*Connecticut Unfair Insurance Practices Act cited; claims under act not barred by 1-year limit of Sec. 38a-307; decision of Appellate Court in 23 CA 814 reversed. 219 C. 644. Connecticut Unfair Insurance Practices Act cited. 226 C. 314; 229 C. 842; 231 C. 756; 238 C. 216; 239 C. 144; 240 C. 287; Id., 799.
Connecticut Unfair Insurance Practices Act cited; must allege properly the commission of the alleged wrongful acts “with such frequency as to indicate a general business practice”. 28 CA 660. Connecticut Unfair Insurance Practices Act cited. 38 CA 134; 44 CA 47.
Connecticut Unfair Insurance Practices Act cited. 44 CS 274.
Sec. 38a-815. (Formerly Sec. 38-60). Unfair practice prohibited.
Sec. 38a-816. (Formerly Sec. 38-61). Unfair practices defined.
Sec. 38a-818. (Formerly Sec. 38-63). Hearing on unfair practice not so defined. Injunction.
Sec. 38a-819. (Formerly Sec. 38-64). Powers to be additional. Regulations.
Secs. 38a-820 to 38a-823. Reserved
Sec. 38a-824. (Formerly Sec. 38-64a). Commissioner to adopt regulations prohibiting redlining.
Sec. 38a-826. (Formerly Sec. 38-55). Misrepresentation to induce change of insurance. Penalty.
Sec. 38a-827. (Formerly Sec. 38-93a). Fictitious grouping for insurance purposes prohibited.
Sec. 38a-827a. Discrimination on basis of lawful travel destination prohibited.
Sec. 38a-828. (Formerly Sec. 38-56). False statement of assets prohibited.
Sec. 38a-829. (Formerly Sec. 38-57). Advertisements to conform to last filed statement.
Sec. 38a-830. (Formerly Sec. 38-58). Penalty.
Sec. 38a-834. Discrimination against living organ donors prohibited.
Sec. 38a-835. Reserved
*Connecticut Unfair Insurance Practices Act cited. 41 CS 548.
Sec. 38a-815. (Formerly Sec. 38-60). Unfair practice prohibited. No person shall engage in this state in any trade practice which is defined in section 38a-816 as, or determined pursuant to sections 38a-817 and 38a-818 to be, an unfair method of competition or an unfair or deceptive act or practice in the business of insurance, nor shall any domestic insurance company engage outside of this state in any act or practice defined in subsections (1) to (12), inclusive, of section 38a-816. The commissioner shall have power to examine the affairs of every person engaged in the business of insurance in this state in order to determine whether such person has been or is engaged in any unfair method of competition or in any unfair or deceptive act or practice prohibited by sections 38a-815 to 38a-819, inclusive. When used in said sections, “person” means any individual, corporation, limited liability company, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society and any other legal entity engaged in the business of insurance, including producers and adjusters.
(1955, S. 2816d; P.A. 73-73, S. 1; P.A. 79-318, S. 2; P.A. 95-79, S. 149, 189; P.A. 96-193, S. 18, 36.)
History: P.A. 73-73 added revised reference to include Subsecs. (6) to (11) of Sec. 38-61; P.A. 79-318 revised reference to Sec. 38-61 to include Subsec. (2); Sec. 38-60 transferred to Sec. 38a-815 in 1991; P.A. 95-79 redefined “person” to include a limited liability company, effective May 31, 1995; P.A. 96-193 substituted “producer” for “agent” and “broker”, effective June 3, 1996.
Annotations to former section 38-60:
Cited. 186 C. 507. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 216 C. 830.
Cited. 9 CA 622; 13 CA 208.
Cited. 39 CS 206; 40 CS 299; Id., 336.
Annotations to present section:
Cited. 219 C. 644; 229 C. 842; 231 C. 756; 239 C. 658. A common-law breach of fiduciary duty arising in the insurance context that does not violate CUIPA or some other statute regulating the insurance industry cannot provide the basis for a valid CUTPA claim; legislative intent in passing CUIPA was to occupy the field with regard to unfair trade practices in the insurance industry. 310 C. 1.
Cited. 45 CA 368.
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Sec. 38a-816. (Formerly Sec. 38-61). Unfair practices defined. The following are defined as unfair methods of competition and unfair and deceptive acts or practices in the business of insurance:
(1) Misrepresentations and false advertising of insurance policies. Making, issuing or circulating, or causing to be made, issued or circulated, any estimate, illustration, circular or statement, sales presentation, omission or comparison which: (A) Misrepresents the benefits, advantages, conditions or terms of any insurance policy; (B) misrepresents the dividends or share of the surplus to be received, on any insurance policy; (C) makes any false or misleading statements as to the dividends or share of surplus previously paid on any insurance policy; (D) is misleading or is a misrepresentation as to the financial condition of any person, or as to the legal reserve system upon which any life insurer operates; (E) uses any name or title of any insurance policy or class of insurance policies misrepresenting the true nature thereof; (F) is a misrepresentation, including, but not limited to, an intentional misquote of a premium rate, for the purpose of inducing or tending to induce to the purchase, lapse, forfeiture, exchange, conversion or surrender of any insurance policy; (G) is a misrepresentation for the purpose of effecting a pledge or assignment of or effecting a loan against any insurance policy; or (H) misrepresents any insurance policy as being shares of stock.
(2) False information and advertising generally. Making, publishing, disseminating, circulating or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated or placed before the public, in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, an advertisement, announcement or statement containing any assertion, representation or statement with respect to the business of insurance or with respect to any person in the conduct of his insurance business, which is untrue, deceptive or misleading.
(3) Defamation. Making, publishing, disseminating or circulating, directly or indirectly, or aiding, abetting or encouraging the making, publishing, disseminating or circulating of, any oral or written statement or any pamphlet, circular, article or literature which is false or maliciously critical of or derogatory to the financial condition of an insurer, and which is calculated to injure any person engaged in the business of insurance.
(4) Boycott, coercion and intimidation. Entering into any agreement to commit, or by any concerted action committing, any act of boycott, coercion or intimidation resulting in or tending to result in unreasonable restraint of, or monopoly in, the business of insurance.
(5) False financial statements. Filing with any supervisory or other public official, or making, publishing, disseminating, circulating or delivering to any person, or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated or delivered to any person, or placed before the public, any false statement of financial condition of an insurer with intent to deceive; or making any false entry in any book, report or statement of any insurer with intent to deceive any agent or examiner lawfully appointed to examine into its condition or into any of its affairs, or any public official to whom such insurer is required by law to report, or who has authority by law to examine into its condition or into any of its affairs, or, with like intent, wilfully omitting to make a true entry of any material fact pertaining to the business of such insurer in any book, report or statement of such insurer.
(6) Unfair claim settlement practices. Committing or performing with such frequency as to indicate a general business practice any of the following: (A) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (B) failing to acknowledge and act with reasonable promptness upon communications with respect to claims arising under insurance policies; (C) failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; (D) refusing to pay claims without conducting a reasonable investigation based upon all available information; (E) failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; (F) not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear; (G) compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds; (H) attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application; (I) attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of the insured; (J) making claims payments to insureds or beneficiaries not accompanied by statements setting forth the coverage under which the payments are being made; (K) making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration; (L) delaying the investigation or payment of claims by requiring an insured, claimant, or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; (M) failing to promptly settle claims, where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; (N) failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; (O) using as a basis for cash settlement with a first party automobile insurance claimant an amount which is less than the amount which the insurer would pay if repairs were made unless such amount is agreed to by the insured or provided for by the insurance policy.
(7) Failure to maintain complaint handling procedures. Failure of any person to maintain complete record of all the complaints which it has received since the date of its last examination. This record shall indicate the total number of complaints, their classification by line of insurance, the nature of each complaint, the disposition of these complaints, and the time it took to process each complaint. For purposes of this subdivision “complaint” means any written communication primarily expressing a grievance.
(8) Misrepresentation in insurance applications. Making false or fraudulent statements or representations on or relative to an application for an insurance policy for the purpose of obtaining a fee, commission, money or other benefit from any insurer, producer or individual.
(9) Any violation of any one of sections 38a-358, 38a-446, 38a-447, 38a-488, 38a-825, 38a-826, 38a-828 and 38a-829. None of the following practices shall be considered discrimination within the meaning of section 38a-446 or 38a-488 or a rebate within the meaning of section 38a-825: (A) Paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, provided any such bonuses or abatement of premiums shall be fair and equitable to policyholders and for the best interests of the company and its policyholders; (B) in the case of policies issued on the industrial debit plan, making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer in an amount which fairly represents the saving in collection expense; (C) readjustment of the rate of premium for a group insurance policy based on loss or expense experience, or both, at the end of the first or any subsequent policy year, which may be made retroactive for such policy year.
(10) Notwithstanding any provision of any policy of insurance, certificate or service contract, whenever such insurance policy or certificate or service contract provides for reimbursement for any services which may be legally performed by any practitioner of the healing arts licensed to practice in this state, reimbursement under such insurance policy, certificate or service contract shall not be denied because of race, color or creed nor shall any insurer make or permit any unfair discrimination against particular individuals or persons so licensed.
(11) Favored agent or insurer: Coercion of debtors. (A) No person may (i) require, as a condition precedent to the lending of money or extension of credit, or any renewal thereof, that the person to whom such money or credit is extended or whose obligation the creditor is to acquire or finance, negotiate any policy or contract of insurance through a particular insurer or group of insurers or producer or group of producers; (ii) unreasonably disapprove the insurance policy provided by a borrower for the protection of the property securing the credit or lien; (iii) require directly or indirectly that any borrower, mortgagor, purchaser, insurer or producer pay a separate charge, in connection with the handling of any insurance policy required as security for a loan on real estate or pay a separate charge to substitute the insurance policy of one insurer for that of another; or (iv) use or disclose information resulting from a requirement that a borrower, mortgagor or purchaser furnish insurance of any kind on real property being conveyed or used as collateral security to a loan, when such information is to the advantage of the mortgagee, vendor or lender, or is to the detriment of the borrower, mortgagor, purchaser, insurer or the producer complying with such a requirement.
(B) (i) Subparagraph (A)(iii) of this subdivision shall not include the interest which may be charged on premium loans or premium advancements in accordance with the security instrument. (ii) For purposes of subparagraph (A)(ii) of this subdivision, such disapproval shall be deemed unreasonable if it is not based solely on reasonable standards uniformly applied, relating to the extent of coverage required and the financial soundness and the services of an insurer. Such standards shall not discriminate against any particular type of insurer, nor shall such standards call for the disapproval of an insurance policy because such policy contains coverage in addition to that required. (iii) The commissioner may investigate the affairs of any person to whom this subdivision applies to determine whether such person has violated this subdivision. If a violation of this subdivision is found, the person in violation shall be subject to the same procedures and penalties as are applicable to other provisions of section 38a-815, subsections (b) and (e) of section 38a-817 and this section. (iv) For purposes of this section, “person” includes any individual, corporation, limited liability company, association, partnership or other legal entity.
(12) Refusing to insure, refusing to continue to insure or limiting the amount, extent or kind of coverage available to an individual or charging an individual a different rate for the same coverage because of physical disability, mental or nervous condition as set forth in section 38a-488a or intellectual disability, except where the refusal, limitation or rate differential is based on sound actuarial principles or is related to actual or reasonably anticipated experience.
(13) Refusing to insure, refusing to continue to insure or limiting the amount, extent or kind of coverage available to an individual or charging an individual a different rate for the same coverage solely because of blindness or partial blindness. For purposes of this subdivision, “refusal to insure” includes the denial by an insurer of disability insurance coverage on the grounds that the policy defines “disability” as being presumed in the event that the insured is blind or partially blind, except that an insurer may exclude from coverage any disability, consisting solely of blindness or partial blindness, when such condition existed at the time the policy was issued. Any individual who is blind or partially blind shall be subject to the same standards of sound actuarial principles or actual or reasonably anticipated experience as are sighted persons with respect to all other conditions, including the underlying cause of the blindness or partial blindness.
(14) Refusing to insure, refusing to continue to insure or limiting the amount, extent or kind of coverage available to an individual or charging an individual a different rate for the same coverage because of exposure to diethylstilbestrol through the female parent.
(15) (A) Failure by an insurer, or any other entity responsible for providing payment to a health care provider pursuant to an insurance policy, to pay accident and health claims, including, but not limited to, claims for payment or reimbursement to health care providers, within the time periods set forth in subparagraph (B) of this subdivision, unless the Insurance Commissioner determines that a legitimate dispute exists as to coverage, liability or damages or that the claimant has fraudulently caused or contributed to the loss. Any insurer, or any other entity responsible for providing payment to a health care provider pursuant to an insurance policy, who fails to pay such a claim or request within the time periods set forth in subparagraph (B) of this subdivision shall pay the claimant or health care provider the amount of such claim plus interest at the rate of fifteen per cent per annum, in addition to any other penalties which may be imposed pursuant to sections 38a-11, 38a-25, 38a-41 to 38a-53, inclusive, 38a-57 to 38a-60, inclusive, 38a-62 to 38a-64, inclusive, 38a-76, 38a-83, 38a-84, 38a-117 to 38a-124, inclusive, 38a-129 to 38a-140, inclusive, 38a-146 to 38a-155, inclusive, 38a-283, 38a-288 to 38a-290, inclusive, 38a-319, 38a-320, 38a-459, 38a-464, 38a-815 to 38a-819, inclusive, 38a-824 to 38a-826, inclusive, and 38a-828 to 38a-830, inclusive. Whenever the interest due a claimant or health care provider pursuant to this section is less than one dollar, the insurer shall deposit such amount in a separate interest-bearing account in which all such amounts shall be deposited. At the end of each calendar year each such insurer shall donate such amount to The University of Connecticut Health Center.
(B) Each insurer or other entity responsible for providing payment to a health care provider pursuant to an insurance policy subject to this section, shall pay claims not later than:
(i) For claims filed in paper format, sixty days after receipt by the insurer of the claimant's proof of loss form or the health care provider's request for payment filed in accordance with the insurer's practices or procedures, except that when there is a deficiency in the information needed for processing a claim, as determined in accordance with section 38a-477, the insurer shall (I) send written notice to the claimant or health care provider, as the case may be, of all alleged deficiencies in information needed for processing a claim not later than thirty days after the insurer receives a claim for payment or reimbursement under the contract, and (II) pay claims for payment or reimbursement under the contract not later than thirty days after the insurer receives the information requested; and
(ii) For claims filed in electronic format, twenty days after receipt by the insurer of the claimant's proof of loss form or the health care provider's request for payment filed in accordance with the insurer's practices or procedures, except that when there is a deficiency in the information needed for processing a claim, as determined in accordance with section 38a-477, the insurer shall (I) notify the claimant or health care provider, as the case may be, of all alleged deficiencies in information needed for processing a claim not later than ten days after the insurer receives a claim for payment or reimbursement under the contract, and (II) pay claims for payment or reimbursement under the contract not later than ten days after the insurer receives the information requested.
(C) As used in this subdivision, “health care provider” means a person licensed to provide health care services under chapter 368d, chapter 368v, chapters 370 to 373, inclusive, 375 to 383c, inclusive, 384a to 384c, inclusive, or chapter 400j.
(16) Failure to pay, as part of any claim for a damaged motor vehicle under any automobile insurance policy where the vehicle has been declared to be a constructive total loss, an amount equal to the sum of (A) the settlement amount on such vehicle plus, whenever the insurer takes title to such vehicle, (B) an amount determined by multiplying such settlement amount by a percentage equivalent to the current sales tax rate established in section 12-408. For purposes of this subdivision, “constructive total loss” means the cost to repair or salvage damaged property, or the cost to both repair and salvage such property, equals or exceeds the total value of the property at the time of the loss.
(17) Any violation of section 42-260, by an extended warranty provider subject to the provisions of said section, including, but not limited to: (A) Failure to include all statements required in subsections (c) and (f) of section 42-260 in an issued extended warranty; (B) offering an extended warranty without being (i) insured under an adequate extended warranty reimbursement insurance policy or (ii) able to demonstrate that reserves for claims contained in the provider's financial statements are not in excess of one-half the provider's audited net worth; (C) failure to submit a copy of an issued extended warranty form or a copy of such provider's extended warranty reimbursement policy form to the Insurance Commissioner.
(18) With respect to an insurance company, hospital service corporation, health care center or fraternal benefit society providing individual or group health insurance coverage of the types specified in subdivisions (1), (2), (4), (5), (6), (10), (11) and (12) of section 38a-469, refusing to insure, refusing to continue to insure or limiting the amount, extent or kind of coverage available to an individual or charging an individual a different rate for the same coverage because such individual has been a victim of domestic violence, as defined in section 17b-112a.
(19) With respect to a property and casualty insurer delivering, issuing for delivery, renewing, amending, continuing or endorsing a property or casualty insurance policy, making any distinction or discrimination against an individual in delivering, issuing for delivery, renewing, amending, continuing, endorsing, offering, withholding, cancelling or setting premiums for such policy, or in the terms of such policy, because the individual has been a victim of domestic violence, as defined in section 17b-112a.
(20) With respect to an insurance company, hospital service corporation, health care center or fraternal benefit society providing individual or group health insurance coverage of the types specified in subdivisions (1), (2), (3), (4), (6), (9), (10), (11) and (12) of section 38a-469, refusing to insure, refusing to continue to insure or limiting the amount, extent or kind of coverage available to an individual or charging an individual a different rate for the same coverage because of genetic information. Genetic information indicating a predisposition to a disease or condition shall not be deemed a preexisting condition in the absence of a diagnosis of such disease or condition that is based on other medical information. An insurance company, hospital service corporation, health care center or fraternal benefit society providing individual health coverage of the types specified in subdivisions (1), (2), (3), (4), (6), (9), (10), (11) and (12) of section 38a-469, shall not be prohibited from refusing to insure or applying a preexisting condition limitation, to the extent permitted by law, to an individual who has been diagnosed with a disease or condition based on medical information other than genetic information and has exhibited symptoms of such disease or condition. For the purposes of this subdivision, “genetic information” means the information about genes, gene products or inherited characteristics that may derive from an individual or family member.
(21) Any violation of sections 38a-465 to 38a-465q, inclusive.
(22) With respect to a managed care organization, as defined in section 38a-478, failing to establish a confidentiality procedure for medical record information, as required by section 38a-999.
(23) Any violation of sections 38a-591d to 38a-591f, inclusive.
(24) Any violation of section 38a-472j.
(25) Any violation of section 38a-833.
(26) Any violation of section 38a-834.
(1955, S. 2817d; 1967, P.A. 852, S. 1; 1969, P.A. 651, S. 1; P.A. 73-73, S. 2; P.A. 79-310; 79-318, S. 1; P.A. 80-259, S. 1; P.A. 82-353, S. 17; P.A. 84-189; P.A. 86-70; 86-407; P.A. 87-16; P.A. 89-250; P.A. 90-121; P.A. 91-17; P.A. 94-86, S. 2; P.A. 95-79, S. 150, 189; 95-193, S. 3; P.A. 96-193, S. 19, 20, 36; P.A. 97-95; 97-126, S. 3; 97-202, S. 13, 18; P.A. 98-27, S. 10, 11; 98-163, S. 3, 4; 98-214, S. 30; P.A. 99-59, S. 2; 99-284, S. 30, 32, 60; P.A. 01-111; June Sp. Sess. P.A. 01-4, S. 43; P.A. 03-57, S. 1; P.A. 05-61, S. 2; 05-97, S. 2; 05-140, S. 1; P.A. 08-175, S. 21; 08-178, S. 50; P.A. 11-58, S. 15, 85; 11-163, S. 1; P.A. 12-145, S. 36–39; P.A. 13-139, S. 35; P.A. 14-122, S. 172; P.A. 19-117, S. 237; P.A. 21-93, S. 1; 21-137, S. 3, 21-156, S. 3.)
History: 1967 act added Subdiv. (7); 1969 act substituted “practitioner of the healing arts licensed to practice in this state” for “person licensed under the provisions of chapter 372” in Subdiv. (7); P.A. 73-73 substituted “insurance policies” for “policy contracts” and restated provisions re misrepresentation of policy terms in Subdiv. (1), inserted new Subdivs. (6) to (8), renumbering former Subdivs. (6) and (7) accordingly, and added Subdiv. (11); P.A. 79-310 added Subdiv. (12); P.A. 79-318 added Subdiv. (6)(o); P.A. 80-259 included refusal to insure because of physical disability or mental retardation in Subdiv. (12); P.A. 82-353 provided that the declination, cancellation or nonrenewal of a private passenger nonfleet auto insurance policy for one or more of the reasons specified in Sec. 38-175w is an unfair insurance practice; P.A. 84-189 added Subdiv. (13), providing that the denial of insurance based on the individual's exposure to diethylstilbestrol is an unfair practice; P.A. 86-70 inserted as Subdiv. (13) prohibition against refusing to insure or otherwise discriminating against an individual due to his blindness or partial blindness, and renumbered the prior Subdiv. (13) concerning exposure to diethylstilbestrol as Subdiv. (14); P.A. 86-407 added new Subdiv. (15) defining as an unfair practice the failure of an insurer to pay accident and health claims within 45 days of receipt by the insurer of proof of loss, with certain exceptions; P.A. 87-16 added Subdiv. (16) defining as an unfair practice the failure to include in the settlement on a totalled motor vehicle an amount equal to what the sales tax would be on the settlement; P.A. 89-250 amended Subdiv. (15) to require that insurers report the percentage of health and accident insurance claims paid more than 45 days after receipt of proof of loss and the total amount of interest paid on such claims; P.A. 90-121 amended Subdiv. (15) to increase the interest rate from 12% to 15% for the failure of an insurer to pay accident and health claims within 45 days of receipt by the insurer of proof of loss and to provide that if interest due a claimant is $1 or less, the insurer shall deposit that amount in a separate interest-bearing account and at the end of each calendar year the funds shall be divided in half and donated to The University of Connecticut Health Center and Uncas-on-Thames Hospital; Sec. 38-61 transferred to Sec. 38a-816 in 1991; P.A. 91-17 amended Subdiv. (15) to delete the requirement that insurers report to the insurance commissioner the total amount of interest paid on health and accident claims paid more than 45 days after the receipt of proof of loss; in 1993 a reference to Sec. 38a-140 was inserted editorially in Subdiv. (15) to replace reference to Sec. 38a-141 which was repealed by P.A. 92-112; P.A. 94-86 added Subdiv. (17) re extended warranty providers. (Revisor's note: A reference in Subdiv. (15) to Sec. 38a-79 was deleted editorially by the Revisors, that section having been repealed by P.A. 94-39); P.A. 95-79 amended Subdiv. (11) to redefine “person” to include a limited liability company, effective May 31, 1995; P.A. 95-193 added Subdiv. (18) re prohibition against refusing to insure victim of family violence; P.A. 96-193 substituted “producer” for “agent” and “broker” in Subdivs. (8) and (11), effective June 3, 1996 (Revisor's note: In 1997 in Subdiv. (8) the phrase “... benefit from any insurers ...” was changed editorially by the Revisors to “ ... benefit from any insurer ...” for consistency, and in Subdiv. (11)(a)(iii) the word “or” was substituted for the comma before “producer” in the phrase “... borrower, mortgagor, purchaser, insurer, producer pay a separate ...”); P.A. 97-95 added Subdiv. (19) re use of genetic information for health insurance; P.A. 97-126 amended Subdiv. (18) by adding reference to Sec. 38a-469(10); P.A. 97-202 added new Subdiv. (20) re violations of viatical settlement provisions, effective January 1, 1998; P.A. 98-27 amended Subdivs. (8) and (11) to make technical changes; P.A. 98-163 amended Subdiv. (15) by adding failure to pay claims to health care providers and deleted one-half donation to the Uncas-on-Thames Hospital, effective January 1, 1999, and applicable to contracts entered into or renewed after that date; P.A. 98-214 amended Subdiv. (15) to delete reference to Sec. 38a-65; P.A. 99-59 amended Subdiv. (15) to substitute “38a-830” for “38a-831”; P.A. 99-284 amended Subdiv. (15) re accident and health claims to designate existing provisions as Subpara. (A) and to substitute “within the time periods set forth in subparagraph (B) of this subdivision” for “within forty-five days, or as otherwise stipulated by contract, of receipt by an insurer of the claimant's proof of loss ...” and “with the forty-five-day period” and to add new Subpara. (B) re time period for paying claims and extensions for alleged deficiencies in information needed for processing and, effective July 1, 2000, added new Subdiv. (21) re failure to establish a confidentiality procedure for medical record information; P.A. 01-111 added Subdiv. (15)(C) defining health care provider; June Sp. Sess. P.A. 01-4 amended Subdiv. (15) by adding provisions in Subparas. (A) and (B) re other entity responsible for providing payment to a health care provider pursuant to an insurance policy; P.A. 03-57 amended Subdiv. (15)(B) to add “as determined in accordance with section 38a-477”; P.A. 05-61 amended Subdiv. (1)(f) to include “an intentional misquote of a premium rate” and to reference purpose of inducing the “purchase” of any insurance policy; P.A. 05-97 added new Subdiv. (22) re violation of Sec. 38a-478m; P.A. 05-140 amended Subdiv. (20) to delete “subsection (a) of section 38a-11 and”; P.A. 08-175 amended Subdiv. (20) by substituting “38a-465q” for “38a-465m”; P.A. 08-178 added cite to Ch. 368d in Subdiv. (15)(C); P.A. 11-58 amended Subdiv. (22) to replace reference to Sec. 38a-478m with “sections 38a-591d to 38a-591f, inclusive”, effective July 1, 2011, and amended Subdiv. (15)(B) by designating existing provision re payment schedule as clause (i) and amending same to change time period for payment to be provided to providers from 45 days to 60 days for claims filed in paper format and by adding clause (ii) re 20-day time period for payment of claims filed in electronic format, effective January 1, 2012; P.A. 11-163 amended Subdiv. (12) to add “mental or nervous condition as set forth in section 38a-488a”; P.A. 12-145 made technical changes in Subdivs. (1), (6), (9) and (11), effective June 15, 2012; P.A. 13-139 amended Subdiv. (12) by substituting “intellectual disability” for “mental retardation”; P.A. 14-122 made a technical change in Subdiv. (7); P.A. 19-117 added Subdiv. (23) re violation of Sec. 38a-472j, effective January 1, 2020; P.A. 21-93 amended Subdiv. (7) by substituting “subdivision” for “subsection”, amended Subdiv. (18) by adding reference to Sec. 38a-469(5) and substituting “victim of domestic violence, as defined in section 17b-112a” for “victim of family violence”, added new Subdiv. (19) re property and casualty insurers and policies for victims of domestic violence, redesignated existing Subdiv. (19) as Subdiv. (20) and amended same by substituting “subdivision” for “subsection” and redesignated existing Subdivs. (20) to (23) as Subdivs. (21) to (24); P.A. 21-137 added Subdiv. (24) re violation of Sec. 38a-833, codified by the Revisors as Subdiv. (25); P.A. 21-156 added Subdiv. (24) re violation of Sec. 38a-834, codified by the Revisors as Subdiv. (26), effective January 1, 2022.
Annotations to former section 38-61:
Cited. 186 C. 507; 192 C. 124. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 212 C. 652; 216 C. 830; 225 C. 566.
Cited. 13 CA 208; 23 CA 585.
Cited. 40 CS 299; Id., 336.
Annotations to present section:
Cited. 219 C. 644; 229 C. 842; 231 C. 756; 238 C. 216; 239 C. 658.
Cited. 28 CA 660; 45 CA 368.
Subdiv. (1):
Trial court properly determined that plaintiff failed to allege facts sufficient to state a cause of action under CUIPA, which prohibits, inter alia, misrepresentations in insurance policies; although plaintiff alleged in complaint that certificate of liability insurance concerning home improvement contractor's coverage under an insurance policy issued by defendant insurance liability carrier was deceptive insofar as it would lead a reasonable person to believe that the contractor had secured insurance coverage for a full year, such an allegation was in direct conflict with certificate language, which repeatedly distinguished between policy expiration and cancellation. 280 C. 619.
Subdiv. (6):
Right to assert a private cause of action for CUIPA violations through CUTPA does not extend to third parties absent subrogation or a judicial determination of insured's liability. 94 CA 41.
Subdiv. (10):
“Practitioner of the healing arts” is defined pursuant to Sec. 20-1 and includes podiatrists; insurer's practice of reimbursing podiatrists and medical doctors at different rates for same services does not constitute “unfair discrimination”; Subdiv. bars denial of reimbursement based on particular license held, but does not preclude setting different reimbursement rates based on particular license held. 302 C. 464.
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Sec. 38a-817. (Formerly Sec. 38-62). Hearings. Subpoenas. Violations. Penalties. Restitution orders. Appeals. (a) Whenever the commissioner has reason to believe that any such person has been engaged or is engaging in violation of sections 38a-815 to 38a-819, inclusive, in any unfair method of competition or any unfair or deceptive act or practice defined in section 38a-816, and that a proceeding by the commissioner in respect thereto would be in the interest of the public, the commissioner shall issue and serve upon such person a statement of the charges in that respect and a notice of a hearing thereon to be held at a time and place fixed in the notice, which shall not be less than thirty days after the date of the service thereof. At the time and place fixed for such hearing, such person shall have an opportunity to be heard and to show cause why an order should not be made by the commissioner requiring such person to cease and desist from the acts, methods or practices so complained of. Upon good cause shown, the commissioner shall permit any person to intervene, appear and be heard at such hearing by counsel or in person. The commissioner, upon such hearing, may administer oaths, examine and cross-examine witnesses and receive oral and documentary evidence, and 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 inquiry. If any person refuses to comply with any subpoena issued hereunder or to testify with respect to any matter concerning which the person may be lawfully interrogated, the superior court for the judicial district of New Britain or the superior court for the judicial district where such person resides may, on application of the commissioner, issue an order requiring such person to comply with such subpoena and to testify. Any failure to obey any such order of the court may be punished by the court as a contempt thereof. Statements of charges, notices, orders and other processes of the commissioner under sections 38a-815 to 38a-819, inclusive, may be served in the manner provided by law for service of process in civil actions.
(b) If, after such hearing, the commissioner determines that the person charged has engaged in an unfair method of competition or an unfair or deceptive act or practice, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the person charged with the violation a copy of such findings and an order requiring such person to cease and desist from engaging in such method of competition, act or practice and if the act or practice is a violation of section 38a-816, the commissioner may order any of the following: (1) Payment of a monetary penalty of not more than five thousand dollars for each act or violation but not to exceed an aggregate penalty of fifty thousand dollars unless the person knew or reasonably should have known that the person was in violation of sections 38a-815 and 38a-816, this subsection and subsection (e) of this section, in which case the penalty shall be not more than twenty-five thousand dollars for each act or violation but not to exceed an aggregate penalty of two hundred fifty thousand dollars in any six-month period; (2) suspension or revocation of the person's license if the person knew or reasonably should have known the person was in violation of said sections and subsections; or (3) restitution of any sums shown to have been obtained in violation of any of the provisions of said sections or any regulation implementing the provisions of said sections.
(c) Any person aggrieved by any such order of the commissioner 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.
(d) No order of the commissioner under sections 38a-815 to 38a-819, inclusive, shall relieve or absolve any person affected by such order from any liability under any other laws of this state.
(e) Any person who violates a cease and desist order of the commissioner made pursuant to this section and while such order is in effect shall, after notice and hearing and upon order of the commissioner, be subject to any of the following: (1) A monetary penalty of not more than fifty thousand dollars for each act or violation; or (2) suspension or revocation of such person's license.
(1955, S. 2818d, 2820d; 1971, P.A. 179, S. 25; 870, S. 125; P.A. 73-73, S. 3, 4; P.A. 76-436, S. 630, 681; P.A. 77-603, S. 27, 125; P.A. 78-280, S. 5, 60, 127; P.A. 81-38; 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; P.A. 99-215, S. 24, 29; P.A. 00-126, S. 1, 2; P.A. 08-178, S. 39.)
History: 1971 acts specified that appeal should be made within 15 days of order causing grievance and to return day between 12 and 30 days after service rather than to “next” or “next but one return day” and, effective September 1, 1971, replaced superior court with court of common pleas, except that courts with cases pending retain jurisdiction unless pending matters deemed transferable; P.A. 73-73 made previous provisions of Subsec. (b) applicable where person has engaged in unfair competition or unfair or deceptive practice and added new provisions applicable to violation of Sec. 38-61 where previously same provisions applied in both cases and replaced previous provisions of Subsec. (e) which had imposed $55 fine for violation of cease and desist order or $500 maximum fine for wilful violation with new penalty provisions; P.A. 76-436 added reference to judicial districts in Subsec. (a) and replaced court of common pleas with superior court in Subsec. (c), effective July 1, 1978; P.A. 77-603 replaced previous detailed appeal provisions of Subsec. (c) with provision requiring that appeals be in accordance with Sec. 4-183 but retained venue in Hartford county; P.A. 78-280 deleted reference to counties in Subsec. (a) and replaced “Hartford county” with “judicial district of Hartford-New Britain” in Subsecs. (a) and (c); P.A. 81-38 made imposition of penalty in Subsec. (e) mandatory rather than optional, i.e. “at the discretion of the commissioner”; 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 effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993; Sec. 38-62 transferred to Sec. 38a-817 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 Subsecs. (a) and (c), effective June 29, 1999; P.A. 00-126 amended Subsec. (b) to add Subdiv. (3) re restitution orders, substitute numeric Subdiv. designators for alphabetic subclause designators and to make technical changes for purposes of gender neutrality and amended Subsec. (e) to substitute numeric designators for alphabetic designators; P.A. 08-178 made technical changes in Subsecs. (a), (b) and (e), amended Subsec. (b)(1) by increasing maximum penalty from $1,000 to $5,000 per violation and maximum aggregate penalty from $10,000 to $50,000, and for violations of which the person knew or reasonably should have known, increasing maximum fine from $5,000 to $25,000 per violation and maximum aggregate penalty in any 6-month period from $50,000 to $250,000, and amended Subsec. (e)(1) by increasing maximum penalty from $10,000 to $50,000 per violation.
Annotations to former section 38-62:
Cited. 186 C. 198. Plaintiffs not required to exhaust administrative remedies before taking action for monetary damages since commission is not authorized to determine or award damages to aggrieved person. Id., 507. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 207 C. 77; 216 C. 830.
Cited. 13 CA 208.
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Sec. 38a-818. (Formerly Sec. 38-63). Hearing on unfair practice not so defined. Injunction. Whenever the commissioner has reason to believe that any person engaged in the business of insurance is engaging in this state in any method of competition or in any act or practice in the conduct of such business which is not defined in section 38a-816, that such method of competition is unfair or that such act or practice is unfair or deceptive and that a proceeding by him in respect thereto would be to the interest of the public, he may issue and serve upon such person a statement of the charges in that respect and a notice of a hearing thereon to be held at a time and place fixed in the notice, which shall not be less than thirty days after the date of the service thereof. Each such hearing shall be conducted in the same manner as the hearings provided for in section 38a-817. The commissioner shall, after such hearing, make a report in writing in which he shall state his findings as to the facts, and he shall serve a copy thereof upon such person. If such report charges a violation of sections 38a-815 to 38a-819, inclusive, and if such method of competition, act or practice has not been discontinued, the commissioner may, through the Attorney General, at any time after ten days after the service of such report, cause a petition to be filed in the superior court for the judicial district wherein the person resides or has his principal place of business, to enjoin and restrain such person from engaging in such method, act or practice. The court shall have jurisdiction of the proceeding and shall have power to make and enter appropriate orders in connection therewith and to issue such writs as are ancillary to its jurisdiction or are necessary in its judgment to prevent injury to the public pendente lite. If the court finds that the method of competition complained of is unfair or that the act or practice complained of is unfair or deceptive, that the proceeding by the commissioner with respect thereto is to the interest of the public and that the findings of the commissioner are supported by the weight of the evidence, it shall issue its order enjoining and restraining the continuance of such method of competition, act or practice.
(1955, S. 2819d; P.A. 78-280, S. 2, 12.)
History: P.A. 78-280 replaced “county” with “judicial district”; Sec. 38-63 transferred to Sec. 38a-818 in 1991.
Annotations to former section 38-63:
Cited. 186 C. 507. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 207 C. 77; 215 C. 277; 216 C. 830.
Cited. 13 CA 208.
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Sec. 38a-819. (Formerly Sec. 38-64). Powers to be additional. Regulations. The powers vested in the commissioner by sections 38a-815 to 38a-819, inclusive, shall be additional to any other powers to enforce any penalties, fines or forfeitures authorized by law with respect to the methods, acts and practices declared to be unfair or deceptive, and the commissioner may issue regulations implementing the provisions of section 38a-816.
(1955, S. 2821d; 1957, P.A. 129, S. 1.)
History: Sec. 38-64 transferred to Sec. 38a-819 in 1991.
Annotations to former section 38-64:
Cited. 186 C. 507. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 207 C. 77; 216 C. 830.
Cited. 13 CA 208.
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Secs. 38a-820 to 38a-823. Reserved for future use.
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Sec. 38a-824. (Formerly Sec. 38-64a). Commissioner to adopt regulations prohibiting redlining. Not later than September 1, 1980, the Insurance Commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to ensure the availability of insurance on real property in the state by prohibiting unfair discrimination in the availability or sale of such insurance on the basis of location, age or disparity between replacement cost and market value of such property. Such regulations shall include, but not be limited to, a statement of those acts, practices or methods which are deemed to constitute such unfair discrimination.
(P.A. 80-424, S. 1, 2; 80-482, S. 345, 348.)
History: P.A. 80-482 abolished department of business regulation created by P.A. 77-614 and restored insurance division as independent department with insurance commissioner as its head; Sec. 38-64a transferred to Sec. 38a-824 in 1991.
Annotation to former section 38-64a:
Cited. 207 C. 77.
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Sec. 38a-825. (Formerly Sec. 38-59). Premium rebate or other special favor. Permissible benefits for value-added products or services. (a) For the purposes of this section, “customer” means an applicant, certificate holder, insured, potential insured or potential certificate holder.
(b) Except as provided in subsection (c) or (d) of this section:
(1) No insurance company doing business in this state, attorney, producer or any other person shall pay or allow, or offer to pay or allow, as inducement to insurance, any rebate of premium payable on the policy, or any special favor or advantage in the dividends or other benefits to accrue thereon, or any valuable consideration or inducement not specified in the policy of insurance; and
(2) No person shall:
(A) Receive or accept from any insurance company, attorney, producer or any other person, as inducement to insurance, any rebate of premium payable on the policy, or any special favor or advantage in the dividends or other benefits to accrue thereon, or any valuable consideration or inducement not specified in the policy of insurance; or
(B) Be excused from testifying or from producing any books, papers, contracts, agreements or documents, at the trial of any other person charged with the violation of any provision of this section or of section 38a-446, on the ground that such testimony or evidence may tend to incriminate such person, provided such person shall not be prosecuted for any act concerning which such person is compelled to so testify or produce documentary or other evidence unless such prosecution is for perjury committed in so testifying.
(c) (1) An insurance company doing business in this state, attorney, producer or any other person may offer or provide to a customer in this state, at no cost or a reduced cost, a value-added product or service that is not specified in the customer's insurance policy if:
(A) Such value-added product or service:
(i) Relates to the insurance coverage provided under the customer's insurance policy; and
(ii) Is primarily designed to:
(I) Provide loss mitigation or loss control;
(II) Reduce claim costs or claim settlement costs;
(III) Provide education about liability risks or risk of loss to persons or property;
(IV) Monitor or assess risk, identify sources of risk or develop strategies for eliminating or reducing risk;
(V) Enhance health;
(VI) Enhance financial wellness through items including, but not limited to, education and financial planning services;
(VII) Provide post-loss services;
(VIII) Incentivize behavioral changes to improve the health, or reduce the risk of death or disability, of a customer; or
(IX) Assist in the administration of employee or retiree benefit insurance coverage;
(B) The cost to the insurance company, attorney, producer or other person offering or providing such value-added product or service for the customer is, in the opinion of the commissioner, reasonable in comparison to the customer's premiums or insurance coverage;
(C) The insurance company, attorney, producer or other person offering or providing such value-added product or service ensures that the customer receives contact information to assist the customer with questions regarding such value-added product or service;
(D) Such value-added product or service is offered and provided in a manner that, in the opinion of the commissioner, is not unfairly discriminatory; and
(E) The availability of such value-added product or service is based on documented and objective criteria, which the insurance company, attorney, producer or other person offering or providing such value-added product or service shall maintain and produce to the commissioner upon the commissioner's request for said criteria.
(2) If an insurance company doing business in this state, attorney, producer or other person does not have sufficient evidence to demonstrate to the commissioner that a value-added product or service satisfies the criteria established in subparagraph (A) of subdivision (1) of this subsection, but believes, in good faith, that the value-added product or service satisfies said criteria, the insurance company, attorney, producer or other person may offer and provide such value-added product or service to customers in this state as part of a pilot or testing program for not more than one year, provided:
(A) Such value-added product or service is offered and provided to customers in a manner that, in the opinion of the commissioner, is not unfairly discriminatory; and
(B) Such insurance company, attorney, producer or other person:
(i) Provides advance notice to the commissioner, in a form and manner prescribed by the commissioner, that such insurance company, attorney, producer or other person intends to commence such pilot or testing program; and
(ii) Shall not commence such pilot or testing program if the commissioner notifies such insurance company, attorney, producer or other person, in a form and manner prescribed by the commissioner and not later than twenty-one days after the commissioner receives notice pursuant to subparagraph (B)(i) of this subdivision, that the commissioner has determined such insurance company, attorney, producer or other person shall not commence such pilot or testing program.
(d) An insurance company doing business in this state, attorney, producer or any other person may offer or give a noncash gift, item or service to or on behalf of a customer:
(1) In connection with the marketing, sale, purchase or retention of a contract of insurance, provided:
(A) The cost of the noncash gift, item or service does not exceed an amount that the commissioner, in the commissioner's discretion, deems reasonable per policy year per term;
(B) The offer is made in a manner that, in the commissioner's opinion, is not unfairly discriminatory; and
(C) The customer is not required to purchase, continue to purchase or renew an insurance policy in exchange for the noncash gift, item or service; or
(2) To a commercial or institutional customer in connection with the marketing, purchase or retention of a contract of insurance, provided:
(A) The cost of the noncash gift, item or service is, in the commissioner's opinion, reasonable in comparison to the premium or proposed premium of the contract of insurance;
(B) The cost of the noncash gift, item or service is not included in any amount charged to another person;
(C) The offer is made in a manner that, in the commissioner's opinion, is not unfairly discriminatory; and
(D) The customer is not required to purchase, continue to purchase or renew an insurance policy in exchange for the noncash gift, item or service.
(e) No insurance company doing business in this state, attorney, producer or any other person, shall:
(1) Offer or provide insurance as an inducement to purchase another policy; or
(2) Use the word “free”, the phrase “no cost” or any word or phrase of similar import in any advertisement.
(f) The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to carry out the purposes of this section.
(1949 Rev., S. 6083; P.A. 96-193, S. 21, 36; P.A. 22-106, S. 1.)
History: Sec. 38-59 transferred to Sec. 38a-825 in 1991; P.A. 96-193 substituted “producer” for “agent, subagent or broker”, effective June 3, 1996; P.A. 22-106 added Subsec. (a) to define “customer”, added Subsec. (b), designated existing provisions as Subdivs. (1), (2)(A) and (2)(B) and made technical and conforming changes in same, added Subsec. (c) re criteria for acceptable value-added products or services and pilot or testing program, added Subsec. (d) re criteria for acceptable noncash gifts, items or services, added Subsec. (e) re prohibition of offer or issuance of insurance as inducement to purchase another policy and prohibition of the word “free”, “no cost” or other similar phrase in advertisements and added Subsec. (f) re the commissioner may adopt regulations to carry out the provisions of this section.
See Sec. 38a-816 re unfair practices.
Annotation to former section 38-59:
Claim that act which permitted filing of rating plan in which individual insurer's judgment as to expense provisions or hazards of a particular risk may reflect cost of providing coverage and, in turn, the amount of the premium, amounts to rebating, held invalid. 153 C. 465, 477.
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Sec. 38a-826. (Formerly Sec. 38-55). Misrepresentation to induce change of insurance. Penalty. No insurance company, producer or any other person, copartnership or corporation shall make or issue, or cause to be made or issued, any written or oral statements, misrepresenting or making incomplete comparisons regarding the terms or conditions or benefits contained in any policy or contract of insurance, legally issued by any insurance company licensed to transact business in this state, for the purpose of inducing or attempting to induce the owner of such policy or contract of insurance to forfeit or surrender such policy or contract of insurance or allow it to lapse for the purpose of replacing such policy or contract of insurance with another. Any person who violates any provision of this section shall be fined not more than five thousand dollars or imprisoned not more than thirty days, or both.
(1949 Rev., S. 6079; P.A. 96-193, S. 22, 36; P.A. 08-178, S. 40.)
History: Sec. 38-55 transferred to Sec. 38a-826 in 1991; P.A. 96-193 substituted “producer” for “agent or broker”, effective June 3, 1996; P.A. 08-178 increased maximum fine from $500 to $5,000 and made a technical change.
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Sec. 38a-827. (Formerly Sec. 38-93a). Fictitious grouping for insurance purposes prohibited. (a) As used in this section, a fictitious grouping means a grouping for rating purposes whereby a differentiation in rate is based solely upon membership in the group, but does not include a grouping where a common majority ownership is present, where those grouped are engaged in a joint venture or a common construction or demolition project or where there is a valid insurable interest on the part of the group.
(b) No insurance company authorized to do business in this state may offer any organization, association or group of individuals privileged rate or premium on property, casualty or surety insurance which is based on a fictitious grouping of members of such organization or association or of such individuals; and no person engaged in the business of insurance shall pay or allow dividends to such a group other than that offered to persons or risks not in such group and the public generally.
(c) A fictitious group to which a contract of property, casualty or surety insurance is issued shall not include a Connecticut resident; and no person engaged in the business of insurance may solicit a Connecticut resident or group of Connecticut residents for the purchase of property, casualty or surety insurance to be issued to a fictitious group at a privileged rate or premium.
(d) This section shall not apply to life or accident and health insurance.
(1967, P.A. 476; P.A. 90-243, S. 47.)
History: P.A. 90-243 divided section into Subsecs. and substituted “may” for “shall” and “property” for “fire” insurance; Sec. 38-93a transferred to Sec. 38a-827 in 1991.
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Sec. 38a-827a. Discrimination on basis of lawful travel destination prohibited. No life insurance company doing business in this state may deny or refuse to accept an application for life insurance, refuse to renew, cancel, restrict or otherwise terminate a policy of life insurance, or make any distinction or discrimination between persons as to the premiums or rates charged for policies of life insurance, on the basis of any past or future lawful travel destination of the applicant or insured, except that such company may deny such application or charge a different premium or rate for coverage under such policy based on a specific lawful travel destination where the denial or rate differential is based on sound actuarial principles or is related to actual or reasonably anticipated experience.
(P.A. 06-5, S. 1.)
History: P.A. 06-5 effective April 21, 2006.
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Sec. 38a-828. (Formerly Sec. 38-56). False statement of assets prohibited. No insurance company or health care center authorized to transact business in this state, nor any agent thereof, shall state or represent, either by advertisement in any newspaper, magazine or periodical or by any sign, circular, card or policy of insurance or contract or certificate of renewal thereof, or otherwise, any funds or assets to be in its possession not actually possessed by it and available for the payment of losses and claims and held for the protection of its policyholders, members or creditors. Any advertisement of or representation as to subscribed capital not actually paid up in cash shall constitute a violation of the provisions of this section.
(1949 Rev., S. 6080; P.A. 96-227, S. 12.)
History: Sec. 38-56 transferred to Sec. 38a-828 in 1991; P.A. 96-227 made the section applicable to health care centers.
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Sec. 38a-829. (Formerly Sec. 38-57). Advertisements to conform to last filed statement. Each advertisement or public announcement and each circular or card made or issued by any insurance company authorized to transact business in this state, which purports to make known the financial standing of any such company by a statement of its assets, shall, with equal conspicuousness, give its liabilities and a summary of operations computed on the basis allowed for its annual statement, and no such public announcement shall be made until such statement has been filed with the Insurance Department of this state, provided nothing herein shall prevent any such company from (a) sending to its shareholders printed statements of its condition as of December thirty-first next preceding or (b) sending to its shareholders or publishing financial statements prepared in accordance with generally accepted accounting principles on either the separate company or consolidated basis and, in the case only of its annual reports, certified by its public accountants, provided annual financial statements prepared on the basis allowed for its annual statement are made available to shareholders.
(1949 Rev., S. 6081; 1967, P.A. 325; 1971, P.A. 427; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 282, 345, 348.)
History: 1967 act required that advertisements, announcements, etc. give a summary of operations; 1971 act substituted “shareholders” for “stockholders” and added provisions re financial statements incorporated as Subdiv. (b); P.A. 77-614 placed insurance commissioner within the department of business regulation and made insurance department a division within that department, effective January 1, 1979; P.A. 80-482 restored insurance commissioner and division to prior independent status and abolished the department of business regulation; Sec. 38-57 transferred to Sec. 38a-829 in 1991.
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Sec. 38a-830. (Formerly Sec. 38-58). Penalty. Any person or corporation which violates any provision of section 38a-828 or 38a-829 shall, for the first offense, forfeit to the state ten thousand dollars and, for each subsequent offense, twenty thousand dollars.
(1949 Rev., S. 6082; P.A. 08-178, S. 41.)
History: Sec. 38-58 transferred to Sec. 38a-830 in 1991; P.A. 08-178 increased forfeitures from $500 to $10,000 for a first offense and from $1,000 to $20,000 for each subsequent offense.
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Sec. 38a-831. (Formerly Sec. 38-32a). Solicitation of insurance contracts from credit cardholders prohibited. Exception. Section 38a-831 is repealed, effective October 1, 1999.
(1967, P.A. 729; 1969, P.A. 669; P.A. 96-193, S. 23, 36; P.A. 99-59, S. 4.)
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Sec. 38a-832. Written or oral communication advising against retention of attorney in personal injury case prohibited. (a) No insurer licensed to transact business in this state may, on behalf of itself or its insured, send or knowingly permit to be sent any written communication or make any oral statement to any person known or believed to have a claim for bodily injury or wrongful death against one of its insureds that affirmatively advises against the need for or discourages the retention of an attorney to represent the interest of such person in prosecuting or settling such bodily injury or wrongful death claim.
(b) If any insurer or any employee of an insurer makes a written or oral communication in violation of subsection (a) of this section, the Insurance Commissioner, after reasonable notice and an opportunity for a hearing, may impose sanctions pursuant to this title, except sections 38a-815 to 38a-830, inclusive, including, but not limited to, the imposition of civil penalties.
(c) An insurer shall be deemed to be in compliance with subsection (a) of this section with respect to any written communication if the written communication in question has been approved, prior to its use, by the Insurance Commissioner who has determined that the proposed written communication does not violate said subsection (a).
(P.A. 97-58, S. 1, 5; P.A. 99-59, S. 3.)
History: P.A. 97-58, S. 1, effective January 1, 1998; P.A. 99-59 amended Subsec. (b) to substitute “38a-830” for “38a-831”.
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Sec. 38a-833. Nonconsensual acquisition or use of genetic information and required genetic testing prohibited. Exception. No insurer, health care center or fraternal benefit society doing business in this state shall:
(1) In connection with the issuance, withholding, extension or renewal of an annuity or an insurance policy for life, credit life, disability, long-term care, accidental injury, specified disease, hospital indemnity or credit accident insurance, request, require, purchase or use information obtained from an entity providing direct-to-consumer genetic testing without the informed written consent of the individual who has been tested; or
(2) Condition insurance rates, the provision or renewal of insurance coverage or benefit or other conditions of insurance for an individual on:
(A) Any requirement or agreement that the individual undergo genetic testing; or
(B) The results of any genetic testing of a member of the individual's family unless the results are contained in the individual's medical record.
(P.A. 21-137, S. 2.)
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Sec. 38a-834. Discrimination against living organ donors prohibited. (a) Notwithstanding any provision of the general statutes, no insurer delivering, issuing for delivery or amending a life insurance policy, long-term care insurance policy or a policy providing disability income protection coverage in this state on or after January 1, 2022, shall, for any such policy issued on or after said date:
(1) Decline to provide coverage, or limit the coverage provided, for an individual under such policy solely because the individual is a living organ donor;
(2) Preclude an individual from donating all or part of an organ as a condition to maintaining coverage under such policy; or
(3) Otherwise engage in discrimination in offering, issuing for delivery, amending or cancelling, or in setting the amount, price or conditions of, coverage for an individual under such policy solely because the individual is a living organ donor.
(b) Any violation of this section shall be deemed an unfair method of competition and unfair and deceptive act or practice in the business of insurance under section 38a-816.
(P.A. 21-156, S. 2.)
History: P.A. 21-156 effective January 1, 2022.
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Sec. 38a-835. Reserved for future use.
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