Current through Register Vol. XLI, No. 38, September 20, 2024
4.1. General
Propositions:
a. No inquiry in an application
for health accident and sickness or life insurance coverage, or in an
investigation conducted by an insurer or an insurance support organization on
its behalf in connection with an application for such coverage shall be
directed toward determining the proposed insured's sexual
orientation.
b. Sexual orientation
may not be used in the underwriting process or in the determination of
insurability.
c. Insurance support
organizations shall be directed by insurers not to investigate, directly or
indirectly, the sexual orientation of a proposed insured or
beneficiary.
4.2.
Medical/Lifestyle Applications Questions and Underwriting Standards.
a. No question shall be used which is
designed to establish the sexual orientation of the proposed insured.
b. Questions relating to the proposed insured
having or having been diagnosed as having AIDS or ARC are permissible if they
are factual and designed to establish the existence of the condition.
For Example: Insurers should not ask "do you believe you may
have . . .?", but rather "do you know or have reasons to know . .
.?"
c. Questions inquiring
as to whether the proposed insured has ever tested positive for the presence of
the HIV virus or HIV virus antibodies are permissible; however, questions
inquiring as to whether the proposed insured has ever been tested for the
presence of the HIV virus or HIV antibodies are prohibited.
d. 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 the proposed insured has been
given an opportunity to provide an explanation for any affirmative answers
given in the application.
For Example: "Have you had chronic cough, significant weight
loss, chronic fatigue, diarrhea, enlarged glands, . . .?" would be permissible.
These questions must relate to a definite time period immediately preceding the
application and must be specific. The proposed insured shall be given the
opportunity to explain the described symptoms.
e. Questions relating to the proposed
insured's having or having been advised to seek treatment by a medical doctor,
health nurse or other medical professional for a sexually transmitted disease
are permissible.
f. Neither the
marital status, the "living arrangements," the occupation, the gender, the
medical history, the beneficiary designation, nor the zip code or other
territorial classification of a proposed insured may be used to establish, or
aid in establishing, the proposed insured's sexual orientation.
g. 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 and are related to
actual or reasonably anticipated experience.
For Example: If a particular territory demonstrates a general
propensity for high risk, an insurer may impose a rate higher for that
territory than for similar risks located in other territories.
h. No questions shall seek to determine if
the proposed insured has demonstrated AIDS-related concerns or has sought
AIDS-related counseling.
i. No
adverse underwriting decision shall be made because medical records or a report
from an insurance support organization show(s) that the proposed insured has
demonstrated AIDS-related concerns or has sought counseling. This subsection
does not apply to a proposed insured seeking treatment and/or
diagnosis.
