BILL NUMBER: AB 2411 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 23, 2010
PASSED THE ASSEMBLY AUGUST 24, 2010
AMENDED IN SENATE AUGUST 2, 2010
AMENDED IN ASSEMBLY APRIL 15, 2010
INTRODUCED BY Assembly Member Jones
(Coauthors: Assembly Members Charles Calderon, Carter, Feuer,
Salas, Solorio, and Torres)
FEBRUARY 19, 2010
An act to amend Section 120 of, and to add Part 9 (commencing with
Section 12880) to Division 2 of, the Insurance Code, relating to
insurance.
LEGISLATIVE COUNSEL'S DIGEST
AB 2411, Jones. Pet insurance.
Existing law provides for the regulation of various types of
insurance by the Department of Insurance.
This bill would provide for the regulation of pet insurance, as
defined. The bill would, in connection with the sale of a new,
amended, or renewed pet insurance policy on or after July 1, 2011,
require pet insurers to reasonably disclose to the consumer (1) if
the policy excludes coverage on the basis of a preexisting condition
or other disorder, as specified, (2) any policy provision that limits
coverage in a specified manner, and (3) whether the insurer reduces
coverage or increases premiums based on claims experience in any
preceding policy period. The bill would also, with respect to pet
insurance policies marketed, issued, amended, renewed, or delivered
on or after July 1, 2011, require pet insurers that determine claim
payments on any basis or that use a benefit schedule to clearly
disclose that basis or schedule in the policy and through a link on
the insurer's Internet Web site, as specified. The bill would enact
other related provisions. The bill would require the department to
post on its Internet Web site a list of the insurers that offer,
issue, or underwrite pet insurance in the state; the names of the
products that those insurers offer, issue, or underwrite; the names
of their general agents with authority to offer, issue, or underwrite
pet insurance; and a link to insurers' company profiles maintained
by the department.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 120 of the Insurance Code is amended to read:
120. Miscellaneous insurance includes insurance against loss from
damage done, directly or indirectly by lightning, windstorm,
tornado, or earthquake; insurance under an open policy indemnifying
the producer of any motion picture, television, theatrical, sport, or
similar production, event, or exhibition against loss by reason of
the interruption, postponement, or cancellation of such production,
event, or exhibition due to death, accidental injury, or sickness
preventing performers, directors, or other principals from commencing
or continuing their respective performance or duties; pet insurance,
as defined in Section 12880; and any insurance not included in any
of the foregoing classes, and which is a proper subject of insurance.
SEC. 2. Part 9 (commencing with Section 12880) is added to
Division 2 of the Insurance Code, to read:
PART 9. PET INSURANCE
12880. For purposes of this part, the following definitions shall
apply:
(a) "Pet insurance" means an individual or group insurance policy
that provides coverage for veterinary expenses.
(b) "Veterinarian" means an individual who holds a valid license
to practice veterinary medicine from the Veterinary Medical Board
pursuant to Chapter 11 (commencing with Section 4800) of Division 2
of the Business and Professions Code or other appropriate licensing
entity in the jurisdiction in which he or she practices.
(c) "Veterinary expenses" means the costs associated with any
medical advice, diagnosis, care, or treatment provided by a
veterinarian, including, but not limited to, the cost of drugs
prescribed by a veterinarian.
(d) "Hereditary disorder" means an abnormality that is genetically
transmitted from parent to offspring and may cause illness or
disease.
12880.1. A policy of pet insurance that is marketed, issued,
amended, renewed, or delivered to a resident of this state on or
after July 1, 2011, regardless of the situs of the contract or master
group policyholder, shall be subject to this part.
12880.2. (a) In connection with the sale of a new, amended, or
renewed policy of pet insurance on or after July 1, 2011, a pet
insurer shall reasonably disclose all of the following to the
consumer:
(1) If the policy excludes coverage due to any of the following:
(A) A preexisting condition.
(B) A hereditary disorder.
(C) A congenital anomaly or disorder.
(2) Any policy provision that limits coverage through a waiting or
affiliation period, a deductible, coinsurance, or an annual or
lifetime policy limit.
(3) Whether the insurer reduces coverage or increases premiums
based on claims experience in any preceding policy period.
(b) If a pet insurer uses any of the terms set forth in
subparagraphs (A) to (C), inclusive, of paragraph (1) of subdivision
(a) in a policy of pet insurance, the insurer shall include a
definition of the term in the policy and shall make that definition
available via a link on the main page of the insurer's Internet Web
site.
(c) A pet insurer that determines claim payments under a pet
insurance policy on any basis shall clearly disclose that basis in
the policy and through a link on the main page of the insurer's
Internet Web site.
(d) A pet insurer that uses a benefit schedule to determine claim
payments under a pet insurance policy shall do both of the following:
(1) Include the applicable benefit schedule in the policy.
(2) Disclose all benefit schedules used by the insurer under its
pet insurance policies through a link on the main page of the insurer'
s Internet Web site.
(e) A pet insurer that determines claim payments under a pet
insurance policy based on usual and customary fees, or any other
reimbursement limitation based on prevailing veterinary service
provider charges, shall do both of the following:
(1) Include a usual and customary fee limitation provision in the
policy that clearly describes the insurer's basis for determining
usual and customary fees and how that basis is applied in calculating
claim payments.
(2) Disclose the insurer's basis for determining usual and
customary charges under the policy via a link on the main page of the
insurer's Internet Web site.
(f) The disclosures required by this section shall be in addition
to any other disclosures required by other applicable law.
12880.3. Notwithstanding any other provision of law, the
department shall publish on its Internet Web site a list of the
insurers that offer, issue, or underwrite pet insurance in the state.
With respect to each insurer listed, the department shall publish on
its Internet Web site the names of the pet insurance products that
the insurer offers, issues, or underwrites in the state, including
any name marketed to consumers, the name of the insurer's general
agent or general agents with authority to offer, issue, or underwrite
pet insurance in the state, if any, and a link to the insurer's
company profile maintained by the department.