HR 4014
110th CONGRESS
1st Session
H. R. 4014
To prohibit discrimination in insurance coverage to victims of
domestic violence, dating violence, sexual assault, or stalking.
IN THE HOUSE OF REPRESENTATIVES
October 31, 2007
Ms. ROYBAL-ALLARD (for herself and Mr. POE) introduced the following
bill; which was referred to the Committee on Financial Services, and in
addition to the Committee on Energy and Commerce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To prohibit discrimination in insurance coverage to victims of
domestic violence, dating violence, sexual assault, or stalking.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Insurance Non-Discrimination for Survivors
Act'.
SEC. 2. 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).
(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.
SEC. 3. DEFINITIONS.
(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.
SEC. 4. 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.
(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.
SEC. 5. 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.
SEC. 6. 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.
SEC. 7. 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.
SEC. 8. SUBROGATION WITHOUT CONSENT PROHIBITED.
Subrogation of claims resulting from abuse is prohibited without the informed
consent of the subject of abuse.
SEC. 9. 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.
SEC. 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.
SEC. 11. EFFECTIVE DATE.
This Act shall apply with respect to any action taken on or after the
date of enactment of this Act.
END
