BILL NUMBER: AB 470 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Niello
FEBRUARY 24, 2009
An act to amend Section 791.13 of the Insurance Code, relating to
insurance information.
LEGISLATIVE COUNSEL'S DIGEST
AB 470, as introduced, Niello. Insurance information:
confidential.
Existing law prohibits insurance institutions, agents, or
insurance-support organizations from disclosing personal or
privileged information collected in connection with an insurance
transaction unless a specified exception applies.
This bill would authorize the disclosure of information from an
accident report, supplemental report, or investigative report to an
insured's lawyer if the insured is otherwise entitled to obtain the
report, as specified.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 791.13 of the Insurance Code is amended to
read:
791.13. An insurance institution, agent, or insurance-support
organization shall not disclose any personal or privileged
information about an individual collected or received in connection
with an insurance transaction unless the disclosure is:
(a) With the written authorization of the individual, and meets
either of the conditions specified in paragraph (1) or (2):
(1) If such the authorization is
submitted by another insurance institution, agent, or
insurance-support organization, the authorization meets the
requirement of Section 791.06.
(2) If such the authorization is
submitted by a person other than an insurance institution, agent, or
insurance-support organization, the authorization is:
(A) Dated.
(B) Signed by the individual.
(C) Obtained one year or less prior to the date a disclosure is
sought pursuant to this section.
(b) To a person other than an insurance institution, agent, or
insurance-support organization, provided such
the disclosure is reasonably necessary:
(1) To enable such the person to
perform a business, professional or insurance function for the
disclosing insurance institution, agent, or insurance-support
organization or insured and such the
person agrees not to disclose the information further without the
individual's written authorization unless the further disclosure:
(A) Would otherwise be permitted by this section if made by an
insurance institution, agent, or insurance-support organization; or
(B) Is reasonably necessary for such person to perform its
function for the disclosing insurance institution, agent, or
insurance-support organization.
(2) To enable such the person to
provide information to the disclosing insurance institution, agent or
insurance-support organization for the purpose of:
(A) Determining an individual's eligibility for an insurance
benefit or payment; or
(B) Detecting or preventing criminal activity, fraud, material
misrepresentation or material nondisclosure in connection with an
insurance transaction.
(c) To an insurance institution, agent, insurance-support
organization or self-insurer, provided the information disclosed is
limited to that which is reasonably necessary under either paragraph
(1) or (2):
(1) To detect or prevent criminal activity, fraud, material
misrepresentation or material nondisclosure in connection with
insurance transactions; or
(2) For either the disclosing or receiving insurance institution,
agent or insurance-support organization to perform its function in
connection with an insurance transaction involving the individual.
(d) To a medical-care institution or medical professional for the
purpose of any of the following:
(1) Verifying insurance coverage or benefits.
(2) Informing an individual of a medical problem of which the
individual may not be aware.
(3) Conducting operations or services audit, provided only such
information is disclosed as is reasonably necessary to accomplish the
foregoing purposes.
(e) To an insurance regulatory authority; or
(f) To a law enforcement or other governmental authority pursuant
to law.
(g) Otherwise permitted or required by law.
(h) In response to a facially valid administrative or judicial
order, including a search warrant or subpoena.
(i) Made for the purpose of conducting actuarial or research
studies, provided:
(1) No individual may be identified in any actuarial or research
report.
(2) Materials allowing the individual to be identified are
returned or destroyed as soon as they are no longer needed.
(3) The actuarial or research organization agrees not to disclose
the information unless the disclosure would otherwise be permitted by
this section if made by an insurance institution, agent or
insurance-support organization.
(j) To a party or a representative of a party to a proposed or
consummated sale, transfer, merger or consolidation of all or part of
the business of the insurance institution, agent or
insurance-support organization, provided:
(1) Prior to the consummation of the sale, transfer, merger, or
consolidation only such information is disclosed as is reasonably
necessary to enable the recipient to make business decisions about
the purchase, transfer, merger, or consolidation.
(2) The recipient agrees not to disclose the information unless
the disclosure would otherwise be permitted by this section if made
by an insurance institution, agent or insurance-support organization.
(k) To a person whose only use of such the
information will be in connection with the marketing of a
product or service, provided:
(1) No medical-record information, privileged information, or
personal information relating to an individual's character, personal
habits, mode of living, or general reputation is disclosed, and no
classification derived from such the
information is disclosed; or
(2) The individual has been given an opportunity to indicate that
he or she does not want personal information disclosed for marketing
purposes and has given no indication that he or she does not want the
information disclosed; and
(3) The person receiving such information agrees not to use it
except in connection with the marketing of a product or service.
() To an affiliate whose only use of the information will be in
connection with an audit of the insurance institution or agent or the
marketing of an insurance product or service, provided the affiliate
agrees not to disclose the information for any other purpose or to
unaffiliated persons.
(m) By a consumer reporting agency, provided the disclosure is to
a person other than an insurance institution or agent.
(n) To a group policyholder for the purpose of reporting claims
experience or conducting an audit of the insurance institution's or
agent's operations or services, provided the information disclosed is
reasonably necessary for the group policyholder to conduct the
review or audit.
(o) To a professional peer review organization for the purpose of
reviewing the service or conduct of a medical-care institution or
medical professional.
(p) To a governmental authority for the purpose of determining the
individual's eligibility for health benefits for which the
governmental authority may be liable.
(q) To a certificate holder or policyholder for the purpose of
providing information regarding the status of an insurance
transaction.
(r) To a lienholder, mortgagee, assignee, lessor, or other person
shown on the records of an insurance institution or agent as having a
legal or beneficial interest in a policy of insurance. The
information disclosed shall be limited to that which is reasonably
necessary to permit the person to protect his or her interest in the
policy and shall be consistent with Article 5.5 (commencing with
Section 770).
(s) To an insured or the insured's lawyer when the
information disclosed is from an accident report, supplemental
report, investigative report or the actual report from a government
agency or is a copy of an accident report or other report which the
insured is entitled to obtain under Section 20012 of the Vehicle Code
or subdivision (f) of Section 6254 of the Government Code.