Title 33, Chapter 39, Section 3
( 33-39-3)
As used in this chapter: (1) "Adverse underwriting decision" means: (A) Any of the following actions with respect to insurance
transactions involving insurance coverage which is individually
underwritten: (i) A declination of insurance coverage; (ii) A termination of insurance coverage; (iii) Failure of an agent to apply for insurance coverage with
a specific insurance institution which the agent represents
and which is requested by an applicant; (iv) In the case of property or casualty insurance coverage: (I) Placement by an insurance institution or agent of a risk
with a residual market mechanism or an unauthorized insurer;
or (II) The charging of a higher rate on the basis of
information which 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; or (B) Notwithstanding subparagraph (A) of this paragraph, the
following actions shall not be considered adverse underwriting
decisions but the insurance institution or agent responsible for
their occurrence shall nevertheless provide the applicant or
policyholder with the specific reason or reasons for their
occurrence: (i) The termination of an individual policy form on a class or
state-wide basis; (ii) A declination of insurance coverage solely because such
coverage is not available on a class or state-wide basis; (iii) The rescission of a policy; or (iv) The accommodation of an insured by an agent who places
insurance for such insured with any insurer, residual market
mechanism, or unauthorized insurer which is satisfactory to
such insured when such insured has been canceled, nonrenewed,
declined, or otherwise unable to obtain coverage for any
reason. (2) "Affiliate" or "affiliated" means a person that directly, or
indirectly through one or more intermediaries, controls, is
controlled by, or is under common control with another person. (3) "Agent" means any agent, broker, subagent, counselor, adjustor, solicitor, or service representative as defined in Code Sections 33-23-1 and 33-23-40. (4) "Applicant" means any person who seeks to contract for insurance coverage other than a person seeking insurance coverage that is not individually underwritten. (5) "Commissioner" means the Commissioner of Insurance of the
State of Georgia. (6) "Consumer report" means any written, oral, or other
communication of information bearing on a natural person's credit
worthiness, credit standing, credit capacity, character, general
reputation, personal characteristics, or mode of living which is
used or expected to be used in connection with an insurance
transaction. (7) "Consumer reporting agency" means any person who: (A) Regularly engages, in whole or in part, in the practice of
assembling or preparing consumer reports for a monetary fee; (B) Obtains information primarily from sources other than
insurance institutions; and (C) Furnishes consumer reports to other persons. (8) "Control" including the term "controlled by" or "under common
control with," means the possession, direct or indirect, of the
power to direct or cause the direction of the management and
policies of a person, whether through the ownership of voting
securities, by contract other than a commercial contract for goods
or nonmanagement services, or otherwise, unless the power is the
result of an official position with or corporate office held by
the person. (9) "Declination of insurance coverage" means a denial, in whole
or in part, by an insurance institution or agent of requested
insurance coverage. (10) "Individual" means any natural person who: (A) In the case of property or casualty insurance, is a past,
present, or proposed named insured or certificate holder; (B) In the case of 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. (11) "Institutional source" means any person or governmental
entity that provides information about an individual to an agent,
insurance institution, or insurance-support organization other
than:
(A) An agent; (B) The individual who is the subject of the information; or (C) A natural person acting in a personal capacity rather than
in a business or professional capacity. (12) "Insurance institution" means any corporation, association,
partnership, reciprocal exchange, interinsurer, Lloyd's insurer,
fraternal benefit society, or other person engaged in the business
of insurance, including medical service corporations, hospital
service corporations, health care plans, and health maintenance
organizations as defined in Chapters 18, 19, 20, and 21.
"Insurance institution" shall not include agents or
insurance-support organizations. (13) "Insurance-support organization" means: (A) Any person who regularly engages, in whole or in part, in
the practice of assembling or collecting information about
natural persons for the primary purpose of providing the
information to an insurance institution or agent for insurance
transactions, including: (i) The furnishing of consumer reports or investigative
consumer reports to an insurance institution or agent for use
in connection with an insurance transaction; or (ii) The collection of personal information from insurance
institutions, agents, 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. (B) Notwithstanding subparagraph (A) of this paragraph, the
following persons shall not be considered "insurance-support
organizations" for purposes of this chapter: agents, government
institutions, insurance institutions, medical care institutions,
and medical professionals. (14) "Insurance transaction" means any transaction involving
insurance primarily for personal, family, or household needs
rather than business or professional needs which entails: (A) The individual determination of an individual's eligibility
for an insurance coverage, benefit, or payment; or (B) The servicing of an insurance application, policy, contract,
or certificate. (15) "Investigative consumer report" means a consumer report or
portion thereof in which information about a natural person's
character, general reputation, personal characteristics, or mode
of living is obtained through personal interviews with the
person's neighbors, friends, associates, acquaintances, or others
who may have knowledge concerning such items of information. (16) "Medical-care institution" means any facility or institution
that is licensed to provide health care services to natural
persons, including but not limited to: health maintenance
organizations, home health agencies, hospitals, medical clinics,
public health agencies, rehabilitation agencies, and skilled
nursing facilities. (17) "Medical professional" means any person licensed or certified
to provide health care services to natural persons, including but
not limited to, a chiropractor, clinical dietitian, clinical
psychologist, dentist, nurse, occupational therapist, optometrist,
pharmacist, physical therapist, physician, podiatrist, psychiatric
social worker, or speech therapist. (18) "Medical-record information" means personal information
which: (A) Relates to an individual's physical or mental condition,
medical history, or medical treatment; and (B) Is obtained from a medical professional or medical-care
institution, from the individual, or from the individual's
spouse, parent, or legal guardian. (19) "Person" means any natural person, corporation, association,
partnership, or other legal entity. (20) "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. "Personal
information" does not include an individual's name, address, and
age when no other underwriting information is gathered on that
individual nor does it include any "privileged information." (21) "Policyholder" means any person who: (A) In the case of individual property or casualty insurance, is
a present named insured; (B) In the case of individual life, health, or disability
insurance, is a present policyholder; or (C) In the case of group insurance which is individually
underwritten, is a present group certificate holder. (22) "Pretext interview" means an interview whereby a person, in
an attempt to obtain information about a natural person, performs
one or more of the following acts: (A) Pretends to be someone he or she is not; (B) Pretends to represent a person he or she is not in fact
representing; (C) Misrepresents the true purpose of the interview; or (D) Refuses to identify himself or herself upon request. (23) "Privileged information" means any individually identifiable
information that:
(A) Relates to a claim for insurance benefits or a civil or
criminal proceeding involving an individual; and (B) Is collected in connection with or in reasonable
anticipation of a claim for insurance benefits or civil or
criminal proceeding involving an individual; provided, however, information otherwise meeting the requirements of this paragraph shall nevertheless be considered "personal information" under this chapter if it is disclosed in violation of Code Section 33-39-14. (24) "Residual market mechanism" means an association, organization, or other entity defined or described in Code Sections 33-9-7, 33-9-8, and 33-9-10. (25) "Termination of insurance coverage" or "termination of an
insurance policy" means either a cancellation or nonrenewal of an
insurance policy, in whole or in part, for any reason other than
the failure to pay a premium as required by the policy. (26) "Unauthorized insurer" means an insurance institution that
has not been granted a certificate of authority by the
Commissioner to transact the business of insurance in this state. |