advises another person about insurance needs and coverages;
(b)
is compensated by the person advised on a basis not directly related to the insurance placed; and
(c)
except as provided in Section 31A-23a-501, is not compensated directly or indirectly by an insurer or producer for advice given. See Utah Code 31A-1-301
Fraud: Intentional deception resulting in injury to another.
Insurance: includes :
(i)
a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
(ii)
a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
(iii)
a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301
Rate: means :
(i)
the cost of a given unit of insurance; or
(ii)
for property or casualty insurance, that cost of insurance per exposure unit either expressed as:
(A)
a single number; or
(B)
a pure premium rate, adjusted before the application of individual risk variations based on loss or expense considerations to account for the treatment of:
the charging of a higher rate for insurance coverage.
(b)
(i)
“Loss reporting agency” means any person who regularly engages, in whole or in part, in the business of assembling or collecting information for the primary purpose of providing the information to insurers or insurance producers for insurance transactions including assembling or collecting loss or claims information.
(ii)
Notwithstanding Subsection (1)(b)(i), the following persons are not loss reporting agents:
(A)
a governmental entity;
(B)
an insurer;
(C)
an insurance producer;
(D)
an insurance consultant;
(E)
a medical care institution or professional; or
(F)
a peer review committee.
(iii)
Notwithstanding Subsection (1)(b)(i), the following are not considered a report from a loss reporting agency:
(A)
a report specifically provided for fraud prevention; and
(B)
that portion of a report that includes information related to consumer credit behavior.
a report specifically provided for fraud prevention; and
(B)
information related to consumer credit behavior.
(c)
(i)
“Score” means a numerical value, categorization, or classification that is:
(A)
derived from a statistical tool, modeling system, or method; and
(B)
developed to predict the likelihood of future insurance claims.
(ii)
A numerical value, categorization, or classification described in Subsection (1)(c)(i) is a score if it is developed to predict the likelihood of future insurance claims regardless of whether it is developed to predict other factors in addition to predicting future insurance claims.
(2)
(a)
An insurer may not make an adverse eligibility or rate decision related to personal lines insurance in whole or in part on the basis of:
(i)
a report by a loss reporting agency of a loss if the loss did not result in the insured requesting the payment of a claim;
(ii)
a telephone call or other inquiry by an insured of a loss if the loss did not result in the insured requesting payment of a claim;
(iii)
a loss that occurred when real property covered by the personal lines insurance was owned by a person other than the:
(A)
insured; or
(B)
person seeking insurance; or
(iv)
a score if the score is determined in whole or in part on the basis of information described in Subsection (2)(a)(i), (ii), or (iii).
(b)
Notwithstanding Subsection (2)(a), an insurer may:
(i)
use the information described in Subsection (2)(a)(iii) to require a review of the condition of the premises; and
(ii)
make an adverse eligibility or rate decision on the basis of the condition of the premises.
(3)
(a)
If an insurer uses a score that is derived from information obtained from a loss reporting agency or an insured, the insurer shall file with the department a certification that the method used to derive the score complies with the provisions of Subsection (2)(a)(iv).
(b)
the insurer shall file a certification required under Subsection (3)(a) within 30 days of the day on which the score described in Subsection (3)(a) is first used by the insurer.
(c)
The department shall classify a certification filed under this Subsection (3) as a protected record under Subsection 63G-2-305(2) except that the insurer is not required to file the information specified in Section 63G-2-309.
