OLR Bill Analysis

sSB 425

AN ACT ENSURING PAYMENT FOR HEALTH CARE SERVICES RENDERED TO CONNECTICUT RESIDENTS WITH AN ELEVATED BLOOD ALCOHOL CONTENT.

SUMMARY:

This bill prohibits health insurance policies from denying coverage for a person's injuries or losses that allegedly occurred when he had an elevated blood alcohol level (BAC) or was under the influence of intoxicating liquor, drugs, or both. An “elevated BAC” is 0. 08% or more. (The bill does not (1) define “under the influence” or (2) specify who makes the determination. It refers to “losses,” which is a property-casualty insurance reference and is not typically used in health insurance policies. It apparently prohibits a policy from denying coverage for health care services rendered to treat injuries in certain circumstances, although it specifies denying coverage for injuries. )

The bill applies to individual and group health insurance policies delivered, issued, amended, renewed, or continued on or after October 1, 2006 that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; and (4) hospital or medical services, including HMOs.

EFFECTIVE DATE: October 1, 2006

BACKGROUND

Related Case

“Driving under the influence” means a person's ability to drive is affected to an appreciable degree (Infield v. Sullivan, 151 Conn. 506 (1964)).

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable Substitute