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This entry was published on 2023-01-06
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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,
or, except where the insurance policy was issued by a health insurer as
defined in subparagraph (B) of paragraph (1) of subsection (h) of this
section, a request to designate an alternative mailing address,
telephone number or method of contact for the purpose of receiving claim
related information if the person states that disclosure of all or part
of the claim related information could endanger the person, the insurer
shall be prohibited for the duration of the order, or until the request
designating an alternative mailing address, telephone number or other
method of contact is cancelled by the requesting person in writing, from
disclosing to the policyholder the address, telephone number or other
method of contact for the insured, or for any person or entity providing
covered services to the insured, any personally identifying information
of the insured, or the nature of the covered services provided to the
insured, or from mailing, delivering, or otherwise providing claim
related information to any mailing address, telephone number, or other
method of contact other than as designated by the requesting person
pursuant to this subsection. 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. An insurer may require a person
making a request to designate an alternative mailing address, telephone
number or other method of contact pursuant to this subsection to: make
the request in writing; include in the request 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 specify an
alternative mailing address, telephone number, or other method of
contact. For the purpose of this subsection, "claim related information"
means all claim or billing information relating specifically to an
insured or person covered by an insurance policy issued by an insurer
other than a health insurer as defined in subparagraph (B) of paragraph
(1) of subsection (h) of this section. 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, (i) a valid order of
protection against another person covered by the group policy, issued by
a court of competent jurisdiction in this state, or, except where the
insurance policy was issued by a health insurer as defined in
subparagraph (B) of paragraph (1) of subsection (h) of this section, a
request to designate an alternative mailing address, telephone number or
other method of contact for the purpose of receiving claim related
information if the person states that disclosure of all or part of the
claim related information could endanger the person, the insurer shall
be prohibited for the duration of the order, or until the request
designating an alternative mailing address, telephone number or other
method of contact is cancelled by the requesting person in writing, from
disclosing to the person against whom a valid order of protection was
issued the address, telephone number or other method of contact for the
insured person covered by the order of protection or for any person or
entity providing covered services to the insured person covered by the
order of protection, any personally identifying information of the
insured, or the nature of the covered services provided to the insured,
or from mailing, delivering, or otherwise providing claim related
information to any mailing address, telephone number, or other method of
contact other than as designated by the requesting person pursuant to
this subsection. 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. An insurer may require a person making
a request to designate an alternative mailing address, telephone number
or other method of contact pursuant to this subsection to: make the
request in writing; include in the request 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 specify an alternative
mailing address, telephone number, or other method of contact. For the
purpose of this subsection, "claim related information" means all claim
or billing information relating specifically to an insured or person
covered by an insurance policy issued by an insurer other than a health
insurer as defined in subparagraph (B) of paragraph (1) of subsection
(h) of this section. 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.