Current through September 16, 2024
1. Except as otherwise provided in subsection
4, if an adverse underwriting decision occurs, the insurance institution or
agent responsible for the decision shall:
(a)
Provide the applicant, policyholder or natural person proposed for coverage
with the specific reason or reasons for the adverse underwriting decision in
writing or advise him or her that, upon submitting a request in writing, he or
she may receive the specific reason or reasons in writing; and
(b) Provide the applicant, policyholder or
natural person proposed for coverage with a summary of the rights established
under subsection 2 and NAC 679B.705 and 679B.710.
2. Upon receiving a written request within 90
business days after notifying an applicant, policyholder or natural person
proposed for coverage of an adverse underwriting decision, the insurance
institution or agent shall furnish within 21 business days after the date of
receiving the written request to the applicant, policyholder or natural person
proposed for coverage:
(a) In writing, the
specific reason or reasons for the adverse underwriting decision if the
information was not initially furnished in writing pursuant to paragraph (a) of
subsection 1; and
(b) The specific
items of personal and privileged information that support those reasons, except
that the insurance institution or agent:
(1)
Is not required to furnish specific items of privileged information if it has a
reasonable suspicion, based upon specific information available for review by
the Commissioner, that the applicant, policyholder or natural person proposed
for coverage has engaged in criminal activity, fraud, material
misrepresentation or material nondisclosure.
(2) Has the option of disclosing information
concerning specific items of medical record information supplied by a medical
care institution or medical professional, including the names and addresses of
the institutional sources of that information, to either the natural person
about whom the information relates or to a medical professional designated by
the natural person and licensed to provide medical care with respect to the
condition to which the information relates.
3. The obligations imposed by this section
upon an insurance institution or agent may be satisfied by another insurance
institution or agent authorized to act on its behalf.
4. When an adverse underwriting decision
results in an oral request or inquiry, the explanation of reasons and summary
of rights required by subsection 1 may be given orally.
Added to NAC by Comm'r
of Insurance, 10-4-88, eff. 1-1-89
NRS
679B.130
