As used in this chapter:
“Adverse underwriting decision” means:
2. Notwithstanding subdivision 1 of this definition, the following actions shall not be considered adverse underwriting decisions, but the insurance institution or agent responsible for their occurrence shall provide the applicant or policyholder with the specific reason or reasons for their occurrence:
“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.”Agent” shall have the meaning as set forth in § 38.2-1800 and shall include surplus lines brokers.”Applicant” means any person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten.”Clear and conspicuous notice” means a notice that is reasonably understandable and designed to call attention to the nature and significance of the information in the notice.”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 that is used or expected to be used in connection with an insurance transaction.”Consumer reporting agency” means any person who:
“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.”Declination of insurance coverage” means a denial, in whole or in part, by an insurance institution or agent of requested insurance coverage.”Financial information” means personal information other than medical record information or records of payment for the provision of health care to an individual.”Financial institution” means any institution the business of which is engaging in financial activities as described in Section 4(k) of the Bank Holding Company Act of 1956 (12 U.S.C. § 1843 (k)).”Financial product or service” means any product or service that a financial holding company could offer by engaging in an activity that is financial in nature or incidental to such a financial activity under Section 4(k) of the Bank Holding Company Act of 1956 (12 U.S.C. § 1843 (k)).”Individual” means any natural person who:
Notwithstanding any provision of this definition to the contrary, for purposes of § 38.2-612.1, “individual” shall not include any natural person who is covered under an employee benefit plan, group or blanket insurance contract, or group annuity contract when the insurance institution or agent that provides such plan or contract: (i) furnishes the notice required under § 38.2-604.1 to the employee benefit plan sponsor, group or blanket insurance contract holder, or group annuity contract holder; and (ii) does not disclose the financial information of the person to a nonaffiliated third party other than as permitted under § 38.2-613.”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:
“Insurance institution” means any corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyd’s type of organization, fraternal benefit society, or other person engaged in the business of insurance, including health maintenance organizations, and health, legal, dental, and optometric service plans. “Insurance institution” shall not include agents or insurance-support organizations.”Insurance-support organization” means 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 (i) the furnishing of consumer reports or investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction or (ii) 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. However, the following persons shall not be considered “insurance-support organizations” for purposes of this chapter: agents, governmental institutions, insurance institutions, medical-care institutions and medical professionals.”Insurance transaction” means any transaction involving insurance primarily for personal, family, or household needs rather than business or professional needs that entails:
“Investigative consumer report” means a consumer report or a 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.”Joint marketing agreement” means a formal written contract pursuant to which an insurance institution jointly offers, endorses, or sponsors a financial product or service with another financial institution.”Life insurance” includes annuities.”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 or health-maintenance organizations.”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, chiropractor, optometrist, physical or occupational therapist, social worker, clinical dietitian, clinical psychologist, licensed professional counselor, licensed marriage and family therapist, pharmacist, or speech therapist.”Medical-record information” means personal information that:
“Nonaffiliated third party” means any person who is not an affiliate of an insurance institution but does not mean (i) an agent who is selling or servicing a product on behalf of the insurance institution or (ii) a person who is employed jointly by the insurance institution and the company that is not an affiliate.”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 (i) privileged information or (ii) any information that is publicly available.”Policyholder” means any person who:
“Policyholder information” means personal information about a policyholder, whether in paper, electronic, or other form, that is maintained by or on behalf of an insurance institution, agent, or insurance-support organization.”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:
“Privileged information” means any individually identifiable information that (i) relates to a claim for insurance benefits or a civil or criminal proceeding involving an individual, and (ii) is collected in connection with or in reasonable anticipation of a claim for insurance benefits or civil or criminal proceeding involving an individual.”Residual market mechanism” means an association, organization, or other entity defined, described, or provided for in the Virginia Automobile Insurance Plan as set forth in § 38.2-2015, or in the Virginia Property Insurance Association as set forth in Chapter 27 (§ 38.2-2700 et seq.) of this title.”Termination of insurance coverage” or “termination of an insurance policy” means either a cancellation or nonrenewal of an insurance policy other than by the policyholder’s request, in whole or in part, for any reason other than the failure to pay a premium as required by the policy.”Unlicensed insurer” means an insurance institution that has not been granted a license by the Commission to transact the business of insurance in Virginia.
1981, c. 389, § 38.1-57.5; 1986, c. 562; 2001, c. 371; 2003, c. 729; 2006, c. 638.