Sec. 38a-975. (Formerly Sec. 38-500). Short title: Connecticut Insurance Information and Privacy Protection Act. Sections 38a-975 to 38a-998, inclusive, may
be cited as the "Connecticut Insurance Information and Privacy Protection Act".
(P.A. 81-368, S. 1, 25.)
History: Sec. 38-500 transferred to Sec. 38a-975 in 1991.
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Sec. 38a-976. (Formerly Sec. 38-501). Definitions. As used in sections 38a-975
to 38a-998, inclusive:
(a) "Adverse underwriting decisions" means: (1) Any of the following actions with
respect to insurance transactions involving insurance coverage which is individually
underwritten: (A) A declination or termination of insurance coverage, (B) failure of an
agent to apply for insurance coverage with a specific insurance institution which the
agent represents and which is requested by an applicant, (C) in the case of a property
or casualty insurance coverage, (i) placement by an insurance institution or agent of a
risk with a residual market mechanism, an unauthorized insurer or an insurance institution which specializes in substandard risks, (ii) the charging of a higher rate on the basis
of information which differs from that which the applicant or policyholder furnished or
(iii) changing a risk from a preferred rate program to a standard rate program or from
a standard rate program to a nonstandard rate program within the same company or
between two companies in the same group and (D) in the case of a life, health or disability
insurance coverage, an offer to insure at higher than standard rates. (2) Notwithstanding
the provisions of subdivision (1) of this subsection, the following actions shall not be
considered adverse underwriting decisions: (A) The termination of an individual policy
form on a class or state-wide basis, (B) a declination of insurance coverage solely because such coverage is not available on a class or state-wide basis, or (C) the rescission
of a policy.
(b) "Affiliate" or "affiliated" has the meaning assigned to it in section 38a-1.
(c) "Agent" shall have the same meaning as "insurance producer", as defined in
section 38a-702a.
(d) "Applicant" means any person who seeks to contract for insurance coverage
other than a person seeking group insurance that is not individually underwritten.
(e) "Commissioner" means the Insurance Commissioner.
(f) "Consumer report" means any written, oral or other communication of information bearing on an individual's credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living which is used or expected to be used in connection with an insurance transaction.
(g) "Consumer reporting agency" means any person who: (1) Regularly engages,
in whole or in part, in the practice of assembling or preparing consumer reports for a
fee, (2) obtains information primarily from sources other than insurance institutions,
and (3) furnishes consumer reports to other persons.
(h) "Control", including the terms "controlled by" or "under common control with",
has the meaning assigned to it in section 38a-1.
(i) "Declination of insurance coverage" means a denial, in whole or in part, by an
insurance institution or agent, of requested insurance coverage.
(j) "Individual" means any person who: (1) In the case of property or casualty insurance, is a past, present or proposed named insured or certificate holder; (2) in the case
of life, health or disability insurance, is a past, present or proposed principal insured or
certificate holder; (3) is a past, present or proposed policyowner; (4) is a past or present
applicant or claimant; or (5) derived, derives or is proposed to derive insurance coverage
under an insurance policy or certificate subject to sections 38a-975 to 38a-998, inclusive.
(k) "Institutional source" means any person or governmental entity that provides
information about an individual to an agent, insurance institution or insurance-support
organization, other than: (1) An agent, (2) the individual who is the subject of the information, or (3) an individual acting in a personal capacity rather than a business or professional capacity.
(l) "Insurance institution" means any corporation, limited liability company, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit
society or other person engaged in the business of insurance, including health care centers, as defined in section 38a-175, medical service corporations, as defined in section
38a-214, managed care organizations, as defined in section 38a-478 and hospital service
corporations, as defined in section 38a-199. It shall not include agents or insurance-support organizations.
(m) (1) "Insurance-support organization" means any person who regularly engages, in whole or in part, in the practice of assembling or collecting information concerning individuals for the primary purpose of providing the information to an insurance
institution or agent for insurance transactions, including: (A) The furnishing of consumer
reports or investigative consumer reports to an insurance institution or agent for use in
connection with an insurance transaction, (B) the collection of personal information
from insurance institutions, agents or other insurance-support organizations for the purpose of detecting or preventing fraud, material misrepresentation or material nondisclosure in connection with insurance underwriting or insurance claim activity, or (C) collecting medical record information from, disclosing medical record information to, or
collecting medical record information on behalf of an insurance institution or agent in the
ordinary course of business, including, but not limited to, utilization review companies,
benefit management entities, including, but not limited to, pharmaceutical benefit and
disease management entities and information or computer management entities. (2)
Notwithstanding subdivision (1) of this subsection, the following persons shall not be
considered "insurance-support organizations" for purposes of sections 38a-975 to 38a-998, inclusive: Agents, government institutions, insurance institutions, medical care
institutions, medical professionals, pharmacies, universities and schools.
(n) "Insurance transaction" means any transaction involving insurance primarily
for personal, family or household needs rather than business or professional needs which
involves: (1) The determination of an individual's eligibility for an insurance coverage,
benefit or payment, or (2) the servicing of an insurance application, policy, contract or
certificate.
(o) "Investigative consumer report" means a consumer report or portion thereof in
which information about an individual's character, general reputation, personal characteristics or mode of living is obtained through personal interviews with the person's
neighbors, friends, associates, acquaintances or others who may have such knowledge.
(p) "Medical-care institution" means any facility or institution that is licensed to
provide health care services to individuals, including but not limited to health care centers, home-health agencies, hospitals, medical clinics, public health agencies, rehabilitation agencies and skilled nursing facilities.
(q) "Medical professional" means any person licensed or certified to provide health
care services to individuals, including but not limited to a chiropractor, clinical dietitian,
clinical psychologist, dentist, nurse, occupational therapist, optometrist, pharmacist,
physical therapist, physician, podiatrist, psychiatric social worker or speech therapist.
(r) "Medical-record information" means personal information which: (1) Relates
to the physical, mental or behavioral health condition, medical history or medical treatment of an individual or a member of the individual's family, and (2) is obtained from
a medical professional or medical-care institution, from a pharmacy or pharmacist, from
the individual, or from the individual's spouse, parent or legal guardian or from the
provision of or payment for health care to or on behalf of an individual or a member of
the individual's family. The term does not include such information from which personal
identifiers that either directly reveal the identity of the patient, or provide a means of
identifying the patient, have been removed or have been encrypted or encoded such that
the identity of the individual is not revealed without the use of an encryption key or code.
(s) "Person" has the meaning assigned to it in section 38a-1.
(t) "Personal information" means any individually identifiable information gathered in connection with an insurance transaction from which judgments can be made
about an individual's character, habits, avocations, finances, occupation, general reputation, credit, health or any other personal characteristics. "Personal information" includes
an individual's name and address and "medical-record information" but does not include
"privileged information".
(u) "Policyholder" means any person who: (1) In the case of individual property or
casualty insurance, is a present named insured; (2) in the case of individual life, health
or disability insurance, is a present policyowner; or (3) in the case of group insurance
which is individually underwritten, is a present group certificate holder.
(v) "Pretext interview" means an interview where a person, in an attempt to obtain
information about an individual, performs one or more of the following acts: (1) Pretends
to be someone he is not, (2) pretends to represent a person he is not in fact representing,
(3) misrepresents the true purpose of the interview, or (4) refuses to identify himself
upon request.
(w) "Privileged information" means any individually identifiable information that:
(1) Relates to a claim for insurance benefits or a civil or criminal proceeding involving
an individual, and (2) is collected in connection with or in reasonable anticipation of a
claim for insurance benefits or a civil or criminal proceeding involving an individual;
provided information otherwise meeting the requirements of this subsection shall nevertheless be considered "personal information" under sections 38a-975 to 38a-998, inclusive, if it is disclosed in violation of section 38a-988.
(x) "Residual market mechanism" means an association, organization or other entity defined or described in sections 38a-328, 38a-329 and 38a-670.
(y) "Termination of insurance coverage" or "termination of an insurance policy"
means either a cancellation or nonrenewal of an insurance policy, in whole or in part,
for any reason other than the failure to pay a premium as required by the policy.
(z) "Unauthorized insurer" has the meaning assigned to it in section 38a-1.
(P.A. 81-368, S. 2, 25; P.A. 83-177, S. 1, 2; P.A. 90-243, S. 165; P.A. 94-160, S. 23, 24; P.A. 95-79, S. 152, 189; P.A.
99-284, S. 17, 60; P.A. 01-113, S. 29, 42.)
History: P.A. 83-177 amended Subsec. (a) by redefining "adverse underwriting decision" to include any change from
a preferred rate program to a standard rate program or from a standard rate program to a nonstandard rate program and
amended Subsec. (x) by including agreements to insure uninsurable applicants as outlined in Sec. 38-201h, within the
definition of a "residual market mechanism"; P.A. 90-243 redefined "affiliate", "affiliated", "control", "person" and "unauthorized insurer"; Sec. 38-501 transferred to Sec. 38a-976 in 1991; P.A. 94-160 substituted "producer" for "insurance
broker" in definition of "agent" to accurately reflect the modernization and nomenclature of the industry, effective June
2, 1994; P.A. 95-79 redefined "insurance institution" to include a limited liability company, effective May 31, 1995;
P.A. 99-284 amended definition of "insurance institution" to include managed care organizations, amended definition of
"insurance-support organization" to add Subpara. (1)(C) re collecting or disclosing medical record information in the
ordinary course of business, and amended Subdiv. (2) to exclude "pharmacies, universities and schools" from the definition
of "insurance-support organization", and amended definition of "medical-record information" to substitute "information
which: (1) Relates to the physical, mental or behavioral health condition, medical history or medical treatment of an
individual or a member of the individual's family" for "information which: (1) Relates to an individual's physical or mental
condition, medical history or medical treatment", amended Subdiv. (2) to include information obtained from a pharmacy
or pharmacist, or from the provision of or payment for health care re an individual or member of the individual's family,
and excluded from definition encrypted or encoded information or other information from which personal identifiers have
been removed, effective July 1, 2000; P.A. 01-113 amended definition of "agent" to delete "insurance agent" from definition, make a technical change and substitute "section 38a-702a" for "section 38a-702", effective September 1, 2002.
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Sec. 38a-977. (Formerly Sec. 38-502). Applicability. Exceptions. (a) The obligations imposed by sections 38a-975 to 38a-998, inclusive, shall apply to those insurance
institutions, agents or insurance-support organizations which, on or after October 1,
1982: (1) In the case of life, health or disability insurance: (A) Collect, receive or maintain information in connection with insurance transactions which pertains to individuals
who are residents of this state or (B) engage in insurance transactions with applicants,
individuals or policyholders who are residents of this state, and (2) in the case of property
or casualty insurance: (A) Collect, receive or maintain information in connection with
insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this state or (B) engage in insurance transactions
involving policies, contracts or certificates of insurance delivered, issued for delivery
or renewed in this state.
(b) The rights granted by sections 38a-975 to 38a-998, inclusive, shall extend to:
(1) In the case of life, health or disability insurance, the following persons who are
residents of this state: (A) Individuals who are the subject of information collected,
received or maintained in connection with insurance transactions and (B) applicants,
individuals or policyholders who engage in or seek to engage in insurance transactions,
and (2) in the case of property or casualty insurance, the following persons: (A) Individuals who are the subject of information collected, received or maintained in connection
with insurance transactions involving policies, contracts or certificates of insurance
delivered, issued for delivery or renewed in the state and (B) applicants, individuals
or policyholders who engage in or seek to engage in insurance transactions involving
policies, contracts or certificates of insurance delivered, issued for delivery or renewed
in this state.
(c) For purposes of this section, a person shall be considered a resident of this state
if the person's last-known mailing address, as shown in the records of the insurance
institution, agent or insurance-support organization, is located in this state.
(d) Notwithstanding the provisions of subsections (a) and (b) of this section, sections
38a-975 to 38a-998, inclusive, shall not apply to information collected from the public
records of a governmental authority and maintained by an insurance institution or its
representatives for the purpose of insuring the title to real property located in this state.
(P.A. 81-368, S. 3, 25; P.A. 82-472, S. 119, 183.)
History: P.A. 82-472 made technical changes and corrections; Sec. 38-502 transferred to Sec. 38a-977 in 1991.
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Sec. 38a-978. (Formerly Sec. 38-503). Use of pretext interviews. No insurance
institution, agent or insurance-support organization shall use or authorize the use of a
pretext interview to obtain information in connection with an insurance transaction;
except it may be used to obtain information from a person or institution that does not
have a recognized privileged relationship with the person to whom the information
relates for the purpose of investigating a claim where, based upon specific information
available for review by the commissioner, there is a reasonable basis for suspecting
criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim.
(P.A. 81-368, S. 4, 25; P.A. 82-472, S. 120, 183.)
History: P.A. 82-472 made technical grammatical correction; Sec. 38-503 transferred to Sec. 38a-978 in 1991.
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Sec. 38a-979. (Formerly Sec. 38-504). Notice of insurance information practices. (a) An insurance institution or agent shall provide a notice of information practices
to all applicants or policyholders in connection with insurance transactions as provided
in this section: (1) In the case of an application for insurance, (A) at the time of the
delivery of the insurance policy or certificate when personal information is collected
only from the applicant or public records or (B) at the time the collection of personal
information is initiated when personal information is collected from a source other than
the applicant or public records, (2) in the case of a policy renewal, the renewal date,
except that no notice shall be required in connection with a policy renewal if: (A) Personal information is collected only from the policyholder or from public records, or (B)
a notice meeting the requirements of this section has been given within the previous
twenty-four months, or (3) in the case of a policy reinstatement or change in insurance
benefits, the time a request for a policy reinstatement or change in insurance benefits
is received by the insurance institution, except that no notice shall be required if personal
information is collected only from the policyholder or public records.
(b) The notice shall be in writing and shall state: (1) Whether personal information
may be collected from persons other than the individual proposed for coverage, (2) the
types of personal information that may be collected, the kinds of investigative techniques
that may be used to collect such information and the sources from which such information may be collected, (3) the types of disclosures identified in subdivisions (2) to (6),
inclusive, (9), (11), (12) and (14) of section 38a-988 and the circumstances under which
such disclosures may be made without prior authorization; provided only those circumstances need be described which occur with such frequency as to indicate a general
business practice, (4) a description of the rights established under sections 38a-983 and
38a-984 and the manner in which these rights may be exercised, and (5) that information
obtained from a report prepared by an insurance-support organization may be retained
by the organization and disclosed to other persons.
(c) In lieu of the notice prescribed in subsection (b) of this section, the insurance
institution or agent may provide an abbreviated notice informing the applicant or policyholder that: (1) Personal information may be collected from persons other than the individual proposed for coverage, (2) such information as well as other personal or privileged
information subsequently collected by the insurance institution or agent may in certain
circumstances be disclosed to third parties without authorization, (3) a right of access
and correction exists with respect to all personal information collected, and (4) the
notice prescribed in subsection (b) of this section must be furnished to the applicant or
policyholder upon request.
(d) The obligations imposed by this section upon an insurance institution or agent
may be satisfied by another insurance institution or agent authorized to act on its behalf.
(P.A. 81-368, S. 5, 25; P.A. 02-24, S. 9.)
History: Sec. 38-504 transferred to Sec. 38a-979 in 1991; P.A. 02-24 amended Subsec. (b) to substitute references to
subdivisions of Sec. 38a-988 for subsection references.
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Sec. 38a-980. (Formerly Sec. 38-505). Insurer to specify questions for marketing or research purposes. An insurance institution or agent shall specify those questions designed solely to obtain information for marketing or research purposes from an
individual in connection with an insurance transaction.
(P.A. 81-368, S. 6, 25; P.A. 82-472, S. 121, 183.)
History: P.A. 82-472 made nonsubstantive change in wording; Sec. 38-505 transferred to Sec. 38a-980 in 1991.
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Sec. 38a-981. (Formerly Sec. 38-506). Content of disclosure authorization
forms. Disclosure of health benefits to exclusive bargaining agent or subgroup
of a multi-bargaining-unit group. (a) Notwithstanding any provision of the general
statutes to the contrary, no insurance institution, agent or insurance-support organization
may utilize as its disclosure authorization form in connection with insurance transactions, a form or statement which authorizes the disclosure of personal or privileged
information concerning an individual to an insurance institution, agent, or insurance-support organization unless the form or statement: (1) Is written in plain language substantially complying with the tests enumerated in subsection (b) of section 42-152; (2)
is dated; (3) specifies the types of persons authorized to disclose information concerning
the individual; (4) specifies the nature of the information authorized to be disclosed;
(5) identifies the insurance institution or agent and the types of representatives of the
insurance institution to whom the individual has authorized the information to be disclosed; (6) specifies the purposes for which the information is collected; (7) specifies
the length of time such authorization shall remain valid, which shall be no longer than:
(A) In the case of authorizations signed for the purpose of collecting information in
connection with an application for an insurance policy, a policy reinstatement or a request for a change in policy benefits: (i) Thirty months from the date the authorization
is signed if the application or request involves life, health or disability insurance, (ii)
one year from the date the authorization is signed if the application or request involves
property or casualty insurance, (B) in the case of authorizations signed for the purpose
of collecting information in connection with a claim for benefits under an insurance
policy: (i) The term of coverage of the policy if the claim involves a health insurance
benefit, (ii) the duration of the claim if it involves an insurance benefit which is not a
health insurance benefit; (8) advises the individual or a person authorized to act on his
behalf that he is entitled to receive a copy of the authorization form.
(b) (1) An insurance institution or a third-party administrator providing insurance
or administrative services with respect to an employer's employee benefit plan which
provides its employees with health benefits shall, upon written request of an exclusive
bargaining agent for such employees, provide such bargaining agent with information
regarding description of health benefits available to such employees, claim experience
regarding such benefits and the cost to the employer for such coverage or administrative
services, as the case may be, for employees in the bargaining unit represented by such
bargaining agent. If such employees constitute a subgroup of a multi-bargaining-unit
group, the information provided by the insurance institution or administrator shall, upon
written request of the exclusive bargaining agent for the subgroup, include a description
of available health benefits, claim experience regarding such benefits and the cost to
the employer for such coverage or administrative services, as the case may be, for the
entire multi-bargaining-unit group or for subgroups within the multi-bargaining-unit
group. A copy of such information shall be provided at the same time to the employer
by the insurance institution or administrator. Such information shall be made available
to the bargaining agent and the employer only if the bargaining agent agrees in writing
to pay all reasonable costs, as determined by the insurance institution or administrator,
that are incurred by the insurance institution or administrator in developing and distributing the information. The information provided to such agent shall relate to the group of
employees as a whole and shall not include any information relating to specific individuals. No requests made pursuant to this subdivision may seek information which relates
to a period of time more than twenty-four months prior to the date such request was
made.
(2) Prior to providing any information pursuant to subdivision (1) of this subsection,
an insurance institution or third-party administrator may require the bargaining agent
requesting such information to provide evidence in writing that such bargaining agent
is currently designated or certified by the proper state or federal authority as the exclusive
bargaining representative or agent of the employees who are the subject of the request.
(3) The provisions of this subsection shall not apply to employees participating in
an employee welfare benefit plan subject to the provisions of Title I of the Employee
Retirement Income Security Act of 1974 (ERISA), Public Law 93-406, as amended
from time to time, or to the exclusive bargaining agents of such employees.
(P.A. 81-368, S. 7, 25; P.A. 82-21, S. 1; P.A. 92-104; P.A. 03-119, S. 3; P.A. 04-10, S. 13; 04-257, S. 65.)
History: P.A. 82-21 replaced the readable language standards of Sec. 38-68u with those of Sec. 42-152(b) and made
several technical corrections; Sec. 38-506 transferred to Sec. 38a-981 in 1991; P.A. 92-104 divided the section into Subsecs.,
added a provision requiring an insurer who provides health benefits to provide bargaining agents with information re
description of the health benefits being offered to employees, claim experience re such benefits and the employer's cost
for the coverage provided such coverage relates to the group as a whole and not to specific individuals if bargaining agent
agrees to compensate the insurer for reasonable costs of providing such information; (Revisor's note: In 2001 the internal
alphabetic and numeric indicators in Subsec. (a) were changed editorially by the Revisors for consistency with customary
statutory usage); P.A. 03-119 amended Subsec. (b)(1) to allow disclosure to a subgroup of a multi-bargaining-unit group;
P.A. 04-10, effective October 1, 2004, and P.A. 04-257, effective June 14, 2004, both made identical technical change in
Subsec. (b)(1) and (3).
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Sec. 38a-982. (Formerly Sec. 38-507). Investigative consumer reports. (a) No
insurance institution, agent or insurance-support organization may prepare or request
an investigative consumer report pertaining to an individual in connection with an insurance transaction involving an application for insurance, a policy renewal, reinstatement
or a change in insurance benefits unless the insurance institution or agent informs the
individual: (1) That he may request to be interviewed in connection with the preparation
of the investigative consumer report and (2) that upon request pursuant to section 38a-983, he is entitled to receive a copy of the investigative consumer report.
(b) If an investigative consumer report is to be prepared by an insurance institution
or agent, the institution or agent shall establish reasonable procedures pertaining to the
conduct of a personal interview requested by an individual.
(c) If an investigative consumer report is to be prepared by an insurance- support
organization, the institution or agent desiring such report shall inform the insurance-support organization whether a personal interview has been requested by the individual.
The insurance-support organization shall establish reasonable procedures pertaining to
the conduct of such interviews, if requested.
(P.A. 81-368, S. 8, 25.)
History: Sec. 38-507 transferred to Sec. 38a-982 in 1991.
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Sec. 38a-983. (Formerly Sec. 38-508). Access to recorded personal information. (a) If an individual, after proper identification, submits a written request to an
insurance institution, agent or insurance-support organization for access to recorded
personal information concerning himself which is reasonably described and accessible,
the institution, agent or insurance-support organization shall within thirty business days
from the date such request is received: (1) Inform the individual of the nature and substance of such recorded personal information in writing, by telephone or by other means
of oral communication; (2) permit the individual to see and copy, in person, such recorded personal information pertaining to him or to obtain a copy of such information
by mail, unless such information is in coded form, in which case an accurate translation
in readable language shall be provided in writing; (3) disclose to the individual the
identity, if recorded, of those persons to whom the insurance institution, agent or insurance-support organization has disclosed such personal information within two years
prior to such request, and if the identity is not recorded, the names of those insurance
institutions, agents, insurance-support organizations or other persons to whom such
information is normally disclosed; and (4) provide the individual with a summary of
the procedures by which he may request correction, amendment or deletion of recorded
personal information.
(b) Any personal information provided pursuant to subsection (a) of this section
shall identify the source of the information if it is an institutional source.
(c) Medical-record information supplied by a medical-care institution or medical
professional and requested under subsection (a) of this section, together with the identity
of the medical professional or medical-care institution which provided such information,
shall be supplied either directly to the individual or to a medical professional designated
by the individual and licensed to provide medical care with respect to the condition to
which the information relates by the insurance institution, agent or insurance-support
organization. If it elects to disclose the information to a medical professional designated
by the individual, the insurance institution, agent or insurance-support organization shall
notify the individual, at the time of the disclosure, that it has provided the information
to the medical professional.
(d) Except for personal information provided under section 38a-985, an insurance
institution, agent or insurance-support organization may charge a reasonable fee to cover
the costs incurred in providing a copy of recorded personal information to individuals.
(e) The obligations imposed by this section upon an insurance institution or agent
may be satisfied by another insurance institution or agent authorized to act on its behalf.
With respect to the copying and disclosure of recorded personal information pursuant to
a request under subsection (a) of this section, an insurance institution, agent or insurance-support organization may make arrangements with an insurance-support organization
or a consumer reporting agency to copy and disclose such information on its behalf.
(f) The rights granted to individuals in this section shall extend to all individuals to
the extent information concerning them is collected and maintained by an insurance
institution, agent or insurance-support organization in connection with an insurance
transaction. The rights granted to all individuals by this subsection shall not extend to
information concerning them that relates to and is collected in connection with or in
reasonable anticipation of, a claim or a civil or criminal proceeding involving them.
(g) For purposes of this section, the term "insurance-support organization" does not
include "consumer reporting agency".
(P.A. 81-368, S. 9, 25; P.A. 82-21, S. 3.)
History: P.A. 82-21 specified that section provisions apply to personal or privileged information collected or received
before or after October 1, 1982; Sec. 38-508 transferred to Sec. 38a-983 in 1991.
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Sec. 38a-984. (Formerly Sec. 38-509). Correction, amendment or deletion of
recorded personal information. (a) Within thirty business days from the date of receipt
of a written request from an individual to correct, amend or delete any recorded personal
information concerning him within its possession, an insurance institution, agent or
insurance-support organization shall either: (1) Correct, amend or delete the portion of
the recorded personal information in dispute; or (2) notify the individual of: (A) Its
refusal to make such correction, amendment or deletion; (B) the reasons for the refusal,
and (C) his right to file a statement as provided in subsection (c) of this section.
(b) If the insurance institution, agent or insurance-support organization corrects,
amends or deletes recorded personal information in accordance with subdivision (1) of
subsection (a) of this section, it shall so notify the individual in writing and furnish the
correction, amendment or fact of deletion to: (1) Any person specifically designated by
the individual who may have, within the preceding two years, received such recorded
personal information; (2) any insurance-support organization whose primary source of
personal information is insurance institutions if such organization has systematically
received such information from the insurance institution within the preceding seven
years; provided that the correction, amendment or deletion need not be furnished if
the organization no longer maintains the information about the individual; and (3) any
insurance-support organization that furnished the personal information that has been
corrected, amended or deleted.
(c) Whenever an individual disagrees with an institution's, agent's or organization's
refusal to correct, amend or delete recorded personal information, the individual shall
be permitted to file with the institution, agent or organization: (1) A concise statement
specifying what the individual believes to be the correct, relevant or fair information,
and (2) a concise statement of the reasons the individual disagrees with the institution's,
agent's or organization's refusal to correct, amend or delete recorded personal information.
(d) In the event an individual files either statement as described in subsection (c)
of this section, the insurance institution, agent or support organization shall: (1) File the
statement with the disputed personal information and provide a means by which anyone
reviewing such information will be cognizant of the individual's statement and have
access to it, (2) in any subsequent disclosure by the institution, agent or organization of
the recorded personal information that is the subject of disagreement, clearly identify
the matter in dispute and provide the individual's statement along with the information
being disclosed, and (3) furnish the statement to the persons in the manner specified in
subsection (b) of this section.
(e) The rights granted to individuals in this section shall extend to all individuals
to the extent information concerning them is collected and maintained by an insurance
institution, agent or insurance-support organization in connection with an insurance
transaction except with respect to information that relates to and is collected in connection with or in reasonable anticipation of, a claim or a civil or criminal proceeding
involving them.
(f) For purposes of this section, the term "insurance-support organization" does not
include "consumer reporting agency".
(P.A. 81-368, S. 10, 25; P.A. 82-21, S. 3.)
History: P.A. 82-21 specified that provisions apply to personal or privileged information collected or received before
or after October 1, 1982; Sec. 38-509 transferred to Sec. 38a-984 in 1991.
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Sec. 38a-985. (Formerly Sec. 38-510). Insurer to provide its reasons for adverse underwriting decisions. (a) Subject to the provisions of sections 38a-307, 38a-323 and 38a-343, in the event of an adverse underwriting decision, the insurance institution or agent responsible for the decision shall: (1) Either provide the applicant, policyholder or individual proposed for coverage with the specific reason for the adverse
underwriting decision in writing or advise such person that upon written request he may
receive the specific reason in writing, and (2) provide the applicant, policyholder or
individual proposed for coverage with a summary of the rights established under subsection (b) of this section and sections 38a-983 and 38a-984.
(b) Upon receipt of a written request within ninety business days from the date of
the mailing of notice or other communication of an adverse underwriting decision to
an applicant, policyholder or individual proposed for coverage, the insurance institution
or agent shall furnish such person within twenty-one business days from the date of
receipt of such written request: (1) The specific reason for the adverse underwriting
decision, in writing, if such information was not initially furnished in writing pursuant
to subdivision (1) of subsection (a) of this section; (2) the specific items of personal
and privileged information that support those reasons, provided: (A) The insurance
institution or agent shall not be required to furnish specific items of privileged information if it has a reasonable suspicion, based upon specific information available for review
by the commissioner, that the applicant, policyholder or individual proposed for coverage has engaged in criminal activity, fraud, material misrepresentation or material nondisclosure, and (B) specific items of medical-record information supplied by a medical-care institution or medical professional shall be disclosed either directly to the individual
to whom the information relates or to a medical professional designated by the individual
and licensed to provide medical care with respect to the condition to which the information relates; and (3) the names and addresses of the institutional sources that supplied
the specific items of information pursuant to subdivision (2) of subsection (b) of this
section, provided that the identity of any medical professional or medical-care institution
shall be disclosed either directly to the individual or to the designated medical professional.
(c) The obligations imposed by this section upon an insurance institution or agent
may be satisfied by another insurance institution or agent authorized to act on its behalf.
(d) When an adverse underwriting decision results solely from an oral request or
inquiry, the explanation of reasons and summary of rights required by subsection (a) of
this section may be given orally.
(e) The insurance institution or agent responsible for the occurrence of any action
specified in subdivision (2) of subsection (a) of section 38a-976 which is not an adverse
underwriting decision shall provide the applicant or policyholder with the specific reason for its occurrence.
(P.A. 81-368, S. 11, 25; P.A. 82-472, S. 122, 183; P.A. 85-156, S. 3.)
History: P.A. 82-472 made technical changes; P.A. 85-156 substituted reference to Sec. 38-185w for reference to Sec.
38-175i in Subsec. (a); Sec. 38-510 transferred to Sec. 38a-985 in 1991.
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Sec. 38a-986. (Formerly Sec. 38-511). Information concerning previous adverse underwriting decisions and coverage through residual market mechanisms.
No insurance institution, agent or insurance-support organization may seek information
in connection with an insurance transaction concerning any previous adverse underwriting decisions experienced by an individual, or any previous insurance coverage obtained
by an individual through a residual market mechanism, unless such institution, agent
or organization also requests the reasons for any previous adverse underwriting decision
or the reasons insurance coverage was previously obtained through a residual market
mechanism.
(P.A. 81-368, S. 12, 25; P.A. 84-546, S. 98, 173.)
History: P.A. 84-546 made technical change, deleting previously existing Subdiv. indicators; Sec. 38-511 transferred
to Sec. 38a-986 in 1991.
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Sec. 38a-987. (Formerly Sec. 38-512). Insurer prohibited from considering
previous adverse underwriting decision or past residual market mechanism coverage. No insurance institution or agent may base an adverse underwriting decision in
whole or in part:
(1) On a previous adverse underwriting decision or on the fact that an individual
previously obtained insurance coverage through a residual market mechanism, provided
an insurance institution or agent may base an adverse underwriting decision on further
information obtained from an insurance institution or agent responsible for a previous
adverse underwriting decision;
(2) On personal information received from an insurance-support organization
whose primary source of information is an insurance institution, provided an insurance
institution or agent may base an adverse underwriting decision on further personal information obtained as the result of information received from an insurance-support organization.
(P.A. 81-368, S. 13, 25; P.A. 02-24, S. 10.)
History: Sec. 38-512 transferred to Sec. 38a-987 in 1991; P.A. 02-24 substituted Subdiv. designators "(1)" and "(2)"
for "(a)" and "(b)".
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Sec. 38a-988. (Formerly Sec. 38-513). Disclosure limitations and conditions.
An insurance institution, agent or insurance-support organization shall not disclose any
personal or privileged information concerning an individual collected or received in
connection with an insurance transaction unless the disclosure is:
(1) Made with the written authorization of the individual, provided: (A) If such
authorization is submitted by another insurance institution, agent or insurance-support
organization, it meets the requirements of section 38a-981, or (B) if such authorization
is submitted by a person other than an insurance institution, agent or insurance-support
organization, it shall be: (i) Dated, (ii) signed by the individual, and (iii) obtained within
one year prior to the date a disclosure is sought pursuant to this subdivision;
(2) Made to a person other than an insurance institution, agent or insurance-support
organization, provided such disclosure is reasonably necessary: (A) To enable such
person to perform a business, professional or insurance function for the disclosing insurance institution, agent or insurance-support organization, and such person agrees not
to disclose the information without the individual's written authorization unless the
disclosure: (i) Would otherwise be permitted by this section if made by an insurance
institution, agent, or insurance-support organization, or (ii) is reasonably necessary for
such person to perform such person's function for the disclosing insurance institution,
agent or insurance-support organization; or (B) to enable such person to provide information to the disclosing insurance institution, agent or insurance-support organization
for the purpose of: (i) Determining an individual's eligibility for an insurance benefit
or payment, or (ii) detecting or preventing criminal activity, fraud, material misrepresentation or material nondisclosure in connection with an insurance transaction;
(3) Made to an insurance institution, agent, insurance-support organization or self-insurer, provided the information disclosed is limited to that which is reasonably necessary: (A) To detect or prevent criminal activity, fraud, material misrepresentation or
material nondisclosure in connection with insurance transactions, or (B) for either the
disclosing or receiving insurance institution, agent or insurance-support organization
to perform its function in connection with an insurance transaction involving the individual;
(4) Made to a medical-care institution or medical professional for the purpose of:
(A) Verifying insurance coverage or benefits; (B) informing an individual of a medical
problem of which such individual may not be aware; or (C) conducting an operations
or services audit, provided only such information is disclosed as is reasonably necessary
to accomplish the foregoing purposes;
(5) Made to an insurance regulatory authority;
(6) Made to a law enforcement or other government authority:(A) To protect the
interests of the insurance institution, agent or insurance-support organization in preventing or prosecuting the perpetration of fraud upon it; or (B) if the institution, agent
or organization reasonably believes that illegal activities have been conducted by the
individual;
(7) Otherwise permitted or required by law;
(8) In response to a facially valid administrative or judicial order, including a search
warrant or subpoena;
(9) Made for the purpose of conducting actuarial or research studies, provided: (A)
No individual may be identified in any actuarial or research report; (B) materials in
which the individual may be identified are returned or destroyed as soon as they are no
longer necessary; and (C) the actuarial or research organization agrees not to disclose
the information unless the disclosure would otherwise be permitted by this section if
made by an insurance institution, agent or insurance-support organization;
(10) Made to a party or a representative of a party to a proposed or consummated
sale, transfer, merger or consolidation of all or part of the business of the insurance
institution, agent or insurance-support organization, provided: (A) Prior to the consummation of the sale, transfer, merger or consolidation only such information is disclosed
as is reasonably necessary to enable the recipient to make business decisions about the
purchase, transfer, merger or consolidation; and (B) the recipient agrees not to disclose
the information unless the disclosure would otherwise be permitted by this section if
made by an insurance institution, agent or insurance-support organization;
(11) Made to a person whose only use of such information will be in connection
with the marketing of a product or service, provided: (A) No medical-record information,
privileged information, or personal information relating to an individual's character,
personal habits, mode of living or general reputation is disclosed, and no classification
derived from such information is disclosed; (B) the individual has been afforded an
opportunity to indicate that the individual does not wish personal information disclosed
for marketing purposes and has given no indication that the individual does not wish
the information disclosed; and (C) the person receiving such information agrees not to
use it except in connection with the marketing of a product or service;
(12) Made to an affiliate whose only use of the information will be in connection
with an audit of the insurance institution or agent or the marketing of an insurance
product or service, provided (A) with regard to individually identifiable medical records
information, written consent of the individual to whom the individually identifiable
medical record pertains is obtained prior to disclosure for marketing purposes, and (B)
the affiliate agrees not to disclose the information for any other purpose or to unaffiliated
persons;
(13) Made by a consumer reporting agency, provided the disclosure is made to a
person other than an insurance institution or agent;
(14) Made to a group policyholder for the purpose of reporting claims experience
or conducting an audit of the insurance institution's or agent's operations or services,
provided the information disclosed is reasonably necessary for the recipient to conduct
the audit;
(15) Made to a professional peer review organization for the purpose of reviewing
the service or conduct of a medical-care institution or medical professional;
(16) Made to a governmental authority for the purpose of determining the individual's eligibility for health benefits for which the governmental authority may be liable;
(17) Made to a certificate holder or policyholder for the purpose of providing information regarding the status of an insurance transaction;
(18) Made to a lienholder, mortgagee, assignee, lessor or other person shown on
the records of an insurance institution or agent as having a legal or beneficial interest
in a policy of insurance, provided: (A) No medical-record information is disclosed unless
the disclosure would otherwise be permitted by this section; and (B) the information
disclosed is limited to that which is reasonably necessary to permit such person to protect
its interests in such policy;
(19) Made pursuant to section 53-445;
(20) Made to the Department of Public Health in conjunction with the investigation
of a health care provider pursuant to section 19a-14.
(P.A. 81-368, S. 14, 25; P.A. 82-21, S. 2, 3; P.A. 93-430, S. 6, 9; P.A. 99-284, S. 39, 60; P.A. 02-24, S. 11; P.A. 06-195, S. 17.)
History: P.A. 82-21 added Subsec. (r), providing that an insurer cannot disclose personal or privileged information
unless disclosure is made to persons having legal interest in the insurance policy and specified that provisions apply to
personal or privileged information collected or received before or after October 1, 1982; Sec. 38-513 transferred to Sec.
38a-988 in 1991; P.A. 93-430 made technical changes for accuracy and added Subdiv. (s), providing that an insurer cannot
disclose personal or privileged information unless such disclosure is made pursuant to health insurance fraud under Sec.
53-445, effective October 1, 1994; P.A. 99-284 amended Subdiv. (l) by adding Subpara. (1) re individually identifiable
medical records and designated existing proviso as Subpara. (2), effective July 1, 2000; P.A. 02-24 changed Subdiv.
designators from (a) to (s) to (1) to (19), deleted "or" at the end of Subdivs. and made technical changes; P.A. 06-195
added Subdiv. (20) to permit insurers to make disclosures to Department of Public Health in conjunction with investigation
of a health care provider.
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Sec. 38a-988a. Sale of individually identifiable medical record information
prohibited. Written consent re disclosure for marketing purposes. Exceptions.
Cause of action for violations. (a) No person, including, but not limited to, insurance
institutions, agents, insurance support organizations, health care professionals, medical
care centers, pharmacies, pharmaceutical companies, schools and universities, and no
person's agent, contractor or employee, shall sell or offer for sale individually identifiable medical record information, as defined in subsection (r) of section 38a-976. No
person shall disclose, for purposes of marketing, individually identifiable medical record
information without the prior written consent of the individual to whom the individually
identifiable medical record information pertains or, in the case of a minor, of the minor's
parent or guardian. Nothing in this section shall be construed to prohibit (1) a person
from disclosing individually identifiable medical record information as permitted under
section 38a-988, any other applicable state or federal law or in connection with a collectively bargained agreement, or (2) a health care provider from transferring individual
identifiable medical record information for the purposes of clinical research, utilization
review, quality review, performance improvement, billing for services or other functions
performed by health care providers or their agents in support of direct patient care,
provided (A) in the case of clinical research, no individually identifiable medical record
information may be disclosed by the clinical researcher, unless the disclosure would
otherwise be permitted, and (B) the entity to whom the information is transferred agrees
not to disclose the information unless the disclosure would otherwise be permitted if
made by the transferer. Nothing in this section shall be construed to prohibit a person
from transferring individually identifiable medical record information to another person
as part of a consummated sale of that person to another person or consummated merger
by that person with another person or to a successor in interest. For the purposes of this
section, "insurance transaction" as used in section 38a-988 shall apply to any insurance
including insurance for personal, family, household, business or professional needs, and
"insurance institution" as used in said section 38a-988 includes self-insured employers
for workers' compensation purposes and third-party administrators.
(b) An individual harmed by a violation of this section may bring an action for
equitable relief, damages or both. Any person who violates the provisions of this section
shall be liable to the individual harmed for double damages, costs and reasonable attorneys' fees. No action under this section shall be brought but within two years from the
date when the violation first occurs or is discovered, or in the exercise of reasonable
care should have been discovered, and except that no such action may be brought more
than five years from the date of the violation complained of.
(P.A. 99-284, S. 18, 60.)
History: P.A. 99-284 effective July 1, 2000.
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Sec. 38a-989. (Formerly Sec. 38-514). Powers of commissioner. (a) The commissioner shall have power to examine and investigate into the affairs of every insurance
institution or agent doing business in this state to determine whether the institution or
agent has been engaged or is engaging in any conduct in violation of sections 38a-975
to 38a-998, inclusive.
(b) The commissioner shall have the power to examine and investigate into the
affairs of every insurance-support organization acting on behalf of an insurance institution or agent which transacts business within this state or without this state which has
an effect on a resident of this state in order to determine whether such insurance-support
organization has been engaged or is engaging in any conduct in violation of sections
38a-975 to 38a-998, inclusive.
(P.A. 81-368, S. 15, 25; P.A. 99-284, S. 19, 60.)
History: Sec. 38-514 transferred to Sec. 38a-989 in 1991; P.A. 99-284 made a technical change, effective July 1, 2000.
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Sec. 38a-990. (Formerly Sec. 38-515). Hearings; subpoenas; service of process.
(a) Whenever the commissioner has reason to believe that an insurance institution, agent
or insurance-support organization has been engaged or is engaging in conduct in this
state which violates this chapter, or if the commissioner believes that an insurance-support organization has been engaged or is engaging in conduct outside this state which
has an effect on a resident of this state and which violates sections 38a-975 to 38a-998,
inclusive, the commissioner shall issue and serve upon such insurance institution, agent
or insurance-support organization a statement of the charges and a notice of a hearing
to be held at a time and place fixed in the notice. The date of such hearing shall not be
less than thirty days after the date of service.
(b) At the time and place fixed for such hearing, the insurance institution, agent or
insurance-support organization shall have an opportunity to answer the charges against
it and present evidence on its own behalf. Upon good cause shown, the commissioner
shall permit any adversely affected person to intervene, appear and be heard at such
hearing by counsel or in person.
(c) At any hearing conducted pursuant to this section, the commissioner may administer oaths, examine and cross-examine witnesses and receive oral and documentary
evidence. The commissioner shall have the power to subpoena witnesses, compel their
attendance and require the production of books, papers, records, correspondence or other
documents that the commissioner deems relevant to the hearing. A stenographic record
of the hearing shall be made upon the request of any party or at the discretion of the
commissioner. If no stenographic record is made and if judicial review is sought, the
commissioner shall prepare a statement of the evidence for use on review. Hearings
conducted under this section shall be governed by the same rules of evidence and procedure applicable to administrative proceedings conducted under the insurance laws of
this state.
(d) Statements of charges, notices, orders and other processes of the commissioner
under sections 38a-975 to 38a-998, inclusive, may be served in the manner provided
by law for service of process in civil actions or by registered mail. A copy of the statement
of charges, notice, order or other process shall be provided to the person whose rights
under said sections have been allegedly violated. A verified return specifying the manner
of service, or return receipt in the case of registered mail, shall be sufficient proof of
service.
(P.A. 81-368, S. 16, 25; P.A. 99-284, S. 20, 60.)
History: Sec. 38-515 transferred to Sec. 38a-990 in 1991; P.A. 99-284 substituted "the commissioner" for "he" and
"that" for "which" and made a technical change, effective July 1, 2000.
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Sec. 38a-991. (Formerly Sec. 38-516). Insurance-support organizations to appoint commissioner to accept service of process. For purposes of sections 38a-975
to 38a-998, inclusive, an insurance-support organization transacting business outside
this state which affects a resident of this state shall be deemed to have appointed the
commissioner to accept service of process on its behalf as provided in section 38a-25.
(P.A. 81-368, S. 17, 25; P.A. 90-243, S. 166; P.A. 99-284, S. 21, 60.)
History: P.A. 90-243 provided that the provisions of section 38a-25 re service of process be applicable to out-of-state
insurance-support organizations; Sec. 38-516 transferred to Sec. 38a-991 in 1991; P.A. 99-284 made a technical change,
effective July 1, 2000.
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Sec. 38a-992. (Formerly Sec. 38-517). Commissioner to prepare findings. (a)
If, after a hearing pursuant to section 38a-990, the commissioner determines that the
insurance institution, agent or insurance-support organization charged has engaged in
conduct or practices in violation of sections 38a-975 to 38a-998, inclusive, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon
such institution, agent or organization a copy of such findings and an order requiring
such institution, agent or organization to cease and desist from engaging in such conduct
or practices.
(b) If, after a hearing pursuant to section 38a-990, the commissioner determines
that the insurance institution, agent or insurance-support organization charged has not
engaged in conduct or practices in violation of sections 38a-975 to 38a-998, inclusive,
the commissioner shall prepare a written report which sets forth the findings of fact
and conclusions. Such report shall be served upon the insurance institution, agent or
insurance-support organization charged and upon the person, if any, whose rights under
said sections were allegedly violated.
(c) The commissioner may modify or set aside any order or report issued under this
section until the expiration of the time allowed under section 38a-994 for filing a petition
for review or until such petition is actually filed, whichever occurs first. If, after the
expiration of the time allowed under section 38a-994 for filing a petition for review, no
petition has been filed, the commissioner may, after notice and opportunity for hearing,
alter, modify or set aside, in whole or in part, any order or report issued under this
section whenever conditions of fact or law warrant such action or if the public interest
so requires.
(P.A. 81-368, S. 18, 25; P.A. 99-284, S. 22, 60.)
History: Sec. 38-517 transferred to Sec. 38a-992 in 1991; P.A. 99-284 substituted "the commissioner" for "he" and
"the findings" for "his findings" and made a technical change, effective July 1, 2000.
Annotation to former section 38-517:
Subsec. (b):
Cited. 215 C. 277.
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Sec. 38a-993. (Formerly Sec. 38-518). Penalties. (a) In any case where a hearing
pursuant to section 38a-990 results in the finding of a negligent violation of sections
38a-975 to 38a-998, inclusive, the commissioner may, in addition to the issuance of a
cease and desist order as prescribed in section 38a-992, order payment of a penalty of
not more than two thousand dollars for each violation but not to exceed twenty thousand
dollars in the aggregate for multiple violations.
(b) (1) In any case where a hearing pursuant to section 38a-990 results in the finding
of an intentional violation of sections 38a-975 to 38a-998, inclusive, the commissioner
may, in addition to the issuance of a cease and desist order as prescribed in section 38a-992, order payment of a penalty of not more than five thousand dollars for each violation
but not to exceed fifty thousand dollars in the aggregate for multiple violations.
(2) In any case where a hearing pursuant to section 38a-990 results in the finding
of an intentional violation of section 38a-988a, the commissioner may, in addition to
the issuance of a cease and desist order as prescribed in section 38a-992, order payment
of a penalty of not more than twenty thousand dollars for each violation but not to exceed
one hundred thousand dollars in the aggregate for multiple violations.
(c) Any person who violates a cease and desist order of the commissioner under
section 38a-992 may, after notice and hearing and upon order of the commissioner, be
subject to one or more of the following, at the discretion of the commissioner: (1) A
penalty of not more than twenty thousand dollars for each violation; or (2) a penalty of
not more than one hundred thousand dollars if the commissioner finds that violations
have occurred with such frequency as to indicate a general business practice; or (3)
suspension or revocation of an insurance institution's or agent's license.
(P.A. 81-368, S. 19, 25; P.A. 97-99, S. 23; P.A. 99-284, S. 23, 60.)
History: Sec. 38-518 transferred to Sec. 38a-993 in 1991; P.A. 97-99 amended Subsec. (a) to increase penalty from
five hundred to two thousand dollars and limit maximum to twenty rather than ten thousand dollars; P.A. 99-284 amended
Subsec. (a) to substitute "a negligent violation" for "an intentional violation" re sections 38a-975 to 38a-998, inclusive,
inserted new Subdiv. (b)(1) re an intentional violation of said sections, inserted new Subdiv. (b)(2) re an intentional violation
of section 38a-988a, redesignated former Subsec. (b) as (c), amended Subdiv. (c)(1) to substitute "twenty thousand dollars"
for "ten thousand dollars" re penalty for each violation and amended Subdiv. (c)(2) to substitute "one hundred thousand
dollars" for "fifty thousand dollars" re penalty for violations that indicate a general business practice, effective July 1, 2000.
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Sec. 38a-994. (Formerly Sec. 38-519). Appeals from orders. (a) Any person aggrieved by an order of the commissioner issued pursuant to sections 38a-975 to 38a-998, inclusive, may appeal therefrom in accordance with the provisions of section 4-183, except venue for such appeal shall be in the judicial district of New Britain.
(b) No order or report of the commissioner under sections 38a-975 to 38a-998,
inclusive, or order of a court to enforce the same shall in any way relieve or absolve
any person affected by such order or report from any liability under any other laws of
this state.
(P.A. 81-368, S. 20, 25; P.A. 88-230, S. 1, 12; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; P.A. 95-220, S. 4-6; 99-215,
S. 24, 29; P.A. 99-284, S. 24, 60.)
History: P.A. 88-230 replaced "judicial district of Hartford-New Britain" with "judicial district of Hartford", effective
September 1, 1991; P.A. 90-98 changed the effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993;
Sec. 38-519 transferred to Sec. 38a-994 in 1991; P.A. 93-142 changed the effective date of P.A. 88-230 from September
1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 95-220 changed the effective date of P.A. 88-230 from
September 1, 1996, to September 1, 1998, effective July 1, 1995; P.A. 99-215 replaced "judicial district of Hartford" with
"judicial district of New Britain" in Subsec. (a), effective June 29, 1999; P.A. 99-284 made a technical change, effective
July 1, 2000.
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Sec. 38a-995. (Formerly Sec. 38-520). Individual remedies. (a) If an insurance
institution, agent or insurance-support organization fails to comply with section 38a-983, 38a-984 or 38a-985 with respect to the rights granted under those sections, any
person whose rights are violated may bring an action for equitable relief.
(b) An insurance institution, agent or insurance-support organization which discloses information in violation of section 38a-988 shall be liable for damages sustained
by the individual concerning whom the information relates, provided that no individual
shall be entitled to a monetary award which exceeds the actual damages sustained by
him as a result of a violation of section 38a-988.
(c) In any action brought pursuant to this section, the court may award costs and
reasonable attorney's fees to the prevailing party.
(d) No action under this section shall be brought but within two years from the date
the alleged violation is or should have been discovered.
(e) Except as specifically provided in this section, there shall be no remedy available
to individuals, in law or in equity, for occurrences constituting a violation of any provision of sections 38a-975 to 38a-998, inclusive.
(P.A. 81-368, S. 21, 25.)
History: Sec. 38-520 transferred to Sec. 38a-995 in 1991.
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Sec. 38a-996. (Formerly Sec. 38-521). Immunity. Any person who discloses personal or privileged information in accordance with sections 38a-975 to 38a-998, inclusive, or who furnishes such information to an insurance institution, agent or insurance-support organization, shall be immune from any civil liability on account of such act,
unless such person disclosed or furnished false information with malice or wilful intent
to injure any person.
(P.A. 81-368, S. 22, 25.)
History: Sec. 38-521 transferred to Sec. 38a-996 in 1991.
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Sec. 38a-997. (Formerly Sec. 38-522). Obtaining information under false pretenses. Fine. Any person who knowingly and wilfully obtains information concerning
an individual from an insurance institution, agent or insurance-support organization
under false pretenses shall be fined not more than ten thousand dollars.
(P.A. 81-368, S. 23, 25.)
History: Sec. 38-522 transferred to Sec. 38a-997 in 1991.
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Sec. 38a-998. (Formerly Sec. 38-523). Severability. If any provision of sections
38a-975 to 38a-998, inclusive, or the application thereof to any person or circumstance
is for any reason held to be invalid, the remainder of said sections and the application
of such provision to other persons or circumstances shall not be affected thereby.
(P.A. 81-368, S. 24, 25.)
History: Sec. 38-523 transferred to Sec. 38a-998 in 1991.
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Sec. 38a-999. Written policies, standards and procedures re medical record
information. (a) An insurance institution, agent or insurance support organization that
regularly collects, uses or discloses medical record information, as defined in subsection
(r) of section 38a-976, shall develop and implement written policies, standards and
procedures for the management, transfer and security of medical record information,
including policies, standards and procedures to guard against the unauthorized collection, use or disclosure of medical record information by the insurance institution, agent
or insurance support organization or any employee or agent thereof. Such policies, standards and procedures shall include:
(1) Limitation on access to medical record information by only those persons who
need to use the medical record information in order to perform their jobs;
(2) Appropriate training for all employees identified in subdivision (4) of this subsection;
(3) Disciplinary measures for violations of the medical record information policies,
standards and procedures;
(4) Identification of the job titles of persons that are authorized to use or disclose
medical record information;
(5) Procedures for authorizing and restricting the collection, use or disclosure of
medical record information;
(6) Methods for handling, disclosing, storing and disposing of medical record information;
(7) Periodic monitoring of the employees' compliance with the policies, standards
and procedures in a manner sufficient for the insurance institution, agent or insurance
support organization to determine compliance with this section and to enforce its policies, standards and procedures; and
(8) Additional protection against unauthorized disclosure of sensitive health information, which shall include information regarding: Sexually transmitted diseases; mental health; substance abuse; the human immunodeficiency virus and acquired immune
deficiency syndrome; and genetic testing, including the fact that an individual has undergone a genetic test.
(b) An insurance institution, agent or insurance support organization shall make the
medical record information policies, standards and procedures developed pursuant to
this section available for review by the Insurance Commissioner.
(c) A summary of such policies, standards and procedures shall be made available
to enrollees upon enrollment and upon request.
(P.A. 99-284, S. 25, 60.)
History: P.A. 99-284 effective July 1, 2000.
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Sec. 38a-999a. Disclosure of individually identifiable medical record information with malicious intent prohibited. Penalty. (a) No person shall disclose individually identifiable medical record information, as defined in subsection (r) of section 38a-976, with the malicious intent to damage an individual's reputation or character.
(b) Any person who violates subsection (a) of this section shall be fined not more
than five hundred dollars or imprisoned not more than three months or both for the first
offense and shall be fined not more than two thousand dollars or imprisoned not more
than one year or both for each subsequent offense.
(P.A. 99-284, S. 26, 60.)
History: P.A. 99-284 effective July 1, 2000.
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