ASSEMBLY, No. 2757

 

STATE OF NEW JERSEY

 

INTRODUCED FEBRUARY 27, 1997

 

 

By Assemblywoman ALLEN and Asemblyman BAGGER

 

 

An Act to prevent discrimination against victims of domestic violence in certain insurance contracts.

 

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

    1. As used in this act:

    "Domestic violence" and "victim of domestic violence" shall have the same meaning as in section 3 of P.L.1991, c.261 (C.2C:25-19).

    "Domestic violence-related condition" means a medical condition which arises in whole or in part from one or more acts of domestic violence.

    "Health benefit plan" means a program, contract, or plan issued by an insurer that provides health care services or expense benefits.

    "Insurer" means (1) any corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society or other person engaged in the business of insurance pursuant to Subtitle 3 of Title 17 of the Revised Statutes (C.17:17-1 et seq.), or Subtitle 3 of Title 17B of the New Jersey Statutes (C.17B:17-1 et seq.); (2) any medical service corporation operating pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.); (3) any hospital service corporation operating pursuant to P.L.1938, c.366 (C.17:48-1 et seq.); (4) any health service corporation operating pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.); (5) any dental service corporation operating pursuant to P.L.1968, c.305 (C.17:48C-1 et seq.); (6) any dental plan organization operating pursuant to P.L.1979, c.478 (C.17:48D-1 et seq.); (7) any risk retention group or purchasing group operating pursuant to the "Liability Risk Retention Act of 1986," 15 U.S.C. s.3901 et seq; and (8) any health maintenance organization operating pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.).

 

    2. No insurer shall discriminate by engaging in the practices set forth in subsections a. through d. of this section against an insured or prospective insured on the basis that the insured or prospective insured, or any person employed by the insured or prospective insured, or with whom the insured or prospective insured has a relationship, is or may be a victim of domestic violence. No insurer shall:

    a. deny, refuse to issue, renew or reissue, cancel or otherwise terminate an insurance policy or health benefit plan;

    b. restrict, exclude or limit an insurance policy or health benefit plan coverage for losses, or deny a claim incurred by an insured as a result of domestic violence;

    c. add a premium differential to any insurance policy or health benefit plan; or

    d. terminate health coverage under a health benefit plan for a victim of domestic violence because the health benefit plan was issued in the name of the perpetrator of domestic violence and the perpetrator of domestic violence has divorced, separated from, or lost custody of the victim of domestic violence; or where the perpetrator of domestic violence has terminated coverage under a health benefit plan voluntarily or involuntarily, and the victim of domestic violence does not qualify for continuation of health benefits coverage under the "Consolidated Omnibus Budget Reconciliation Act of 1985," (COBRA) Pub.L. 93-406 (29 U.S.C. § 1161 et seq.). Nothing in this subsection shall prohibit the insurer from requiring the victim of domestic violence to pay the full premium for coverage under the health benefit plan or requiring the victim to reside or work within the insurer's service area, provided that these requirements apply to all insureds. The insurer may terminate coverage after the continuation coverage required by this subsection has been in force for 18 months if it offers conversion to an equivalent plan. The continuation coverage required by this subsection shall be satisfied by COBRA coverage provided to a victim of domestic violence and shall not be in addition to coverage provided under COBRA.

 

    3. No insurer shall use, disclose or transfer the applicant's or insured's name, address, telephone number, information regarding the applicant's or insured's status as a victim of domestic violence or domestic violence-related condition, or the prospective insured's or insured's status as a family member, employer, associate or person in a relationship with a victim of domestic violence, for a purpose unrelated to the direct provision of health care services, except when required by the Commissioner of Banking and Insurance or a court of competent jurisdiction. Nothing in this section shall limit or preclude a victim of domestic violence from

    a. obtaining the victim's medical records from an insurer; or

    b. providing evidence of or information regarding domestic violence to an insurer for the sole purpose of (1) facilitating treatment of a domestic violence-related condition or (2) demonstrating that a medical condition is related to domestic violence.

 

    4. Insurers shall develop written policies and procedures to protect the safety and privacy of victims of domestic violence and to implement the provisions of this act. These policies and procedures shall be followed by the insurer and insurance producers when taking an application, investigating a claim, pursuing subrogation or taking any other action relating to a policy or claim involving a victim of domestic violence.

 

    5. a. The Commissioner of Banking and Insurance shall investigate an insurer to determine whether the insurer has violated any provision of this act. A person aggrieved by a violation of this act may file a complaint with the commissioner.

    b. A person who believes to be adversely affected by a violation of this act may maintain a private cause of action against the insurer in a State or federal court of competent jurisdiction seeking the penalties provided in this section, as well as any additional remedies available by law.

    c. The commissioner may:

    (1) order an insurer that has violated this act to pay a monetary penalty of $5,000.00 for each violation of this act; or

    (2) obtain equitable relief in a State or federal court of competent jurisdiction against an insurer, as well as the costs of suit, attorney's fees and expert witness fees.

 

    6. The Commissioner of Banking and Insurance may adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the purposes of this act.

 

    7. This act shall take effect immediately.

 

 

STATEMENT

 

    This bill prohibits discrimination against insureds or prospective insureds on the basis of domestic violence. Insurers would be forbidden from refusing to issue policies, restricting or limiting policy benefits, or adding premium differentials to insurance policies because the insured or prospective insured, or any person employed by the insured or prospective insured, or with whom the insured or prospective insured has a relationship, is or may be a victim of domestic violence. This bill applies to property/casualty insurers and life and health insurers, who are required to develop written policies and procedures to safeguard the privacy and safety of domestic violence victims. Insurers and insurance producers must follow these policies and procedures.


                            

Prohibits insurers from discriminating against insureds on the basis of domestic violence.