Permissible Actions by Insurers

Checkout our iOS App for a better way to browser and research.

Underwriting in accordance with the standards set forth in this section shall be deemed not to be a violation of this part. Upon request of the commissioner, a health carrier or insurer of an individual or group policy that has taken an action that adversely affects a subject of abuse on the basis of an abuse-related medical condition must explain the reason for its action to the commissioner in writing and must be able to demonstrate that its action:

  1. Does not have the purpose or effect of treating abuse status as a medical condition or underwriting criterion;
  2. Is otherwise permissible by law and applies in the same manner and to the same extent to all applicants and insureds with a similar medical condition without regard to whether the condition or claim is abuse-related; and
  3. Is based on a determination, made in conformance with actual or reasonably anticipated actuarial experience.


Download our app to see the most-to-date content.