44-7402. Terms, defined.

688 words·~3 min read·/ne/chapter-44/44-7402

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

For purposes of the Unfair Discrimination Against Subjects of Abuse in Insurance Act:

(1)Abuse means the occurrence of one or more of the following acts by a current or former family member or household member:

(a)(i) Attempting to cause or intentionally or knowingly causing another person, including a minor child, bodily injury, physical harm, rape, sexual assault, or involuntary sexual intercourse, or

(ii)attempting to cause or recklessly causing another person, including a minor child, bodily injury, physical harm, severe emotional distress, or psychological trauma so as to intimidate or attempt to control the behavior of another person, including a minor child;

(b)Knowingly engaging in a course of conduct or repeatedly committing acts toward another person, including a minor child, including following the person or minor child without proper authority, under circumstances that place the person or minor child in reasonable fear of bodily injury or physical harm;

(c)Subjecting another person, including a minor child, to false imprisonment; or

(d)Attempting to cause or intentionally, knowingly, or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another person, including a minor child;

(2)Abuse-related claim means a claim under a policy for a loss resulting from an act of abuse;

(3)Abuse-related medical condition means a medical condition sustained by a subject of abuse which arises in whole or in part out of an act or pattern of abuse;

(4)Abuse status means the fact or the perception on the part of the insurer that a person is, has been, or may be a subject of abuse, irrespective of whether the person has sustained abuse-related medical conditions or incurred abuse-related claims;

(5)Confidential abuse information means information about acts of abuse or abuse status of a subject of abuse, the address and home and work telephone number of a subject of abuse or the status of an applicant or insured as a family member, employer, or associate of, or a person in a relationship with, a subject of abuse;

(6)Director means the Director of Insurance;

(7)Health benefit plan or plan means a policy, contract, certificate, or agreement offered by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. Health benefit plan includes accident-only, credit accident and health, dental, vision, Medicare supplement, or long-term care insurance, coverage issued as a supplement to liability insurance, short-term and catastrophic health insurance policies, and a policy that pays on a cost-incurred basis. Health benefit plan does not include workers' compensation or similar insurance;

(8)Health carrier means an entity subject to the insurance laws and insurance rules and regulations of this state, or subject to the jurisdiction of the director, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a prepaid limited health service organization, or any other entity providing a plan of health insurance, health benefits, or health services;

(9)Insured means a party named on a policy as the person with legal rights to benefits provided by such policy, except that for life insurance, insured means the person whose life is covered under the policy. For group plans and group insurance, insured includes a covered person;

(10)Insurer means a person or other legal entity engaged in the business of insurance in this state, including agents, brokers, adjusters, and third-party administrators. Insurer includes a health carrier;

(11)Policy means a contract or certificate of insurance, annuity, or indemnity, including endorsements, riders, and binders, issued, proposed for issuance, or intended for issuance in this state by an insurer. Policy includes a health benefit plan; and

(12)Subject of abuse means a person against whom an act of abuse has been directed

(a)who has current or prior injuries, illnesses, or disorders that resulted from abuse or

(b)who seeks, may have sought, or had reason to seek

(i)medical or psychological treatment for abuse, or

(ii)protection, court-ordered protection, or shelter from abuse.