Short title

This Act may be cited as the

Insurance Non-Discrimination for Survivors Act

Definitions

In this Act, except as otherwise expressly provided: (1)

Course of conduct

The term course of conduct means a course of repeatedly maintaining a visual or physical proximity to a person or conveying verbal or written threats, including threats conveyed through electronic communications, or threats implied by conduct. (2)

Electronic communications

The term electronic communications includes communications via telephone (including mobile phone), computer, e-mail, video recorder, fax machine, telex, or pager. (3)

Employ; State

The terms employ and State have the meanings given the terms in section 3 of the Fair Labor Standards Act of 1938 (29 U.S.C. 203). (4)

Employee

(A)

In general

The term employee means any person employed by an employer. In the case of an individual employed by a public agency, such term means an individual employed as described in section 3(e)(2) of the Fair Labor Standards Act of 1938 (29 U.S.C. 203(e)(2)). (B)

Basis

The term includes a person employed as described in subparagraph (A) on a full- or part-time basis, for a fixed time period, on a temporary basis, pursuant to a detail, or as a participant in a work assignment as a condition of receipt of Federal or State income-based public assistance. (5)

Employer

The term employer— (A)means any person engaged in commerce or in any industry or activity affecting commerce who employs 15 or more individuals; and (B)includes any person acting directly or indirectly in the interest of an employer in relation to an employee, and includes a public agency that employs individuals as described in section 3(e)(2) of the Fair Labor Standards Act of 1938, but does not include any labor organization (other than when acting as an employer) or anyone acting in the capacity of officer or agent of such labor organization. (6)

Employment benefits

The term employment benefits means all benefits provided or made available to employees by an employer, including group life insurance, health insurance, disability insurance, sick leave, annual leave, educational benefits, and pensions, regardless of whether such benefits are provided by a practice or written policy of an employer or through an employee benefit plan, as defined in section 3(3) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(3)). (7)

Person

The term person has the meaning given the term in section 3 of the Fair Labor Standards Act of 1938 (29 U.S.C. 203). (8)

Repeatedly

The term repeatedly means on 2 or more occasions. (9)

Sexual assault

The term sexual assault has the meaning given the term in section 40002 of the Violence Against Women Act of 1994 (42 U.S.C. 13925). (10)

Victim of domestic violence, dating violence, sexual assault, or stalking

The term victim of domestic violence, dating violence, sexual assault, or stalking includes a person who has been a victim of domestic violence, dating violence, sexual assault, or stalking and a person whose family or household member has been a victim of domestic violence, dating violence, sexual assault, or stalking.

Definitions

In this Act: (1)

Abuse

The term abuse means the occurrence of 1 or more of the following acts by a current or former household or family member, intimate partner, or caretaker: (A)Attempting to cause or causing another person bodily injury, physical harm, substantial emotional distress, or psychological trauma. (B)Attempting to engage in or engaging in rape, sexual assault, or involuntary sexual intercourse. (C)Engaging in a course of conduct or repeatedly committing acts toward another person, including following the person without proper authority and under circumstances that place the person in reasonable fear of bodily injury or physical harm. (D)Subjecting another person to false imprisonment or kidnapping. (E)Attempting to cause or causing damage to property so as to intimidate or attempt to control the behavior of another person. (2)

Health carrier

The term health carrier means a person that contracts or offers to contract on a risk-assuming basis to provide, deliver, arrange for, pay for, or reimburse any of the cost of health care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services. (3)

Insured

The term insured means a party named on a policy, certificate, or health benefit plan, including an individual, corporation, partnership, association, unincorporated organization, or any similar entity, as the person with legal rights to the benefits provided by the policy, certificate, or health benefit plan. For group insurance, the term includes a person who is a beneficiary covered by a group policy, certificate, or health benefit plan. For life insurance, the term refers to the person whose life is covered under an insurance policy. (4)

Insurer

The term insurer means any person, reciprocal exchange, inter insurer, Lloyds insurer, fraternal benefit society, or other legal entity engaged in the business of insurance, including agents, brokers, adjusters, and third-party administrators. The term includes employers who provide or make available employment benefits through an employee benefit plan, as defined in section 3(3) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 102(3)). The term also includes health carriers, health benefit plans, and life, disability, and property and casualty insurers. (5)

Policy

The term policy means a contract of insurance, certificate, indemnity, suretyship, or annuity issued, proposed for issuance, or intended for issuance by an insurer, including endorsements or riders to an insurance policy or contract. (6)

Subject of abuse

The term subject of abuse means— (A)a person against whom an act of abuse has been directed; (B)a person who has prior or current injuries, illnesses, or disorders that resulted from abuse; or (C)a person who seeks, may have sought, or had reason to seek medical or psychological treatment for abuse, protection, court-ordered protection, or shelter from abuse.

Discriminatory acts prohibited

(a)

In general

No insurer may, directly or indirectly, engage in any of the following acts or practices on the basis that the applicant or insured, or any person employed by the applicant or insured or with whom the applicant or insured is known to have a relationship or association, is, has been, or may be the subject of abuse or has incurred or may incur abuse-related claims: (1)Denying, refusing to issue, renew, or reissue, or canceling or otherwise terminating an insurance policy or health benefit plan. (2)Restricting, excluding, or limiting insurance coverage for losses or denying a claim, except as otherwise permitted or required by State laws relating to life insurance beneficiaries. (3)Adding a premium differential to any insurance policy or health benefit plan. (b)

Prohibition on limitation of claims

No insurer may, directly or indirectly, deny or limit payment to an insured who is a subject of abuse if the claim for payment is a result of the abuse. (c)

Prohibition on termination

(1)

In general

No insurer or health carrier may terminate health coverage for a subject of abuse because coverage was originally issued in the name of the abuser and the abuser has divorced, separated from, or lost custody of the subject of abuse or the abuser’s coverage has terminated voluntarily or involuntarily and the subject of abuse does not qualify for an extension of coverage under part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1161 et seq.) or section 4980B of the Internal Revenue Code of 1986. (2)

Payment of premiums

Nothing in paragraph (1) shall be construed to prohibit the insurer from requiring that the subject of abuse pay the full premium for the subject’s coverage under the health plan if the requirements are applied to all insured of the health carrier. (3)

Exception

An insurer may terminate group coverage to which this subsection applies after the continuation coverage period required by this subsection has been in force for 18 months if it offers conversion to an equivalent individual plan. (4)

Continuation coverage

The continuation of health coverage required by this subsection shall be satisfied by any extension of coverage under part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1161 et seq.) or section 4980B of the Internal Revenue Code of 1986 provided to a subject of abuse and is not intended to be in addition to any extension of coverage otherwise provided for under such part 6 or section 4980B. (d)

Use of information

(1)

Limitation

(A)

In general

In order to protect the safety and privacy of subjects of abuse, no person employed by or contracting with an insurer or health benefit plan may (without the consent of the subject)— (i)use, disclose, or transfer information relating to abuse status, acts of abuse, abuse-related medical conditions, or the applicant’s or insured’s status as a family member, employer, associate, or person in a relationship with a subject of abuse for any purpose unrelated to the direct provision of health care services unless such use, disclosure, or transfer is required by an order of an entity with authority to regulate insurance or an order of a court of competent jurisdiction; or (ii)disclose or transfer information relating to an applicant’s or insured’s mailing address or telephone number or the mailing address and telephone number of a shelter for subjects of abuse, unless such disclosure or transfer— (I)is required in order to provide insurance coverage; and (II)does not have the potential to endanger the safety of a subject of abuse. (B)

Rule of construction

Nothing in this paragraph may be construed to limit or preclude a subject of abuse from obtaining the subject’s own insurance records from an insurer. (2)

Authority of subject of abuse

A subject of abuse, at the absolute discretion of the subject of abuse, may provide evidence of abuse to an insurer for the limited purpose of facilitating treatment of an abuse-related condition or demonstrating that a condition is abuse-related. Nothing in this paragraph shall be construed as authorizing an insurer or health carrier to disregard such provided evidence.

Insurance protocols for subjects of abuse

Insurers shall develop and adhere to written policies specifying procedures to be followed by employees, contractors, producers, agents, and brokers for the purpose of protecting the safety and privacy of a subject of abuse and otherwise implementing this Act when taking an application, investigating a claim, or taking any other action relating to a policy or claim involving a subject of abuse.

Reasons for adverse actions

An insurer that takes an action that adversely affects a subject of abuse, shall advise the applicant or insured who is the subject of abuse of the specific reasons for the action in writing. For purposes of this section, reference to general underwriting practices or guidelines shall not constitute a specific reason.

Life insurance

Nothing in this Act shall be construed to prohibit a life insurer from declining to issue a life insurance policy if the applicant or prospective owner of the policy is or would be designated as a beneficiary of the policy, and if— (1)the applicant or prospective owner of the policy lacks an insurable interest in the insured; or (2)the applicant or prospective owner of the policy is known, on the basis of police or court records, to have committed an act of abuse against the proposed insured.

Subrogation without consent prohibited

Subrogation of claims resulting from abuse is prohibited without the informed consent of the subject of abuse.

Enforcement

(a)

Federal Trade Commission

Any act or practice prohibited by this Act shall be treated as an unfair and deceptive act or practice pursuant to section 5 of the Federal Trade Commission Act (15 U.S.C. 45) and the Federal Trade Commission shall enforce this Act in the same manner, by the same means, and with the same jurisdiction, powers, and duties as though all applicable terms and provisions of the Federal Trade Commission Act were incorporated into and made a part of this Act, including issuing a cease and desist order granting any individual relief warranted under the circumstances, including temporary, preliminary, and permanent injunctive relief and compensatory damages. (b)

Private cause of action

(1)

In general

An applicant or insured who believes that the applicant or insured has been adversely affected by an act or practice of an insurer in violation of this Act may maintain an action against the insurer in a Federal or State court of original jurisdiction. (2)

Relief

Upon proof of such conduct by a preponderance of the evidence in an action described in paragraph (1), the court may award appropriate relief, including temporary, preliminary, and permanent injunctive relief and compensatory and punitive damages, as well as the costs of suit and reasonable fees for the aggrieved individual’s attorneys and expert witnesses. (3)

Statutory damages

With respect to compensatory damages in an action described in paragraph (1), the aggrieved individual may elect, at any time prior to the rendering of final judgment, to recover in lieu of actual damages, an award of statutory damages in the amount of $5,000 for each violation.

10.

No Preemption

Nothing in this Act shall be construed as superseding any law of a State or political subdivision of a State that provides greater protection to victims of domestic violence than provided in this Act.

11.

Effective date

This Act shall apply with respect to any action taken on or after the date of enactment of this Act.