33-19-305. Previous adverse underwriting decisions. An insurance institution or insurance producer may not base an adverse underwriting decision in whole or in part:

Terms Used In Montana Code 33-19-305

  • Adverse underwriting decision: means any of the following actions with respect to insurance transactions involving insurance coverage that are individually underwritten:

    (i)a declination of insurance coverage;

    (ii)a termination of insurance coverage;

    (iii)failure of an insurance producer to apply for insurance coverage with a specific insurance institution that the insurance producer represents and that is requested by an applicant;

    (iv)in the case of a property or casualty insurance coverage:

    (A)placement by an insurance institution or insurance producer of a risk with a residual market mechanism, an unauthorized insurer, or an insurance institution that specializes in substandard risks; or

    (B)the charging of a higher rate on the basis of information that differs from that which the applicant or policyholder furnished;

    (v)in the case of a life, health, or disability insurance coverage, an offer to insure at higher than standard rates. See Montana Code 33-19-104

  • Individual: means a natural person who:

    (a)regarding property or casualty insurance, is a past, present, or proposed named insured or certificate holder;

    (b)regarding life, health, or disability insurance, is a past, present, or proposed principal insured or certificate holder;

    (c)is a past, present, or proposed policyowner;

    (d)is a past or present applicant;

    (e)is a past or present claimant; or

    (f)derived, derives, or is proposed to derive insurance coverage under an insurance policy or certificate subject to this chapter. See Montana Code 33-19-104

  • Insurance institution: means a corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society, or other person engaged in the business of insurance, including health maintenance organizations, and health service corporations as defined in 33-30-101. See Montana Code 33-19-104
  • Insurance producer: means an insurance producer as defined in 33-17-102 and 33-30-311. See Montana Code 33-19-104
  • Insurance-support organization: means a person who assembles or collects information about natural persons for the purpose of providing the information to an insurance institution or insurance producer for insurance transactions, including:

    (i)the furnishing of consumer reports or investigative consumer reports to an insurance institution or insurance producer for use in connection with an insurance transaction; or

    (ii)the collection of personal information from insurance institutions, insurance producers, 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. See Montana Code 33-19-104

  • 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. See Montana Code 33-19-104
  • Residual market mechanism: means an association, organization, or other entity defined or described in 61-6-144. See Montana Code 33-19-104

(1)on the fact of a previous adverse underwriting decision or on the fact that an individual previously obtained insurance coverage through a residual market mechanism, but an insurance institution or insurance producer may base an adverse underwriting decision on further information obtained from an insurance institution or insurance producer responsible for a previous adverse underwriting decision;

(2)on personal information received from an insurance-support organization whose primary source of information is insurance institutions, but an insurance institution or insurance producer may base an adverse underwriting decision on further personal information obtained as the result of information received from such insurance-support organization.