31A-22-1308 - Use of loss history by insurers.
31A-22-1308. Use of loss history by insurers.
(1) For purposes of this section:
(a) "Adverse eligibility or rate decision" means:
(i) declining insurance coverage;
(ii) terminating insurance coverage;
(iii) not renewing insurance coverage; or
(iv) the charging of a higher rate for insurance coverage.
(b) (i) "Loss reporting agency" means any person who regularly engages, in whole or inpart, in the business of assembling or collecting information for the primary purpose of providingthe information to insurers or insurance producers for insurance transactions includingassembling or collecting loss or claims information.
(ii) Notwithstanding Subsection (1)(b)(i), the following persons are not loss reportingagents:
(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 froma 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.
(iv) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, thedepartment may define by rule what constitutes:
(A) 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 ofwhether 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 personallines 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 insuredrequesting 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 theinsured requesting payment of a claim;
(iii) a loss that occurred when real property covered by the personal lines insurance wasowned 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 informationdescribed 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 thecondition of the premises; and
(ii) make an adverse eligibility or rate decision on the basis of the condition of thepremises.
(3) (a) If an insurer uses a score that is derived from information obtained from a lossreporting agency or an insured, the insurer shall file with the department a certification that themethod 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 ofthe 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 aprotected record under Subsection 63G-2-305(2) except that the insurer is not required to file theinformation specified in Section 63G-2-309.
(d) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, thecommissioner shall make rules providing for the form and procedure of filing the certificationrequired by Subsection (3)(a).
Amended by Chapter 382, 2008 General Session