Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter H - UNFAIR DISCRIMINATION
Section 21.704 - Unfair Discrimination
Universal Citation: 28 TX Admin Code § 21.704
Current through Reg. 50, No. 13; March 28, 2025
(a) General propositions.
(1) No inquiry in an
application for health or life insurance coverage, or in an investigation
conducted by or on behalf of an insurer in connection with an application for
such coverage, may be directed toward determining the proposed insured's sexual
orientation.
(2) Sexual orientation
may not be used in the underwriting process or in the determination of
insurability.
(3) Insurers may not
direct, require, or request insurance support organizations to investigate,
directly or indirectly, the sexual orientation of a proposed insured or a
beneficiary.
(b) Medical/lifestyle applications, questions, and underwriting standards.
(1) No question may be used which is designed
to establish the sexual orientation of the proposed insured.
(2) Questions relating to the proposed
insured having, or having been diagnosed as having, acquired immune deficiency
syndrome (AIDS) or AIDS-related complex are permissible if they are factual and
designed to establish the existence of the condition.
(3) Questions relating to medical and other
factual matters intending to reveal the possible existence of a medical
condition are permissible if they are not used as a proxy to establish the
sexual orientation of the proposed insured, and if the proposed insured has
been given an opportunity to provide an explanation for any affirmative answers
given in the application.
(4)
Questions relating to applicant's having, or having been diagnosed as having,
sexually transmitted disease are permissible.
(5) Neither the marital status, the living
arrangements, the occupation, the gender, the medical history, the beneficiary
designation, nor the zip code or other classification of a proposed insured may
be used to establish, or aid in establishing, the proposed insured's sexual
orientation.
(6) For purposes of
rating a proposed insured for health and life insurance, an insurer may impose
territorial rates, but only if the rates are based on sound actuarial
principles or are related to actual or reasonably anticipated
experience.
(7) No adverse
underwriting decision may be made because medical records or a report from any
other source shows that the proposed insured has demonstrated acquired immune
deficiency syndrome-related concerns by seeking counseling from health care
professionals. This paragraph does not apply to a proposed insured seeking or
having sought treatment.
(8)
Whenever a proposed insured is requested to take an HIV-related test in
connection with an application for insurance, the use of such a test must be
revealed to the proposed insured or to any other person legally authorized to
consent to such a test, and his or her written authorization obtained. The form
of such authorization must be printed on a separate piece of paper and must
contain the specific language in the form, entitled Notice and Consent for
HIV-Related Testing, which the Texas Department of Insurance has adopted and
incorporated herein by reference, effective January 7, 1997. This form is
published by the Texas Department of Insurance and copies of this form are
available from and on file at the offices of the Texas Department of Insurance,
Life and Health Lines, MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030.
Other information may be included so long as it is not misleading or violative
of any applicable law or rule. Testing may be required only on a
nondiscriminatory basis. No adverse underwriting decision shall be made on the
basis of such a positive HIV-related test unless the established test protocol
as provided by §
21.705 of this title (relating to
Nondiscriminatory Testing for Human Immunodeficiency Virus) has been
followed.
(9) Insurers are
permitted to ask a proposed insured whether the proposed insured has tested
positive on an acquired immune deficiency syndrome-related test.
(10) The result of an HIV-related test is
confidential.
(A) An insurer may not release
or disclose the test results or allow them to become known, except in the
following circumstances:
(i) as may be
required by law; or
(ii) pursuant
to the written request or authorization of the proposed insured or other person
legally authorized to consent to the test on behalf of the proposed insured,
with such release pursuant to written request limited to:
(I) the proposed insured;
(II) the person legally authorized to consent
to the test;
(III) a licensed
physician, medical practitioner, or other person designated by the proposed
insured;
(IV) an insurance medical
information exchange under procedures that are designed to assure
confidentiality, including the use of general codes that also cover results of
tests for other diseases or conditions not related to AIDS, or for the
preparation of statistical reports that do not disclose the identity of any
particular proposed insured;
(V) a
reinsurer, if the reinsurer is involved in the underwriting process, under
procedures that are designed to assure confidentiality;
(VI) persons within the insurer's
organization who have the responsibility to make underwriting decisions on
behalf of the insurer; or
(VII)
outside legal counsel who needs such information to effectively represent the
insurer in regard to matters concerning the proposed insured.
(B) Should a proposed
insured or the person legally authorized to consent to the test request that
the test result be sent to him or her directly, in addition to being provided
notice as otherwise required by law, the insurer shall mail the test result to
the proposed insured or the person legally authorized to consent to the test by
registered mail with delivery restricted to the addressee.
(C) Written notice of a positive HIV-related
test result must be provided by the insurer to either:
(i) a physician designated by the proposed
insured or other person legally authorized to consent to the test; or
(ii) in the absence of such designation, to
the Texas Department of Health, in order that the proposed insured be provided
notice of such result as required by law.
(c) Severability. If any provision of this section or the application thereof to any person or circumstance is held invalid for any reason, the invalidity shall not affect the other provisions or any other application of the provisions of this section which can be given effect without the invalid provisions or application. To this end, all provisions of this subchapter are declared to be severable.
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