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Updated 2013−14 Wis. Stats. Published and certified under s. 35.18. January 1, 2015.

631.89

INSURANCE CONTRACTS GENERALLY

Updated 13−14 Wis. Stats.

10

cleic acid extracted from an individual’s cells in order to deter- mine the presence of a genetic disease or disorder or the individu- al’s predisposition for a particular genetic disease or disorder.

(2) An insurer, the state with respect to a self−insured health plan, or a county, city, village or school board that provides health care services for individuals on a self−insured basis, may not do any of the following:

(a) Require or request directly or indirectly any individual or a member of the individual’s family to obtain a genetic test.

(b) Require or request directly or indirectly any individual to reveal whether the individual or a member of the individual’s fam- ily has obtained a genetic test or what the results of the test, if obtained by the individual or a member of the individual’s family, were.

(bm) Require or request directly or indirectly a health care pro- vider, as defined in s. 146.81 (1) (a) to (p), who is or may be pro- viding or who has or may have provided health care services to an individual to reveal whether the individual or a member of the individual’s family has obtained a genetic test or what the results of the test, if obtained by the individual or a member of the individ- ual’s family, were.

(c) Condition the provision of insurance coverage or health care benefits on whether an individual or a member of the individ- ual’s family has obtained a genetic test or what the results of the test, if obtained by the individual or a member of the individual’s family, were.

(d) Consider in the determination of rates or any other aspect of insurance coverage or health care benefits provided to an indi- vidual whether an individual or a member of the individual’s fam- ily has obtained a genetic test or what the results of the test, if obtained by the individual or a member of the individual’s family, were.

(3) (a) Subsection (2) does not apply to an insurer writing life insurance coverage or income continuation insurance coverage.

(b) An insurer writing life insurance coverage or income con- tinuation insurance coverage that obtains information under sub.

  • (2)

    (a) or (b) may not do any of the following:

  • 1.

    Use the information contrary to sub. (2) (c) or (d) in writing

a type of insurance coverage other than life or income continua- tion for the individual or a member of the individual’s family.

2. Provide for rates or any other aspect of coverage that is not reasonably related to the risk involved.

History: 1991 a. 269; 1997 a. 74; 2009 a. 28.

631.90 Restrictions on use of tests for HIV. (1) In this section, “HIV test” has the meaning given in s. 252.01 (2m).

(2) With regard to policies issued or renewed on and after July 20, 1985, an insurer may not do any of the following:

(a) Require or request directly or indirectly any individual to reveal whether the individual has obtained an HIV test or what the results of this test, if obtained by the individual, were.

(b) Condition the provision of insurance coverage on whether an individual has obtained an HIV test or what the results of this test, if obtained by the individual, were.

(c) Consider in the determination of rates or any other aspect of insurance coverage provided to an individual whether an indi- vidual has obtained an HIV test or what the results of this test, if obtained by the individual, were.

(3) (a) Subsection (2) does not apply with regard to an HIV test for use in the underwriting of individual life, accident and health insurance policies that the commissioner finds and des- ignates by rule as sufficiently reliable for use in the underwriting of individual life, accident and health insurance policies.

(b) Paragraph (a) does not authorize the use of an HIV test to discriminate in violation of s. 628.34 (3).

History: 1985 a. 29, 73; 1987 a. 70 ss. 34, 36; 1989 a. 201 ss. 31, 36; 1995 a. 27 s. 9126 (19); 2007 a. 20 s. 9121 (6) (a); 2009 a. 209. Cross−reference: See also s. Ins 3.53, Wis. adm. code.

631.93

Prohibited provisions concerning HIV infec-

tion. (1) DEFINITIONS. In this section, “HIV infection” means pathological state produced by a human body in response to presence of HIV, as defined in s. 631.90 (1).

the the

(2) ACCIDENT AND HEALTH INSURANCE. An accident or health insurance policy may not contain exclusions or limitations,

including deductibles or copayments, for coverage of the treat-

ment of HIV infection or any illness or medical condition arising from or related to HIV infection, unless the exclusions or limita- tions apply generally to other illnesses or medical conditions cov- ered by the policy.

(3) LIFE INSURANCE. A life insurance policy may not deny or limit benefits solely because the insured’s death is caused, directly or indirectly, by HIV infection or any illness or medical condition arising from or related to HIV infection.

History: 1989 a. 201.

631.95 abuse.

Restrictions on insurance practices; domestic (1) DEFINITIONS. In this section:

    • (a)

      “Abuse” has the meaning given in s. 813.122 (1) (a).

    • (b)

      “Disability insurance policy” has the meaning given in s.

      • 632.895

        (1) (a).

        • (c)

          “Domestic abuse” has the meaning given in s. 968.075 (1)

    • (a)

      .

      • (2)

        GENERAL PROHIBITIONS. Except as provided in sub. (3), an

insurer may not do any of the following:

(a) Refuse to provide or renew coverage to a person, or cancel a person’s coverage, under an individual or group insurance policy or a certificate of group insurance on the basis that the per- son has been, or the insurer has reason to believe that the person is, a victim of abuse or domestic abuse or that a member of the per- son’s family has been, or the insurer has reason to believe that a member of the person’s family is, a victim of abuse or domestic abuse.

(b) Refuse to provide or renew coverage to an employer or other group, or cancel an employer’s or other group’s coverage, under a group insurance policy on the basis that an employee or other group member has been, or the insurer has reason to believe that an employee or other group member is, a victim of abuse or domestic abuse or that a member of an employee’s or other group member’s family has been, or the insurer has reason to believe that a member of an employee’s or other group member’s family is, a victim of abuse or domestic abuse.

(c) Use as a factor in the determination of rates or any other aspect of insurance coverage under an individual or group insur- ance policy or a certificate of group insurance the knowledge or suspicion that a person or an employee or other group member has been or is a victim of abuse or domestic abuse or that a member of the person’s or an employee’s or other group member’s family has been or is a victim of abuse or domestic abuse.

(d) Under an individual or group disability insurance policy or a certificate of group disability insurance, exclude or limit cover- age of, or deny a claim for, health care services or items related to the treatment of injury or disease resulting from abuse or domestic abuse on the basis that a person or an employee or other group member has been, or the insurer has reason to believe that a person or an employee or other group member is, a victim of abuse or domestic abuse or that a member of the person’s or an employee’s or other group member’s family has been, or the insurer has reason to believe that a member of the person’s or an employee’s or other group member’s family is, a victim of abuse or domestic abuse.

(e) Under an individual or group life insurance policy or a cer- tificate of group life insurance, deny or limit benefits in the event that the death of the person whose life is insured results from abuse or domestic abuse on the basis that the person whose life is insured has been, or the insurer has reason to believe that the person whose life is insured is, a victim of abuse or domestic abuse or that a member of the family of the person whose life is insured has been,

or the insurer has reason to believe that a member of the family of

2013−14 Wisconsin Statutes updated through 2013 Wis. Act 380 and all Supreme Court Orders entered before Jan. 1, 2015. Pub- lished and certified under s. 35.18. Changes effective after Jan. 1, 2015 are designated by NOTES. (Published 1−1−15)

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