(215 ILCS 5/1001)(from Ch. 73, par. 1065.701) Sec. 1001. Purpose. The purpose of this Article is to establish standards for the collection, use and disclosure of information gathered in connection with insurance transactions by insurance institutions, agents or insurance‑support organizations; to maintain a balance between the need for information by those conducting the business of insurance and the public's need for fairness in insurance information practices, including the need to minimize intrusiveness; to establish a regulatory mechanism to enable natural persons to ascertain what information is being or has been collected about them in connection with insurance transactions and to have access to such information for the purpose of verifying or disputing its accuracy; to limit the disclosure of information collected in connection with insurance transactions; and to enable insurance applicants and policyholders to obtain the reasons for any adverse underwriting decision. Further, this Article shall grant the Director the authority to enforce Title V of the Gramm‑Leach‑Bliley Act (Public Law 106‑102, 106th Congress). (Source: P.A. 92‑556, eff. 6‑24‑02.)
(215 ILCS 5/1002)(from Ch. 73, par. 1065.702) Sec. 1002. Scope. (A) The obligations imposed by this Article shall apply to those insurance institutions, agents or insurance‑support organizations which, on or after the effective date of this Article: (1) in the case of life, health or disability insurance: (a) collect, receive or maintain information in connection with insurance transactions which pertains to natural persons who are residents of this State, or (b) engage in insurance transactions with applicants, individuals or policyholders who are residents of this State, and (2) in the case of property or casualty insurance: (a) collect, receive or maintain information in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, or (b) engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (B) The rights granted by this Article shall extend to: (1) in the case of life, health or disability insurance, the following persons who are residents of this State: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions, and (2) in the case of property or casualty insurance, the following persons: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (C) For purposes of this Section, a person shall be considered a resident of this State if the person's last known mailing address, as shown in the records of the insurance institution, agent or insurance‑support organization, is located in this State. (D) Notwithstanding subsections (A) and (B) above, this Article shall not apply to information collected from the public records of a governmental authority and maintained by an insurance institution or its representatives for the purpose of insuring the title to real property located in this State. (Source: P.A. 81‑1430.)
(215 ILCS 5/1003)(from Ch. 73, par. 1065.703) Sec. 1003. Definitions. As used in this Article: (A) "Adverse underwriting decision" means: (1) any of the following actions with respect to
insurance transactions involving insurance coverage which is individually underwritten:
(a) a declination of insurance coverage, (b) a termination of insurance coverage, (c) 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,
(d) in the case of a property or casualty
insurance coverage:
(i) placement by an insurance institution or
agent of a risk with a residual market mechanism, an unauthorized insurer or an insurance institution which specializes in substandard risks, or
(ii) the charging of a higher rate on the
basis of information which differs from that which the applicant or policyholder furnished, or
(e) in the case of life, health or disability
insurance coverage, an offer to insure at higher than standard rates.
(2) Notwithstanding paragraph (1) above, 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:
(a) the termination of an individual policy form
on a class or statewide basis,
(b) a declination of insurance coverage solely
because such coverage is not available on a class or statewide basis, or
(c) the rescission of a policy. (B) "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. (C) "Agent" means an individual, firm, partnership, association or corporation who is involved in the solicitation, negotiation or binding of coverages for or on applications or policies of insurance, covering property or risks located in this State. For the purposes of this Article, both "Insurance Agent" and "Insurance Broker", as defined in Section 490, shall be considered an agent. (D) "Applicant" means any person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten. (E) "Director" means the Director of Insurance. (F) "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. (G) "Consumer reporting agency" means any person who: (1) regularly engages, in whole or in part, in the
practice of assembling or preparing consumer reports for a monetary fee,
(2) obtains information primarily from sources other
than insurance institutions, and
(3) furnishes consumer reports to other persons. (H) "Control", including the terms "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. (I) "Declination of insurance coverage" means a denial, in whole or in part, by an insurance institution or agent of requested insurance coverage. (J) "Individual" means any natural person who: (1) in the case of property or casualty insurance,
is a past, present or proposed named insured or certificateholder;
(2) in the case of life, health or disability
insurance, is a past, present or proposed principal insured or certificateholder;
(3) is a past, present or proposed policyowner; (4) is a past or present applicant; (5) is a past or present claimant; or (6) derived, derives or is proposed to derive
insurance coverage under an insurance policy or certificate subject to this Article.
(K) "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: (1) an agent, (2) the individual who is the subject of the
information, or
(3) a natural person acting in a personal capacity
rather than in a business or professional capacity.
(L) "Insurance institution" means any corporation, association, partnership, reciprocal exchange, inter‑insurer, Lloyd's insurer, fraternal benefit society or other person engaged in the business of insurance, health maintenance organizations as defined in Section 2 of the Health Maintenance Organization Act, voluntary health services plans as defined in Section 2 of the Voluntary Health Services Plans Act, and dental service plans as defined in Section 4 of the Dental Service Plan Act. "Insurance institution" shall not include agents or insurance‑support organizations. (M) "Insurance‑support organization" means: (1) 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:
(a) the furnishing of consumer reports or
investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction, or
(b) 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.
(2) Notwithstanding paragraph (1) above, the
following persons shall not be considered "insurance‑support organizations" for purposes of this Article: agents, government institutions, insurance institutions, medical care institutions and medical professionals.
(N) "Insurance transaction" means any transaction involving insurance primarily for personal, family or household needs rather than business or professional needs which entails: (1) the determination of an individual's eligibility
for an insurance coverage, benefit or payment, or
(2) the servicing of an insurance application,
policy, contract or certificate.
(O) "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. (P) "Medical‑care institution" means any facility or institution that is licensed to provide health care services to natural persons, including but not limited to: hospitals, skilled nursing facilities, home‑health agencies, medical clinics, rehabilitation agencies and public‑health agencies and health‑maintenance organizations. (Q) "Medical professional" means any person licensed or certified to provide health care services to natural persons, including but not limited to, a physician, dentist, nurse, optometrist, chiropractor, naprapath, pharmacist, physical or occupational therapist, psychiatric social worker, speech therapist, clinical dietitian or clinical psychologist. (R) "Medical‑record information" means personal information which: (1) relates to an individual's physical or mental
condition, medical history or medical treatment, and
(2) is obtained from a medical professional or
medical‑care institution, from the individual, or from the individual's spouse, parent or legal guardian.
(S) "Person" means any natural person, corporation, association, partnership or other legal entity. (T) "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" includes an individual's name and address and "medical‑record information" but does not include "privileged information". (U) "Policyholder" means any person who: (1) in the case of individual property or casualty
insurance, is a present named insured;
(2) in the case of individual life, health or
disability insurance, is a present policyowner; or
(3) in the case of group insurance which is
individually underwritten, is a present group certificateholder.
(V) "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: (1) pretends to be someone he or she is not, (2) pretends to represent a person he or she is not
in fact representing,
(3) misrepresents the true purpose of the interview,
or
(4) refuses to identify himself or herself upon
request.
(W) "Privileged information" means any individually identifiable information that: (1) relates to a claim for insurance benefits or a civil or criminal proceeding involving an individual, and (2) 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 subsection shall nevertheless be considered "personal information" under this Article if it is disclosed in violation of Section 1014 of this Article. (X) "Residual market mechanism" means an association, organization or other entity described in Article XXXIII of this Act, or Section 7‑501 of The Illinois Vehicle Code. (Y) "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. (Z) "Unauthorized insurer" means an insurance institution that has not been granted a certificate of authority by the Director to transact the business of insurance in this State. (Source: P.A. 90‑7, eff. 6‑10‑97; 90‑177, eff. 7‑23‑97; 90‑372, eff. 7‑1‑98; 90‑655, eff. 7‑30‑98.)
(215 ILCS 5/1004)(from Ch. 73, par. 1065.704) Sec. 1004. Pretext Interviews. No insurance institution, agent or insurance‑support organization shall use or authorize the use of pretext interviews to obtain information in connection with an insurance transaction; provided, however, a pretext interview may be undertaken to obtain information from a person or institution that does not have a generally or statutorily recognized privileged relationship with the person about whom the information relates for the purpose of investigating a claim where, based upon specific information available for review by the Director, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim. (Source: P.A. 82‑108.)
(215 ILCS 5/1005)(from Ch. 73, par. 1065.705) Sec. 1005. Notice of Insurance Information Practices. (A) An insurance institution or agent shall provide a notice of information practices to all applicants or policyholders in connection with insurance transactions as provided below: (1) in the case of an application for insurance, a notice shall be provided no later than: (a) at the time of the delivery of the insurance policy or certificate when personal information is collected only from the applicant or from public records, or (b) at the time the collection of personal information is initiated when personal information is collected from a source other than the applicant or public records; (2) in the case of a policy renewal, a notice shall be provided no later than the policy renewal date, except that no notice shall be required in connection with a policy renewal if: (a) personal information is collected only from the policyholder or from public records, or (b) a notice meeting the requirements of this Section has been given within the previous 24 months; or (3) in the case of a policy reinstatement or change in insurance benefits, a notice shall be provided no later than the time a request for a policy reinstatement or change in insurance benefits is received by the insurance institution, except that no notice shall be required if personal information is collected only from the policyholder or from public records. (B) The notice required by subsection (A) shall be in writing and shall state: (1) whether personal information may be collected from persons other than the individual or individuals proposed for coverage; (2) the types of personal information that may be collected and the types of sources and investigative techniques that may be used to collect such information; (3) the types of disclosures identified in subsections (B), (C), (D), (E), (F), (I), (K), (L) and (N) of Section 1014 of this Article and the circumstances under which such disclosures may be made without prior authorization; provided, however, only those circumstances need be described which occur with such frequency as to indicate a general business practice; (4) a description of the rights established under Sections 1009 and 1010 of this Article and the manner in which such rights may be exercised; and (5) that information obtained from a report prepared by an insurance‑support organization may be retained by the insurance‑support organization and disclosed to other persons. (C) In lieu of the notice prescribed in subsection (B), the insurance institution or agent may provide an abbreviated notice informing the applicant or policyholder that: (1) personal information may be collected from persons other than the individual or individuals proposed for coverage, (2) such information as well as other personal or privileged information subsequently collected by the insurance institution or agent may in certain circumstances be disclosed to third parties without authorization, (3) a right of access and correction exists with respect to all personal information collected, and (4) the notice prescribed in subsection (B) will be furnished to the applicant or policyholder upon request. (D) The obligations imposed by this Section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf. (Source: P.A. 82‑108.)
(215 ILCS 5/1006)(from Ch. 73, par. 1065.706) Sec. 1006. Marketing and Research Surveys. An insurance institution or agent shall clearly specify those questions designed to obtain information solely for marketing or research purposes from an individual in connection with an insurance transaction. (Source: P.A. 82‑108.)
(215 ILCS 5/1007)(from Ch. 73, par. 1065.707) Sec. 1007. Content of Disclosure Authorization Forms. Notwithstanding any other provision of law of this State, no insurance institution, agent or insurance‑support organization may utilize as its disclosure authorization form in connection with insurance transactions a form or statement which authorizes the disclosure of personal or privileged information about an individual to the insurance institution, agent or insurance‑support organization unless the form or statement: (A) is written in plain language; (B) is dated; (C) specifies the types of persons authorized to disclose information about the individual; (D) specifies the nature of the information authorized to be disclosed; (E) names the insurance institution or agent and identifies by generic reference representatives of the insurance institution to whom the individual is authorizing information to be disclosed; (F) specifies the purposes for which the information is collected; (G) specifies the length of time such authorization shall remain valid, which shall be no longer than: (1) in the case of authorizations signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement or a request for change in policy benefits: (a) 30 months from the date the authorization is signed if the application or request involves life, health or disability insurance, (b) one year from the date the authorization is signed if the application or request involves property or casualty insurance; (2) in the case of authorizations signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy, (a) the term of coverage of the policy if the claim is for a health insurance benefit, (b) the duration of the claim if the claim is not for a health insurance benefit; and (H) advises the individual or a person authorized to act on behalf of the individual that the individual or the individual's authorized representative is entitled to receive a copy of the authorization form. (Source: P.A. 82‑108.)
(215 ILCS 5/1008)(from Ch. 73, par. 1065.708) Sec. 1008. Investigative Consumer Reports. (A) No insurance institution, agent or insurance‑support organization may prepare or request an investigative consumer report about an individual in connection with an insurance transaction involving an application for insurance, a policy renewal, a policy reinstatement or a change in insurance benefits unless the insurance institution or agent informs the individual: (1) that he or she may request to be interviewed in connection with the preparation of the investigative consumer report, and (2) that upon a request pursuant to Section 1009, he or she is entitled to receive a copy of the investigative consumer report. (B) If an investigative consumer report is to be prepared by an insurance institution or agent, the insurance institution or agent shall institute reasonable procedures to conduct a personal interview requested by an individual. (C) If an investigative consumer report is to be prepared by an insurance‑support organization, the insurance institution or agent desiring such report shall inform the insurance‑support organization whether a personal interview has been requested by the individual. The insurance‑support organization shall institute reasonable procedures to conduct such interviews, if requested. (Source: P.A. 82‑108.)
(215 ILCS 5/1009)(from Ch. 73, par. 1065.709) Sec. 1009.
(215 ILCS 5/1001)(from Ch. 73, par. 1065.701) Sec. 1001. Purpose. The purpose of this Article is to establish standards for the collection, use and disclosure of information gathered in connection with insurance transactions by insurance institutions, agents or insurance‑support organizations; to maintain a balance between the need for information by those conducting the business of insurance and the public's need for fairness in insurance information practices, including the need to minimize intrusiveness; to establish a regulatory mechanism to enable natural persons to ascertain what information is being or has been collected about them in connection with insurance transactions and to have access to such information for the purpose of verifying or disputing its accuracy; to limit the disclosure of information collected in connection with insurance transactions; and to enable insurance applicants and policyholders to obtain the reasons for any adverse underwriting decision. Further, this Article shall grant the Director the authority to enforce Title V of the Gramm‑Leach‑Bliley Act (Public Law 106‑102, 106th Congress). (Source: P.A. 92‑556, eff. 6‑24‑02.)
(215 ILCS 5/1002)(from Ch. 73, par. 1065.702) Sec. 1002. Scope. (A) The obligations imposed by this Article shall apply to those insurance institutions, agents or insurance‑support organizations which, on or after the effective date of this Article: (1) in the case of life, health or disability insurance: (a) collect, receive or maintain information in connection with insurance transactions which pertains to natural persons who are residents of this State, or (b) engage in insurance transactions with applicants, individuals or policyholders who are residents of this State, and (2) in the case of property or casualty insurance: (a) collect, receive or maintain information in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, or (b) engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (B) The rights granted by this Article shall extend to: (1) in the case of life, health or disability insurance, the following persons who are residents of this State: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions, and (2) in the case of property or casualty insurance, the following persons: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (C) For purposes of this Section, a person shall be considered a resident of this State if the person's last known mailing address, as shown in the records of the insurance institution, agent or insurance‑support organization, is located in this State. (D) Notwithstanding subsections (A) and (B) above, this Article shall not apply to information collected from the public records of a governmental authority and maintained by an insurance institution or its representatives for the purpose of insuring the title to real property located in this State. (Source: P.A. 81‑1430.)
(215 ILCS 5/1003)(from Ch. 73, par. 1065.703) Sec. 1003. Definitions. As used in this Article: (A) "Adverse underwriting decision" means: (1) any of the following actions with respect to
insurance transactions involving insurance coverage which is individually underwritten:
(a) a declination of insurance coverage, (b) a termination of insurance coverage, (c) 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,
(d) in the case of a property or casualty
insurance coverage:
(i) placement by an insurance institution or
agent of a risk with a residual market mechanism, an unauthorized insurer or an insurance institution which specializes in substandard risks, or
(ii) the charging of a higher rate on the
basis of information which differs from that which the applicant or policyholder furnished, or
(e) in the case of life, health or disability
insurance coverage, an offer to insure at higher than standard rates.
(2) Notwithstanding paragraph (1) above, 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:
(a) the termination of an individual policy form
on a class or statewide basis,
(b) a declination of insurance coverage solely
because such coverage is not available on a class or statewide basis, or
(c) the rescission of a policy. (B) "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. (C) "Agent" means an individual, firm, partnership, association or corporation who is involved in the solicitation, negotiation or binding of coverages for or on applications or policies of insurance, covering property or risks located in this State. For the purposes of this Article, both "Insurance Agent" and "Insurance Broker", as defined in Section 490, shall be considered an agent. (D) "Applicant" means any person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten. (E) "Director" means the Director of Insurance. (F) "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. (G) "Consumer reporting agency" means any person who: (1) regularly engages, in whole or in part, in the
practice of assembling or preparing consumer reports for a monetary fee,
(2) obtains information primarily from sources other
than insurance institutions, and
(3) furnishes consumer reports to other persons. (H) "Control", including the terms "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. (I) "Declination of insurance coverage" means a denial, in whole or in part, by an insurance institution or agent of requested insurance coverage. (J) "Individual" means any natural person who: (1) in the case of property or casualty insurance,
is a past, present or proposed named insured or certificateholder;
(2) in the case of life, health or disability
insurance, is a past, present or proposed principal insured or certificateholder;
(3) is a past, present or proposed policyowner; (4) is a past or present applicant; (5) is a past or present claimant; or (6) derived, derives or is proposed to derive
insurance coverage under an insurance policy or certificate subject to this Article.
(K) "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: (1) an agent, (2) the individual who is the subject of the
information, or
(3) a natural person acting in a personal capacity
rather than in a business or professional capacity.
(L) "Insurance institution" means any corporation, association, partnership, reciprocal exchange, inter‑insurer, Lloyd's insurer, fraternal benefit society or other person engaged in the business of insurance, health maintenance organizations as defined in Section 2 of the Health Maintenance Organization Act, voluntary health services plans as defined in Section 2 of the Voluntary Health Services Plans Act, and dental service plans as defined in Section 4 of the Dental Service Plan Act. "Insurance institution" shall not include agents or insurance‑support organizations. (M) "Insurance‑support organization" means: (1) 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:
(a) the furnishing of consumer reports or
investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction, or
(b) 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.
(2) Notwithstanding paragraph (1) above, the
following persons shall not be considered "insurance‑support organizations" for purposes of this Article: agents, government institutions, insurance institutions, medical care institutions and medical professionals.
(N) "Insurance transaction" means any transaction involving insurance primarily for personal, family or household needs rather than business or professional needs which entails: (1) the determination of an individual's eligibility
for an insurance coverage, benefit or payment, or
(2) the servicing of an insurance application,
policy, contract or certificate.
(O) "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. (P) "Medical‑care institution" means any facility or institution that is licensed to provide health care services to natural persons, including but not limited to: hospitals, skilled nursing facilities, home‑health agencies, medical clinics, rehabilitation agencies and public‑health agencies and health‑maintenance organizations. (Q) "Medical professional" means any person licensed or certified to provide health care services to natural persons, including but not limited to, a physician, dentist, nurse, optometrist, chiropractor, naprapath, pharmacist, physical or occupational therapist, psychiatric social worker, speech therapist, clinical dietitian or clinical psychologist. (R) "Medical‑record information" means personal information which: (1) relates to an individual's physical or mental
condition, medical history or medical treatment, and
(2) is obtained from a medical professional or
medical‑care institution, from the individual, or from the individual's spouse, parent or legal guardian.
(S) "Person" means any natural person, corporation, association, partnership or other legal entity. (T) "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" includes an individual's name and address and "medical‑record information" but does not include "privileged information". (U) "Policyholder" means any person who: (1) in the case of individual property or casualty
insurance, is a present named insured;
(2) in the case of individual life, health or
disability insurance, is a present policyowner; or
(3) in the case of group insurance which is
individually underwritten, is a present group certificateholder.
(V) "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: (1) pretends to be someone he or she is not, (2) pretends to represent a person he or she is not
in fact representing,
(3) misrepresents the true purpose of the interview,
or
(4) refuses to identify himself or herself upon
request.
(W) "Privileged information" means any individually identifiable information that: (1) relates to a claim for insurance benefits or a civil or criminal proceeding involving an individual, and (2) 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 subsection shall nevertheless be considered "personal information" under this Article if it is disclosed in violation of Section 1014 of this Article. (X) "Residual market mechanism" means an association, organization or other entity described in Article XXXIII of this Act, or Section 7‑501 of The Illinois Vehicle Code. (Y) "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. (Z) "Unauthorized insurer" means an insurance institution that has not been granted a certificate of authority by the Director to transact the business of insurance in this State. (Source: P.A. 90‑7, eff. 6‑10‑97; 90‑177, eff. 7‑23‑97; 90‑372, eff. 7‑1‑98; 90‑655, eff. 7‑30‑98.)
(215 ILCS 5/1004)(from Ch. 73, par. 1065.704) Sec. 1004. Pretext Interviews. No insurance institution, agent or insurance‑support organization shall use or authorize the use of pretext interviews to obtain information in connection with an insurance transaction; provided, however, a pretext interview may be undertaken to obtain information from a person or institution that does not have a generally or statutorily recognized privileged relationship with the person about whom the information relates for the purpose of investigating a claim where, based upon specific information available for review by the Director, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim. (Source: P.A. 82‑108.)
(215 ILCS 5/1005)(from Ch. 73, par. 1065.705) Sec. 1005. Notice of Insurance Information Practices. (A) An insurance institution or agent shall provide a notice of information practices to all applicants or policyholders in connection with insurance transactions as provided below: (1) in the case of an application for insurance, a notice shall be provided no later than: (a) at the time of the delivery of the insurance policy or certificate when personal information is collected only from the applicant or from public records, or (b) at the time the collection of personal information is initiated when personal information is collected from a source other than the applicant or public records; (2) in the case of a policy renewal, a notice shall be provided no later than the policy renewal date, except that no notice shall be required in connection with a policy renewal if: (a) personal information is collected only from the policyholder or from public records, or (b) a notice meeting the requirements of this Section has been given within the previous 24 months; or (3) in the case of a policy reinstatement or change in insurance benefits, a notice shall be provided no later than the time a request for a policy reinstatement or change in insurance benefits is received by the insurance institution, except that no notice shall be required if personal information is collected only from the policyholder or from public records. (B) The notice required by subsection (A) shall be in writing and shall state: (1) whether personal information may be collected from persons other than the individual or individuals proposed for coverage; (2) the types of personal information that may be collected and the types of sources and investigative techniques that may be used to collect such information; (3) the types of disclosures identified in subsections (B), (C), (D), (E), (F), (I), (K), (L) and (N) of Section 1014 of this Article and the circumstances under which such disclosures may be made without prior authorization; provided, however, only those circumstances need be described which occur with such frequency as to indicate a general business practice; (4) a description of the rights established under Sections 1009 and 1010 of this Article and the manner in which such rights may be exercised; and (5) that information obtained from a report prepared by an insurance‑support organization may be retained by the insurance‑support organization and disclosed to other persons. (C) In lieu of the notice prescribed in subsection (B), the insurance institution or agent may provide an abbreviated notice informing the applicant or policyholder that: (1) personal information may be collected from persons other than the individual or individuals proposed for coverage, (2) such information as well as other personal or privileged information subsequently collected by the insurance institution or agent may in certain circumstances be disclosed to third parties without authorization, (3) a right of access and correction exists with respect to all personal information collected, and (4) the notice prescribed in subsection (B) will be furnished to the applicant or policyholder upon request. (D) The obligations imposed by this Section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf. (Source: P.A. 82‑108.)
(215 ILCS 5/1006)(from Ch. 73, par. 1065.706) Sec. 1006. Marketing and Research Surveys. An insurance institution or agent shall clearly specify those questions designed to obtain information solely for marketing or research purposes from an individual in connection with an insurance transaction. (Source: P.A. 82‑108.)
(215 ILCS 5/1007)(from Ch. 73, par. 1065.707) Sec. 1007. Content of Disclosure Authorization Forms. Notwithstanding any other provision of law of this State, no insurance institution, agent or insurance‑support organization may utilize as its disclosure authorization form in connection with insurance transactions a form or statement which authorizes the disclosure of personal or privileged information about an individual to the insurance institution, agent or insurance‑support organization unless the form or statement: (A) is written in plain language; (B) is dated; (C) specifies the types of persons authorized to disclose information about the individual; (D) specifies the nature of the information authorized to be disclosed; (E) names the insurance institution or agent and identifies by generic reference representatives of the insurance institution to whom the individual is authorizing information to be disclosed; (F) specifies the purposes for which the information is collected; (G) specifies the length of time such authorization shall remain valid, which shall be no longer than: (1) in the case of authorizations signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement or a request for change in policy benefits: (a) 30 months from the date the authorization is signed if the application or request involves life, health or disability insurance, (b) one year from the date the authorization is signed if the application or request involves property or casualty insurance; (2) in the case of authorizations signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy, (a) the term of coverage of the policy if the claim is for a health insurance benefit, (b) the duration of the claim if the claim is not for a health insurance benefit; and (H) advises the individual or a person authorized to act on behalf of the individual that the individual or the individual's authorized representative is entitled to receive a copy of the authorization form. (Source: P.A. 82‑108.)
(215 ILCS 5/1008)(from Ch. 73, par. 1065.708) Sec. 1008. Investigative Consumer Reports. (A) No insurance institution, agent or insurance‑support organization may prepare or request an investigative consumer report about an individual in connection with an insurance transaction involving an application for insurance, a policy renewal, a policy reinstatement or a change in insurance benefits unless the insurance institution or agent informs the individual: (1) that he or she may request to be interviewed in connection with the preparation of the investigative consumer report, and (2) that upon a request pursuant to Section 1009, he or she is entitled to receive a copy of the investigative consumer report. (B) If an investigative consumer report is to be prepared by an insurance institution or agent, the insurance institution or agent shall institute reasonable procedures to conduct a personal interview requested by an individual. (C) If an investigative consumer report is to be prepared by an insurance‑support organization, the insurance institution or agent desiring such report shall inform the insurance‑support organization whether a personal interview has been requested by the individual. The insurance‑support organization shall institute reasonable procedures to conduct such interviews, if requested. (Source: P.A. 82‑108.)
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(215 ILCS 5/1001)(from Ch. 73, par. 1065.701) Sec. 1001. Purpose. The purpose of this Article is to establish standards for the collection, use and disclosure of information gathered in connection with insurance transactions by insurance institutions, agents or insurance‑support organizations; to maintain a balance between the need for information by those conducting the business of insurance and the public's need for fairness in insurance information practices, including the need to minimize intrusiveness; to establish a regulatory mechanism to enable natural persons to ascertain what information is being or has been collected about them in connection with insurance transactions and to have access to such information for the purpose of verifying or disputing its accuracy; to limit the disclosure of information collected in connection with insurance transactions; and to enable insurance applicants and policyholders to obtain the reasons for any adverse underwriting decision. Further, this Article shall grant the Director the authority to enforce Title V of the Gramm‑Leach‑Bliley Act (Public Law 106‑102, 106th Congress). (Source: P.A. 92‑556, eff. 6‑24‑02.)
(215 ILCS 5/1002)(from Ch. 73, par. 1065.702) Sec. 1002. Scope. (A) The obligations imposed by this Article shall apply to those insurance institutions, agents or insurance‑support organizations which, on or after the effective date of this Article: (1) in the case of life, health or disability insurance: (a) collect, receive or maintain information in connection with insurance transactions which pertains to natural persons who are residents of this State, or (b) engage in insurance transactions with applicants, individuals or policyholders who are residents of this State, and (2) in the case of property or casualty insurance: (a) collect, receive or maintain information in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, or (b) engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (B) The rights granted by this Article shall extend to: (1) in the case of life, health or disability insurance, the following persons who are residents of this State: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions, and (2) in the case of property or casualty insurance, the following persons: (a) natural persons who are the subject of information collected, received or maintained in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State, and (b) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State. (C) For purposes of this Section, a person shall be considered a resident of this State if the person's last known mailing address, as shown in the records of the insurance institution, agent or insurance‑support organization, is located in this State. (D) Notwithstanding subsections (A) and (B) above, this Article shall not apply to information collected from the public records of a governmental authority and maintained by an insurance institution or its representatives for the purpose of insuring the title to real property located in this State. (Source: P.A. 81‑1430.)
(215 ILCS 5/1003)(from Ch. 73, par. 1065.703) Sec. 1003. Definitions. As used in this Article: (A) "Adverse underwriting decision" means: (1) any of the following actions with respect to
insurance transactions involving insurance coverage which is individually underwritten:
(a) a declination of insurance coverage, (b) a termination of insurance coverage, (c) 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,
(d) in the case of a property or casualty
insurance coverage:
(i) placement by an insurance institution or
agent of a risk with a residual market mechanism, an unauthorized insurer or an insurance institution which specializes in substandard risks, or
(ii) the charging of a higher rate on the
basis of information which differs from that which the applicant or policyholder furnished, or
(e) in the case of life, health or disability
insurance coverage, an offer to insure at higher than standard rates.
(2) Notwithstanding paragraph (1) above, 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:
(a) the termination of an individual policy form
on a class or statewide basis,
(b) a declination of insurance coverage solely
because such coverage is not available on a class or statewide basis, or
(c) the rescission of a policy. (B) "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. (C) "Agent" means an individual, firm, partnership, association or corporation who is involved in the solicitation, negotiation or binding of coverages for or on applications or policies of insurance, covering property or risks located in this State. For the purposes of this Article, both "Insurance Agent" and "Insurance Broker", as defined in Section 490, shall be considered an agent. (D) "Applicant" means any person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten. (E) "Director" means the Director of Insurance. (F) "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. (G) "Consumer reporting agency" means any person who: (1) regularly engages, in whole or in part, in the
practice of assembling or preparing consumer reports for a monetary fee,
(2) obtains information primarily from sources other
than insurance institutions, and
(3) furnishes consumer reports to other persons. (H) "Control", including the terms "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. (I) "Declination of insurance coverage" means a denial, in whole or in part, by an insurance institution or agent of requested insurance coverage. (J) "Individual" means any natural person who: (1) in the case of property or casualty insurance,
is a past, present or proposed named insured or certificateholder;
(2) in the case of life, health or disability
insurance, is a past, present or proposed principal insured or certificateholder;
(3) is a past, present or proposed policyowner; (4) is a past or present applicant; (5) is a past or present claimant; or (6) derived, derives or is proposed to derive
insurance coverage under an insurance policy or certificate subject to this Article.
(K) "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: (1) an agent, (2) the individual who is the subject of the
information, or
(3) a natural person acting in a personal capacity
rather than in a business or professional capacity.
(L) "Insurance institution" means any corporation, association, partnership, reciprocal exchange, inter‑insurer, Lloyd's insurer, fraternal benefit society or other person engaged in the business of insurance, health maintenance organizations as defined in Section 2 of the Health Maintenance Organization Act, voluntary health services plans as defined in Section 2 of the Voluntary Health Services Plans Act, and dental service plans as defined in Section 4 of the Dental Service Plan Act. "Insurance institution" shall not include agents or insurance‑support organizations. (M) "Insurance‑support organization" means: (1) 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:
(a) the furnishing of consumer reports or
investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction, or
(b) 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.
(2) Notwithstanding paragraph (1) above, the
following persons shall not be considered "insurance‑support organizations" for purposes of this Article: agents, government institutions, insurance institutions, medical care institutions and medical professionals.
(N) "Insurance transaction" means any transaction involving insurance primarily for personal, family or household needs rather than business or professional needs which entails: (1) the determination of an individual's eligibility
for an insurance coverage, benefit or payment, or
(2) the servicing of an insurance application,
policy, contract or certificate.
(O) "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. (P) "Medical‑care institution" means any facility or institution that is licensed to provide health care services to natural persons, including but not limited to: hospitals, skilled nursing facilities, home‑health agencies, medical clinics, rehabilitation agencies and public‑health agencies and health‑maintenance organizations. (Q) "Medical professional" means any person licensed or certified to provide health care services to natural persons, including but not limited to, a physician, dentist, nurse, optometrist, chiropractor, naprapath, pharmacist, physical or occupational therapist, psychiatric social worker, speech therapist, clinical dietitian or clinical psychologist. (R) "Medical‑record information" means personal information which: (1) relates to an individual's physical or mental
condition, medical history or medical treatment, and
(2) is obtained from a medical professional or
medical‑care institution, from the individual, or from the individual's spouse, parent or legal guardian.
(S) "Person" means any natural person, corporation, association, partnership or other legal entity. (T) "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" includes an individual's name and address and "medical‑record information" but does not include "privileged information". (U) "Policyholder" means any person who: (1) in the case of individual property or casualty
insurance, is a present named insured;
(2) in the case of individual life, health or
disability insurance, is a present policyowner; or
(3) in the case of group insurance which is
individually underwritten, is a present group certificateholder.
(V) "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: (1) pretends to be someone he or she is not, (2) pretends to represent a person he or she is not
in fact representing,
(3) misrepresents the true purpose of the interview,
or
(4) refuses to identify himself or herself upon
request.
(W) "Privileged information" means any individually identifiable information that: (1) relates to a claim for insurance benefits or a civil or criminal proceeding involving an individual, and (2) 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 subsection shall nevertheless be considered "personal information" under this Article if it is disclosed in violation of Section 1014 of this Article. (X) "Residual market mechanism" means an association, organization or other entity described in Article XXXIII of this Act, or Section 7‑501 of The Illinois Vehicle Code. (Y) "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. (Z) "Unauthorized insurer" means an insurance institution that has not been granted a certificate of authority by the Director to transact the business of insurance in this State. (Source: P.A. 90‑7, eff. 6‑10‑97; 90‑177, eff. 7‑23‑97; 90‑372, eff. 7‑1‑98; 90‑655, eff. 7‑30‑98.)
(215 ILCS 5/1004)(from Ch. 73, par. 1065.704) Sec. 1004. Pretext Interviews. No insurance institution, agent or insurance‑support organization shall use or authorize the use of pretext interviews to obtain information in connection with an insurance transaction; provided, however, a pretext interview may be undertaken to obtain information from a person or institution that does not have a generally or statutorily recognized privileged relationship with the person about whom the information relates for the purpose of investigating a claim where, based upon specific information available for review by the Director, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim. (Source: P.A. 82‑108.)
(215 ILCS 5/1005)(from Ch. 73, par. 1065.705) Sec. 1005. Notice of Insurance Information Practices. (A) An insurance institution or agent shall provide a notice of information practices to all applicants or policyholders in connection with insurance transactions as provided below: (1) in the case of an application for insurance, a notice shall be provided no later than: (a) at the time of the delivery of the insurance policy or certificate when personal information is collected only from the applicant or from public records, or (b) at the time the collection of personal information is initiated when personal information is collected from a source other than the applicant or public records; (2) in the case of a policy renewal, a notice shall be provided no later than the policy renewal date, except that no notice shall be required in connection with a policy renewal if: (a) personal information is collected only from the policyholder or from public records, or (b) a notice meeting the requirements of this Section has been given within the previous 24 months; or (3) in the case of a policy reinstatement or change in insurance benefits, a notice shall be provided no later than the time a request for a policy reinstatement or change in insurance benefits is received by the insurance institution, except that no notice shall be required if personal information is collected only from the policyholder or from public records. (B) The notice required by subsection (A) shall be in writing and shall state: (1) whether personal information may be collected from persons other than the individual or individuals proposed for coverage; (2) the types of personal information that may be collected and the types of sources and investigative techniques that may be used to collect such information; (3) the types of disclosures identified in subsections (B), (C), (D), (E), (F), (I), (K), (L) and (N) of Section 1014 of this Article and the circumstances under which such disclosures may be made without prior authorization; provided, however, only those circumstances need be described which occur with such frequency as to indicate a general business practice; (4) a description of the rights established under Sections 1009 and 1010 of this Article and the manner in which such rights may be exercised; and (5) that information obtained from a report prepared by an insurance‑support organization may be retained by the insurance‑support organization and disclosed to other persons. (C) In lieu of the notice prescribed in subsection (B), the insurance institution or agent may provide an abbreviated notice informing the applicant or policyholder that: (1) personal information may be collected from persons other than the individual or individuals proposed for coverage, (2) such information as well as other personal or privileged information subsequently collected by the insurance institution or agent may in certain circumstances be disclosed to third parties without authorization, (3) a right of access and correction exists with respect to all personal information collected, and (4) the notice prescribed in subsection (B) will be furnished to the applicant or policyholder upon request. (D) The obligations imposed by this Section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf. (Source: P.A. 82‑108.)
(215 ILCS 5/1006)(from Ch. 73, par. 1065.706) Sec. 1006. Marketing and Research Surveys. An insurance institution or agent shall clearly specify those questions designed to obtain information solely for marketing or research purposes from an individual in connection with an insurance transaction. (Source: P.A. 82‑108.)
(215 ILCS 5/1007)(from Ch. 73, par. 1065.707) Sec. 1007. Content of Disclosure Authorization Forms. Notwithstanding any other provision of law of this State, no insurance institution, agent or insurance‑support organization may utilize as its disclosure authorization form in connection with insurance transactions a form or statement which authorizes the disclosure of personal or privileged information about an individual to the insurance institution, agent or insurance‑support organization unless the form or statement: (A) is written in plain language; (B) is dated; (C) specifies the types of persons authorized to disclose information about the individual; (D) specifies the nature of the information authorized to be disclosed; (E) names the insurance institution or agent and identifies by generic reference representatives of the insurance institution to whom the individual is authorizing information to be disclosed; (F) specifies the purposes for which the information is collected; (G) specifies the length of time such authorization shall remain valid, which shall be no longer than: (1) in the case of authorizations signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement or a request for change in policy benefits: (a) 30 months from the date the authorization is signed if the application or request involves life, health or disability insurance, (b) one year from the date the authorization is signed if the application or request involves property or casualty insurance; (2) in the case of authorizations signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy, (a) the term of coverage of the policy if the claim is for a health insurance benefit, (b) the duration of the claim if the claim is not for a health insurance benefit; and (H) advises the individual or a person authorized to act on behalf of the individual that the individual or the individual's authorized representative is entitled to receive a copy of the authorization form. (Source: P.A. 82‑108.)
(215 ILCS 5/1008)(from Ch. 73, par. 1065.708) Sec. 1008. Investigative Consumer Reports. (A) No insurance institution, agent or insurance‑support organization may prepare or request an investigative consumer report about an individual in connection with an insurance transaction involving an application for insurance, a policy renewal, a policy reinstatement or a change in insurance benefits unless the insurance institution or agent informs the individual: (1) that he or she may request to be interviewed in connection with the preparation of the investigative consumer report, and (2) that upon a request pursuant to Section 1009, he or she is entitled to receive a copy of the investigative consumer report. (B) If an investigative consumer report is to be prepared by an insurance institution or agent, the insurance institution or agent shall institute reasonable procedures to conduct a personal interview requested by an individual. (C) If an investigative consumer report is to be prepared by an insurance‑support organization, the insurance institution or agent desiring such report shall inform the insurance‑support organization whether a personal interview has been requested by the individual. The insurance‑support organization shall institute reasonable procedures to conduct such interviews, if requested. (Source: P.A. 82‑108.)
(215 ILCS 5/1009)(from Ch. 73, par. 1065.709) Sec. 1009.
