By Davila H.B. No. 1713
75R2946 DLF-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to discrimination against victims of family violence in
1-3 the issuance of insurance.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 21, Insurance Code, is
1-6 amended by adding Article 21.21-5 to read as follows:
1-7 Art. 21.21-5. DISCRIMINATION AGAINST VICTIMS OF FAMILY
1-8 VIOLENCE
1-9 Sec. 1. DEFINITIONS. In this article:
1-10 (1) "Family violence" has the meaning assigned by
1-11 Section 71.01, Family Code.
1-12 (2) "Health benefit plan" means a health benefit plan
1-13 to which this article applies under Section 2(a)(2) of this
1-14 article.
1-15 (3) "Health benefit plan provider" means an entity
1-16 that writes, issues, or otherwise provides a health benefit plan.
1-17 (4) "Insurance policy" means a policy to which this
1-18 article applies under Section 2(a)(1) of this article.
1-19 (5) "Insurer" means the issuer of an insurance policy.
1-20 Sec. 2. SCOPE OF ARTICLE. This article applies to:
1-21 (1) any group or individual policy of insurance, other
1-22 than a health benefit plan, written by:
1-23 (A) a domestic or foreign, stock or mutual,
1-24 life, health, or accident insurance company;
2-1 (B) a domestic or foreign, stock or mutual, fire
2-2 and casualty insurance company;
2-3 (C) a Mexican casualty company;
2-4 (D) a domestic or foreign Lloyd's plan insurer;
2-5 (E) a domestic or foreign reciprocal or
2-6 insurance exchange;
2-7 (F) a domestic or foreign fraternal benefit
2-8 society;
2-9 (G) a stipulated premium insurance company;
2-10 (H) a nonprofit legal service corporation;
2-11 (I) a statewide mutual assessment company;
2-12 (J) a local mutual aid association;
2-13 (K) a local mutual burial association;
2-14 (L) an association exempt under Article 14.17 of
2-15 this code;
2-16 (M) a nonprofit hospital, medical, or dental
2-17 service corporation, including a company subject to Chapter 20 of
2-18 this code;
2-19 (N) a county mutual insurance company;
2-20 (O) a farm mutual insurance company;
2-21 (P) a risk retention group;
2-22 (Q) a purchasing group;
2-23 (R) a surplus lines carrier; and
2-24 (S) a guaranty association created and operating
2-25 under Article 21.28-C or 21.28-D of this code; and
2-26 (2) a health benefit plan that provides benefits for
2-27 medical or surgical expenses incurred as a result of a health
3-1 condition, accident, or sickness, including:
3-2 (A) an individual, group, blanket, or franchise
3-3 insurance policy or insurance agreement, a group hospital service
3-4 contract, or an individual or group evidence of coverage that is
3-5 offered by:
3-6 (i) an insurance company;
3-7 (ii) a group hospital service corporation
3-8 operating under Chapter 20 of this code;
3-9 (iii) a fraternal benefit society
3-10 operating under Chapter 10 of this code;
3-11 (iv) a stipulated premium insurance
3-12 company operating under Chapter 22 of this code; or
3-13 (v) a health maintenance organization
3-14 operating under the Texas Health Maintenance Organization Act
3-15 (Chapter 20A, Vernon's Texas Insurance Code); and
3-16 (B) to the extent permitted by the Employee
3-17 Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
3-18 seq.), a health benefit plan that is offered by:
3-19 (i) a multiple employer welfare
3-20 arrangement as defined by Section 3, Employee Retirement Income
3-21 Security Act of 1974 (29 U.S.C. Section 1002); or
3-22 (ii) another analogous benefit
3-23 arrangement.
3-24 Sec. 3. PROHIBITIONS. (a) An insurer or health benefit
3-25 plan provider may not directly or indirectly discriminate in the
3-26 writing of an insurance policy or health benefit plan because any
3-27 of the following persons are the subject of family violence:
4-1 (1) the applicant for coverage, insured, or enrollee;
4-2 (2) an employee of the applicant, insured, or
4-3 enrollee; or
4-4 (3) another person with whom the applicant, insured,
4-5 or enrollee is known to have a personal or business relationship or
4-6 association.
4-7 (b) Subsection (a) of this section applies without regard to
4-8 whether the person has an injury, illness, or disorder that
4-9 resulted from family violence or whether the person sought or
4-10 should have sought medical or psychological treatment or protection
4-11 or shelter from family violence.
4-12 (c) For purposes of Subsection (a) of this section, an
4-13 insurer or health benefit plan provider discriminates in the
4-14 writing of an insurance policy or health benefit plan if the
4-15 insurer or health benefit plan provider:
4-16 (1) denies, refuses to issue or renew, or cancels or
4-17 otherwise terminates an insurance policy or health benefit plan
4-18 because a person described by Subsection (a) of this section is the
4-19 subject of family violence;
4-20 (2) restricts, excludes, or limits coverage for a loss
4-21 resulting from family violence or denies a claim solely because the
4-22 claim is a result of family violence, except as provided by Article
4-23 21.23 of this code; or
4-24 (3) charges a different premium because a person
4-25 described by Subsection (a) of this section is the subject of
4-26 family violence.
4-27 Sec. 4. CONTINUATION COVERAGE. (a) A health benefit plan
5-1 provider shall offer continuation coverage under a health benefit
5-2 plan to a person who is the subject of family violence if:
5-3 (1) the health benefit plan was originally issued in
5-4 the name of the perpetrator of family violence and the person who
5-5 is the subject of family violence has divorced or separated from or
5-6 is no longer in the custody of the perpetrator; or
5-7 (2) the perpetrator's health benefit plan has
5-8 terminated voluntarily or involuntarily.
5-9 (b) The provider may require the victim of family violence
5-10 to pay the health benefit plan premium.
5-11 (c) The commissioner shall adopt rules to implement this
5-12 section.
5-13 Sec. 5. USE OF INFORMATION. (a) Except as ordered by the
5-14 commissioner or a court, an insurer or health benefit plan provider
5-15 may not use, disclose, or transfer information relating to the fact
5-16 that a person described by Section 3(a) of this article is the
5-17 subject of family violence or has a medical condition that results,
5-18 at least in part, from family violence.
5-19 (b) This section does not prohibit the disclosure of
5-20 information related to the direct provision of health care or
5-21 disclosure by a medical professional as necessary to comply with
5-22 Chapter 73, Family Code.
5-23 (c) This section does not prohibit a person who is the
5-24 subject of family violence from obtaining the person's own medical
5-25 records from an insurer or health benefit plan provider.
5-26 (d) A person who is the subject of family violence may
5-27 disclose that fact to an insurer or health benefit plan provider to
6-1 demonstrate that a medical condition results, at least in part,
6-2 from family violence or to facilitate treatment of the condition.
6-3 Sec. 6. STATEMENT OF REASONS FOR ADVERSE ACTION. (a) An
6-4 insurer or health benefit plan provider that takes an action with
6-5 respect to an insurance policy or health benefit plan that is
6-6 adverse to the interests of an applicant for coverage or a covered
6-7 person who is the subject of family violence shall provide the
6-8 applicant or covered person a written statement of each reason for
6-9 the action.
6-10 (b) A statement that an action with respect to an insurance
6-11 policy or health benefit plan was taken because of an insurer's or
6-12 health benefit plan's general underwriting standards or guidelines
6-13 does not satisfy the requirements of this section.
6-14 (c) For purposes of this section, an action that is adverse
6-15 to the interests of an applicant or covered person includes
6-16 denying, refusing to issue or renew, or canceling or otherwise
6-17 terminating an insurance policy or health benefit plan.
6-18 Sec. 7. LIFE INSURANCE. This article does not prohibit an
6-19 insurer from declining to issue a life insurance policy if the
6-20 applicant for coverage or prospective owner of the policy:
6-21 (1) is or would be designated as a beneficiary of the
6-22 policy; and
6-23 (2) lacks an insurable interest in the insured or is
6-24 known, on the basis of law enforcement or court records, to have
6-25 committed an act of family violence.
6-26 Sec. 8. SUBROGATION. Notwithstanding any other law, an
6-27 insurer or health benefit plan provider is not subrogated to a
7-1 claim of a person who is the subject of family violence against the
7-2 perpetrator of family violence unless:
7-3 (1) the insurer or health benefit plan provider
7-4 obtains the informed consent of the person who is the subject of
7-5 family violence; or
7-6 (2) the person who is the subject of family violence
7-7 has recovered damages for the claim.
7-8 Sec. 9. SANCTIONS. An insurer or health benefit plan
7-9 provider who violates this article commits unfair discrimination
7-10 under Article 21.21-6 of this code, as added by Chapter 415, Acts
7-11 of the 74th Legislature, Regular Session, 1995, and an unfair and
7-12 deceptive practice under Article 21.21 of this code and is subject
7-13 to the penalties imposed under those articles.
7-14 SECTION 2. Section 14(b), Texas Health Maintenance
7-15 Organization Act (Article 20A.14, Vernon's Texas Insurance Code),
7-16 is amended to read as follows:
7-17 (b) Articles 21.21, 21.21A, 21.21-2, 21.21-3, and 21.21-5,
7-18 Insurance Code, Article 21.21-6, Insurance Code, as added by
7-19 Chapter 415, Acts of the 74th Legislature, Regular Session, 1995,
7-20 and Chapter 122, Acts of the 57th Legislature, Regular Session,
7-21 1961 (Article 21.21-1, Vernon's Texas Insurance Code), apply to
7-22 health maintenance organizations that offer both basic and single
7-23 health care coverages and to basic and single health care plans and
7-24 the evidence of coverage under those plans, except to the extent
7-25 that the commissioner determines that the nature of health
7-26 maintenance organizations and health care plans and evidence of
7-27 coverage renders any provision of those articles clearly
8-1 inappropriate.
8-2 SECTION 3. This Act takes effect September 1, 1997, and
8-3 applies only to an insurance policy or health benefit plan that is
8-4 delivered, issued for delivery, or renewed on or after January 1,
8-5 1998. An insurance policy or health benefit plan that is
8-6 delivered, issued for delivery, or renewed before January 1, 1998,
8-7 is governed by the law as it existed immediately before the
8-8 effective date of this Act, and that law is continued in effect for
8-9 that purpose.
8-10 SECTION 4. The importance of this legislation and the
8-11 crowded condition of the calendars in both houses create an
8-12 emergency and an imperative public necessity that the
8-13 constitutional rule requiring bills to be read on three several
8-14 days in each house be suspended, and this rule is hereby suspended.