Title 33, Chapter 6, Section 4
( 33-6-4)
(a) As used in this Code section, the term "policy" means any
insuring bond issued by an insurer. (b) The following acts or practices are deemed unfair methods of
competition and unfair and deceptive acts or practices in the
business of insurance: (1) 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
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 statement,
assertion, or representation is untrue, deceptive, or misleading; (2) Making, issuing, circulating, or causing to be made, issued,
or circulated any estimate, illustration, circular, or statement
misrepresenting the terms of any policy issued or to be issued,
the benefits or advantages promised thereby, or the dividends or
share of the surplus to be received thereon; making any false or
misleading statement as to the dividends or share of surplus
previously paid on similar policies; making any misleading
representation or any misrepresentation as to the financial
condition of any insurer, as to the legal reserve system upon
which any life insurer operates; using any name or title of any
policy or class of policies misrepresenting the true nature
thereof; or making any misrepresentation to any policyholder
insured in any company for the purpose of inducing or tending to
induce the policyholder to lapse, forfeit, or surrender his
insurance. A dividend estimate prepared on company forms and
clearly indicating, in type equal in size to that used in figures
showing amounts of estimated dividends, that the dividends are
based on estimates made by the company based upon past experience
of the company shall not be considered misrepresentation and false
advertising within the meaning of this paragraph; (3) 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 substantially misrepresents
the financial condition of an insurer and which is calculated to
injure any person engaged in the business of insurance; (4) 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) Filing with any supervisory or other public official or
making, publishing, disseminating, circulating, delivering to any
person, or placing before the public or causing directly or
indirectly to be made, published, disseminated, circulated,
delivered to any person, or placed before the public any false
statement of financial condition of an insurer with the intent to
deceive; (6) 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, willfully
omitting to make a true entry of any material fact pertaining to
the business of such insurer in any book, report, or statement of
the insurer; (7) Issuing or delivering or permitting agents, officers, or
employees to issue or deliver agency or company stock or other
capital stock, benefit certificates or shares in any common-law
corporation, securities, or any special or advisory board
contracts of any kind promising returns and profits as an
inducement to insurance; (8)(A)(i) Making or permitting any unfair discrimination
between individuals of the same class, same policy amount, and
equal expectation of life in the rates charged for any
contract of life insurance or of life annuity, in the
dividends or other benefits payable thereon, or in any other
of the terms and conditions of the contract. (ii) Making or permitting any unfair discrimination between
individuals of the same class and of essentially the same
hazard in the amount of premium, policy fees, or rates charged
for any policy or contract of accident or sickness insurance,
in the benefits payable thereunder, in any of the terms or
conditions of the contract, or in any other manner whatever. (iii) Making or permitting any unfair discrimination in the
issuance, renewal, or cancellation of any policy or contract
of insurance against direct loss to residential property and
the contents thereof, in the amount of premium, policy fees,
or rates charged for the policies or contracts when the
discrimination is based solely upon the age or geographical
location of the property within a rated fire district without
regard to objective loss experience relating thereto. (B) Knowingly permitting or offering to make or making any
contract of insurance or agreement as to the contract other than
as plainly expressed in the contract issued thereon; paying,
allowing, giving, or offering to pay, allow, or give directly or
indirectly, as inducement to any contract of insurance, any
rebate of premiums payable on the contract, any special favor or
advantage in the dividends or other benefits thereon, or any
valuable consideration or inducement whatever not specified in
the contract, except in accordance with an applicable rate
filing, rating plan, or rating system filed with and approved by
the Commissioner; giving, selling, purchasing, or offering to
give, sell, or purchase as inducement to such insurance or in
connection therewith any stocks, bonds, or other securities of
any company, any dividends or profits accrued thereon, or
anything of value whatsoever not specified in the contract; or
receiving or accepting as inducement to contracts of insurance
any rebate of premium payable on the contract, any special favor
or advantage in the dividends or other benefit to accrue
thereon, or any valuable consideration or inducement not
specified in the contract. (C) Nothing in subparagraphs (A) and (B) of this paragraph shall
be construed as including within the definition of
discrimination or rebates any of the following practices: (i) In the case of any contract of life insurance or life
annuity, paying bonuses to policyholders or otherwise abating
their premiums in whole or in part out of surplus accumulated
from nonparticipating insurance, provided that any bonuses or
abatement of premiums shall be fair and equitable to
policyholders and for the best interest of the company and its
policyholders; (ii) In the case of life or accident and sickness insurance
policies issued on the industrial debit or weekly premium
plan, making allowance in an amount which fairly represents
the saving in collection expense to policyholders who have
continuously for a specified period made premium payments
directly to an office of the insurer; (iii) Making a readjustment of the rate of premium for a
policy based on the loss or expense experienced at the end of
the first or any subsequent policy year of insurance
thereunder, which adjustment may be made retroactive only for
the policy year; (iv) Issuing life or accident and sickness insurance policies
covering bona fide employees of the insurer at a rate less
than the rate charged other persons in the same class; (v) Issuing life or accident and sickness policies on a
salary-saving, payroll deduction, preauthorized, postdated,
automatic check, or draft plan at a reduced rate commensurate
with the savings made by the use of such plan; (vi) Paying commissions or other compensation to duly licensed
agents or brokers or allowing or returning dividends, savings,
or unabsorbed premium deposits to participating policyholders,
members, or subscribers; (vii) Paying by an insurance agent of part or all of the
commissions on public insurance to a nonprofit association of
insurance agents which is affiliated with a recognized state
or national insurance agents' association, which commissions
are to be used in whole or in part for one or more civic
enterprises; (9) Failing to instruct and require properly that agents shall, in
the solicitation of insurance and the filling out of applications
of insurance on behalf of policyholders, incorporate therein all
material facts relevant to the risk being written, which facts are
known to the agent or could have been known by proper diligence; (10) Encouraging agents to accept applications which contain
material misrepresentations or conceal material information which,
if stated in the application, would prevent issuance of the policy
or which would void a policy from its inception according to its
terms even though premiums had been paid on the policy;
(11) Any insurer or agent of same becoming a party to requiring or
imposing as a condition to the sale of real or personal property
or to the financing of real or personal property, as a condition
to the granting of or an extension of a loan which is to be
secured by the title to or a lien of any kind on real or personal
property, or as a condition to the performance of any other act in
connection with the sale, financing, or lending, whether the
person thus acts for himself or for anyone else, that the
insurance or any renewal thereof to be issued on said property as
collateral to said sale or loan shall be written through any
particular insurance company or agent, provided that this
paragraph shall not apply to a policy purchased by the seller,
financier, or lender from his or its own funds and not charged to
the purchaser or borrower in the sale price of the property or the
amount of the loan or required to be paid for out of his personal
funds; provided, further, that such seller, financier, or lender
may disapprove for reasons affecting solvency or other sensible
and sufficient reasons, the insurance company selected by the
buyer or borrower. This paragraph shall not apply to title
insurance; (12)(A) Representing that any insurer or agent is employed by or otherwise associated with any medicare program as defined in Code Section 33-43-1 or the United States Social Security Administration or that any insurance policy sold or offered for sale has been endorsed or sponsored by the federal or state government. (B) Knowingly selling or offering to sell medicare supplement insurance coverage as defined in Code Section 33-43-1 which is not in compliance with the provisions of Chapter 43 of this title, relating to medicare supplement insurance, or the rules and regulations promulgated by the Commissioner pursuant to Chapter 43 of this title. (C) Representing that any individual policy is a group policy or
that the insurer, agent, or policy is endorsed, sponsored by, or
associated with any group, association, or other organization
unless such is, in fact, the case. (D) Knowingly selling to Medicaid recipients substantially
unnecessary coverage which duplicates benefits provided under
the Medicaid program without disclosing to the prospective buyer
that it may not be to the buyer's benefit or that it might
actually be to the buyer's detriment to purchase the additional
coverage; (13)(A) Making direct response advertising by an insurer,
including radio or television advertisement, of any individual
or group life insurance policy in which computation of the death
benefit is of such a technical nature that such death benefit
cannot reasonably be properly presented in the advertisement and
understood by a member of the insuring public. Policies, other
than variable life or other interest sensitive policies, which
provide for multiple changes in death benefits, combinations of
increasing and nonuniformly decreasing term insurance, or
increasing life insurance benefits equal to or slightly greater
than the premiums paid during the early years of the coverage
combined with accidental death benefits are types of contracts
within the purview of this subparagraph. Additionally, any life
insurance policy which cannot be truthfully, completely,
clearly, and accurately disclosed in an advertisement falls
within this subparagraph. (B) Making direct response advertising by an insurer, including
radio or television advertisement, of any individual or group
accident and sickness or life insurance policy which is
misleading in fact or by implication that the coverage is
"guaranteed issue" when there are conditions to be met by those
persons to be insured, such as limited medical questions or
other underwriting guidelines of the insurer. (C) Making direct response advertising by an insurer, including
radio or television advertisement, of any individual or group
accident and sickness or life insurance policy where such
advertisement has not been approved for use in this state by the
Commissioner of Insurance; (14) Failing to disclose in printed advertising material that
medical benefits are calculated on the basis of usual, customary,
and reasonable charges; or (15)(A) As used in this paragraph: (i) "Confidential family violence information" means
information about acts of family violence, the status of a
victim of family violence, an individual's medical condition
that the insurer knows or has reason to know is related to
family violence, or the home and work addresses and telephone
numbers of a subject of family violence. (ii) "Family violence" means family violence as defined in Code Sections 19-13-1 and 19-13-20 and as limited by Code Section 19-13-1. (B) No person shall deny or refuse to accept an application;
refuse to insure; refuse to renew; refuse to reissue; cancel,
restrict, or otherwise terminate; charge a different rate for
the same coverage; add a premium differential; or exclude or
limit coverage for losses or deny a claim incurred by an insured
on the basis that the applicant or insured is or has been a
victim of family violence or that such person knows or has
reason to know the applicant or insured may be a victim of
family violence; nor shall any person take or fail to take any
of the aforesaid actions on the basis that an applicant or
insured provides shelter, counseling, or protection to victims
of family violence. (C) No person shall request, directly or indirectly, any
information the person knows or reasonably should know relates
to acts of family violence or an applicant's or insured's status
as a victim of family violence or make use of such information
however obtained, except for the limited purpose of complying
with legal obligations, verifying an individual's claim to be a
subject of family violence, cooperating with a victim of family
violence in seeking protection from family violence, or
facilitating the treatment of a family violence related medical
condition. When a person has information in their possession
that clearly indicates that the insured or applicant is a
subject of family violence, the disclosure or transfer of the
information by a person to any person, entity, or individual is
a violation of this Code section, except: (i) To the subject of abuse or an individual specifically
designated in writing by the subject of abuse; (ii) To a health care provider for the direct provision of
health care services; (iii) To a licensed physician identified and designated by the
subject of abuse; (iv) When ordered by the Commissioner or a court of competent
jurisdiction or otherwise required by law; (v) When necessary for a valid business purpose to transfer
information that includes family violence information that
cannot reasonably be segregated without undue hardship.
Family violence information may be disclosed pursuant to this
division only to the following persons or entities, all of
whom shall be bound by this subparagraph: (I) A reinsurer that seeks to indemnify or indemnifies all
or any part of a policy covering a subject of abuse and that
cannot underwrite or satisfy its obligations under the
reinsurance agreement without that disclosure; (II) A party to a proposed or consummated sale, transfer,
merger, or consolidation of all or part of the business of
the person; (III) Medical or claims personnel contracting with the
person, only where necessary to process an application or
perform the person's duties under the policy or to protect
the safety or privacy of a subject of abuse; or (IV) With respect to address and telephone number, to
entities with whom the person transacts business when the
business cannot be transacted without the address and
telephone number; (vi) To an attorney who needs the information to represent the
person effectively, provided the person notifies the attorney
of its obligations under this paragraph and requests that the
attorney exercise due diligence to protect the confidential
abuse information consistent with the attorney's obligation to
represent the person; (vii) To the policy owner or assignee, in the course of
delivery of the policy, if the policy contains information
about abuse status; or (viii) To any other entities deemed appropriate by the
Commissioner. (D) It is unfairly discriminatory to terminate group coverage for a subject of family violence because coverage was originally issued in the name of the perpetrator of the family violence and the perpetrator has divorced, separated from, or lost custody of the subject of family violence, or the perpetrator's coverage has terminated voluntarily or involuntarily. If termination results from an act or omission of the perpetrator, the subject of family violence shall be deemed a qualifying eligible individual under Code Section 33-24-21.1 and may obtain continuation and conversion of such coverages notwithstanding the act or omission of the perpetrator. A person may request and receive family violence information to implement the continuation and conversion of coverages under this subparagraph. (E) Subparagraph (C) of this paragraph shall not preclude a
subject of family violence from obtaining his or her insurance
records. Subparagraph (C) of this paragraph shall not prohibit
a person from asking about a medical condition or a claims
history or from using medical information or a claims history to
underwrite or to carry out its duties under the policy to the
extent otherwise permitted under this paragraph and other
applicable law. (F) No person shall take action that adversely affects an
applicant or insured on the basis of a medical condition, claim,
or other underwriting information that the person knows or has
reason to know is family violence related and which: (i) Has the purpose or effect of treating family violence
status as a medical condition or underwriting criterion; (ii) Is based upon correlation between a medical condition and
family violence; (iii) Is not otherwise permissible by law and does not apply
in the same manner and to the same extent to all applicants
and insureds similarly situated without regard to whether the
condition or claim is family violence related; or (iv) Except for claim actions, is not based on a
determination, made in conformance with sound actuarial and
underwriting principles and guidelines generally applied in
the insurance industry and supported by reasonable statistical
evidence, that there is a correlation between the applicant's
or insured's circumstances and a material increase in
insurance risk. (G) No person shall fail to pay losses arising out of family
violence against an innocent first-party claimant to the extent
of such claimant's legal interest in the covered property, if
the loss is caused by the intentional act of an insured against
whom a family violence complaint is brought for the act causing
this loss. (H) No person shall use other exclusions or limitations on
coverage which the Commissioner has determined through the
policy filing and approval process to unreasonably restrict the
ability of victims of family violence to be indemnified for such
losses. (I) Any person issuing, delivering, or renewing a policy of
insurance in this state at any time within a period of 24 months
after July 1, 2000, shall include with such policy or renewal
certificate a notice attached thereto containing the following
language: "NOTICE The laws of the State of Georgia prohibit insurers from
unfairly discriminating against any person based upon his or
her status as a victim of family violence." (c) Any person violating this Code section by making unlawful, false
representations as to the policy sold shall be guilty of a
misdemeanor. |