC) CHAPTER 28, ARTICLE 26
§ 2612. Discrimination based on being a victim of domestic violence.
(a) No individual, insurer or entity subject to the supervision of the
superintendent shall solely because a person is or has been a victim of
domestic violence:

(1) refuse to issue or renew, deny or cancel any insurance policy or
contract;

(2) demand or require a greater premium or payment from any person;

(3) designate domestic violence as a preexisting condition, for which
coverage will be denied or reduced;

(4) fix any lower rate or discriminate in the fees or commissions of
agents or brokers for writing or renewing such a policy.

(b) The fact that a person is or has been a victim of domestic
violence is not a permitted underwriting criterion.

(c) For the purposes of this section, the following terms shall be
defined as:

(1) "victim of domestic violence" shall be as defined by subdivision
one of section four hundred fifty-nine-a of the social services law.

(2) "insurer" shall mean an insurer, a corporation organized pursuant
to article forty-three of this chapter, a municipal cooperative health
benefit plan established pursuant to article forty-seven of this
chapter, a health maintenance organization certified pursuant to article
forty-four of the public health law or a provider issued a special
certificate of authority pursuant to section four thousand four hundred
three-a of such law, or an agent, representative or designee thereof
regulated pursuant to this chapter.

(3) "policy" shall mean a policy of insurance issued pursuant to this
chapter, a child health insurance plan issued pursuant to title one-A of
article twenty-five of the public health law or medical assistance or
health care services provided pursuant to title eleven or eleven-D of
article five of the social services law.

(d) The prohibitions contained in subsection (a) of this section shall
not preclude an insurer from taking any of the actions described in
subsection (a) of this section so long as such insurer relies on
underwriting criteria reasonably related to the physical or mental
condition of a person, their property or claim history and the decision
was based on sound underwriting and actuarial principles reasonably
related to actual or anticipated loss experience. In such case the
selection criteria permitted must be based on such principles. The
insurer shall notify the insured of its specific reason or reasons for
such decision.

(e) An insurer that complies with subsections (a), (f) and (g) of this
section and acts reasonably and in good faith shall not be subject to
civil or criminal liability on account of compliance with such
subsections.

(f) If any person covered by an insurance policy issued to another
person as the policyholder delivers to the insurer that issued the
policy, at its home office, a valid order of protection against the
policyholder, issued by a court of competent jurisdiction in this state,
the insurer shall be prohibited for the duration of the order from
disclosing to the policyholder the address and telephone number of the
insured, or of any person or entity providing covered services to the
insured. If a child is the covered person, the right established by this
subsection may be asserted by, and shall also extend to, the parent or
guardian of the child. The superintendent, in consultation with the
commissioner of health and the office of children and family services
and the office for the prevention of domestic violence, shall promulgate
rules to guide and enable insurers to guard against the disclosure of
the address and location of an insured who is a victim of domestic
violence.

(g) If any person covered by a group insurance policy delivers to the
insurer that issued the policy, at its home office, a valid order of
protection against another person covered by the group policy, issued by
a court of competent jurisdiction in this state, the insurer shall be
prohibited for the duration of the order from disclosing to the person
against whom the valid order of protection was issued the address and
telephone number of the insured person covered by the order of
protection, or of any person or entity providing covered services to the
insured person covered by the order of protection. If a child is the
covered person, the right established by this subsection may be asserted
by, and shall also extend to, the parent or guardian of the child. The
superintendent, in consultation with the commissioner of health, the
office of children and family services and the office for the prevention
of domestic violence, shall promulgate rules to guide and enable
insurers to guard against the disclosure of the address and location of
an insured who is a victim of domestic violence.

(h)(1) For purposes of this subsection:

(A) "Claim related information" means all claim or billing information
relating specifically to an insured, subscriber or person covered by an
insurance policy or contract issued by the health insurer.

(B) "Health insurer" means an insurer licensed to write accident and
health insurance or salary protection insurance in this state, a
corporation organized pursuant to article forty-three of this chapter, a
municipal cooperative health benefit plan established pursuant to
article forty-seven of this chapter, a health maintenance organization
certified pursuant to article forty-four of the public health law or a
provider issued a special certificate of authority pursuant to section
four thousand four hundred three-a of such law, or an agent,
representative or designee thereof regulated pursuant to this chapter.

(2)(A) A health insurer shall accommodate a reasonable request by a
person covered by an insurance policy or contract issued by the health
insurer to receive communications of claim related information from the
health insurer by alternative means or at alternative locations if the
person clearly states that disclosure of all or part of the information
could endanger the person.

(B) If a child is covered by an insurance policy or contract issued by
the health insurer, then the child's parent or guardian may make a
request to the health insurer pursuant to subparagraph (A) of this
paragraph.

(3) A health insurer may require: a person to make a request pursuant
to paragraph two of this subsection in writing; the request to contain a
statement that disclosure of all or part of the claim related
information to which the request pertains could endanger the person or
child; and the specification of an alternative address, telephone number
or other method of contact.

(4) With respect to an insurer authorized to write accident and health
insurance in this state, this subsection shall apply only to a policy of
accident and health insurance or a policy of salary protection
insurance, as defined in subsection (a) of section one thousand one
hundred thirteen of this chapter.

(5) Nothing in this subsection shall prevent, hinder, or otherwise
affect the entry of an appropriate order made in the best interests of a
child by a court of competent jurisdiction adjudicating disputed issues
of child welfare or custody.

(6) Except with the express consent of the person making a request
pursuant to subparagraph (A) of paragraph two of this subsection, a
health insurer shall not disclose to the policyholder (i) the address,
telephone number, or any other personally identifying information of the
person who made the request or child for whose benefit a request was
made; (ii) the nature of the health care services provided; or (iii) the
name or address of the provider of the covered services.

(7) A health insurer that makes reasonable and good faith efforts to
comply with this subsection shall not be subject to civil or criminal
liability on the ground of non-compliance with this subsection.

(8) The superintendent, in consultation with the commissioner of
health, the office of children and family services and the office for
the prevention of domestic violence, shall promulgate rules to guide
health insurers in guarding against the disclosure of the information
protected pursuant to this subsection.