Underwriting or Rating Risk on Basis of Physical or Mental Condition Caused by Abuse

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Sec. 8. This chapter does not prohibit an insurer from inquiring about, underwriting, or rating a risk on the basis of a physical or mental condition, even if that condition has been caused by abuse if:

(1) the insurer routinely underwrites or charges a different rate for that condition in the same manner with respect to all individuals who apply for or are covered by an insurance policy or a health plan regardless of whether the individual has been the victim of abuse;

(2) the individual's status as being, having been, or having the potential to be the subject of abuse is not considered to be a physical or mental condition;

(3) the insurer does not:

(A) refuse to insure or refuse to contract with;

(B) refuse to continue to insure or refuse to continue to contract with;

(C) limit the amount, extent, or coverage available; or

(D) charge a different rate for the same coverage;

solely because of a physical or mental condition, except where the refusal, limitation, or rate differential is based on sound actuarial principles or is related to actuarial or reasonably anticipated experience; and

(4) the underwriting or rating is not used to evade the intent of this chapter.

As added by P.L.188-1996, SEC.2.


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