Trade Practices and Frauds

KRS tit. XXV, ch. 304, subtit. 12

in effect

KRS 304.12-010 Unfair competition -- Unfair, deceptive practices prohibited

304.12-010. Unfair competition -- Unfair, deceptive practices prohibited No person shall engage in this state in any practice which is prohibited in this subtitle, or which is defined therein as, or determined pursuant thereto to be, an unfair method of competition or any unfair or deceptive act or practice in the business of insurance. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 1, effective June 18, 1970.

KRS 304.12-013 Prohibited unfair or deceptive practices in the writing of insurance

304.12-013. Prohibited unfair or deceptive practices in the writing of insurance (1) The purpose of this section is to prohibit unfair or deceptive practices in the transaction of life and health insurance with respect to the human immunodeficiency virus infection and related matters. This section applies to all life and health insurance contracts which are delivered or issued for delivery in Kentucky on or after July 13, 1990. (2) This section shall not prohibit an insurer from contesting the validity of an insurance contract or whether a claim is covered under an insurance contract to the extent allowed by law. (3) As used in this section: (a) "Human immunodeficiency virus" (HIV) means the causative agent of acquired immunodeficiency syndrome (AIDS) or any other type of immunosuppression caused by the human immunodeficiency virus; (b) "Insurance contract" means a contract issued by an insurer as defined in this section; and (c) "Insurer" means an insurer, a nonprofit hospital, medical-surgical, dental, and health service corporation, a health maintenance organization, or a prepaid dental plan organization. (4) (a) In the underwriting of an insurance contract regarding human immunodeficiency virus infection and health conditions derived from such infection, the insurer shall utilize medical tests which are reliable predictors of risk. Only a test which is recommended by the Centers for Disease Control or by the Food and Drug Administration is deemed to be reliable for the purposes of this section. If a specific Centers for Disease Control or Food and Drug Administration-recommended test indicates the existence or possible existence of human immunodeficiency virus infection or a health condition related to the human immunodeficiency virus infection, before relying on a single test to deny issuance of an insurance contract, limit coverage under an insurance contract, or to establish the premium for an insurance contract, the insurer shall follow the applicable Centers for Disease Control or Food and Drug Administration-recommended test protocol and shall utilize any applicable Centers for Disease Control or Food and Drug Administration- recommended follow-up tests or series of tests to confirm the indication. (b) Prior to testing, the insurer shall disclose in writing its intent to test the applicant for the human immunodeficiency virus infection or for a specific health condition derived therefrom and shall obtain the applicant's written informed consent to administer the test. Written informed consent shall include a fair explanation of the test, including its purpose, potential uses and limitations, the meaning of its results, and the right to confidential treatment of information. Use of a form prescribed by the department shall raise a conclusive presumption of informed consent. (c) An applicant shall be notified of a positive test result by a physician designated by the applicant, or, in the absence of such designation, by the Cabinet for Health and Family Services. The notification shall include: 1. Face-to-face post-test counseling on the meaning of the test results, the possible need for additional testing, and the need to eliminate behavior which might spread the disease to others; 2. The availability in the geographic area of any appropriate health-care services, including mental health care, and appropriate social and support services; 3. The benefits of locating and counseling any person by whom the infected person may have been exposed to human immunodeficiency virus and any person whom the infected person may have exposed to the virus; and 4. The availability, if any, of the services of public health authorities with respect to locating and counseling any person described in subparagraph 3. of this paragraph. (d) A medical test for human immunodeficiency virus infection or for a health condition derived from the infection shall only be required or given to an applicant for an insurance contract on the basis of the applicant's health condition or health history, on the basis of the amount of insurance applied for, or if the test is required of all applicants. (e) An insurer may ask whether an applicant for an insurance contract has been tested positive for human immunodeficiency virus infection or other health conditions derived from such infection. Insurers shall not inquire whether the applicant has been tested for or has received a negative result from a specific test for human immunodeficiency virus infection or for a health condition derived from such infection. (f) Insurers shall maintain strict confidentiality of the results of tests for human immunodeficiency virus infection or a specific health condition derived from human immunodeficiency virus infection. Information regarding specific test results shall be disclosed only as required by law or pursuant to a written request or authorization by the applicant. Insurers may disclose results pursuant to a specific written request only to the following persons: 1. The applicant; 2. A licensed physician or other person designated by the applicant; 3. An insurance medical-information exchange under procedures that are used to assure confidentiality, such as the use of general codes that also cover results of tests for other diseases or conditions not related to human immunodeficiency virus infection; 4. For the preparation of statistical reports that do not disclose the identity of any particular applicant; 5. Reinsurers, contractually retained medical personnel, and insurer affiliates if these entities are involved solely in the underwriting process and under procedures that are designed to assure confidentiality; 6. To insurer personnel who have the responsibility to make underwriting decisions; and 7. To outside legal counsel who needs the information to represent the insurer effectively in regard to matters concerning the applicant. (g) Insurers shall use for the processing of human immunodeficiency virus-related tests only those laboratories that are certified by the United States Department of Health and Human Services under the Clinical Laboratory Improvement Act of 1967, which permit testing of specimens in interstate commerce, and which subject themselves to ongoing proficiency testing by the College of American Pathologists, the American Association of Bioanalysts, or an equivalent program approved by the Centers for Disease Control. (5) (a) An insurance contract shall not exclude coverage for human immunodeficiency virus infection. An insurance contract shall not contain benefit provisions, terms, or conditions which apply to human immunodeficiency virus infection in a different manner than those which apply to any other health condition. Insurance contracts which violate this paragraph shall be disapproved by the commissioner pursuant to KRS 304.14- 130(1)(a), 304.32-160, and 304.38-050. (b) A health insurance contract shall not be canceled or nonrenewed solely because a person or persons covered by the contract has been diagnosed as having or has been treated for human immunodeficiency virus infection. (c) Sexual orientation shall not be used in the underwriting process or in the determination of which applicants shall be tested for exposure to the human immunodeficiency virus infection. Neither the marital status, the living arrangements, the occupation, the gender, the beneficiary designation, nor the zip code or other territorial classification of an applicant's sexual orientation. (d) This subsection does not prohibit the issuance of accident only or specified disease insurance contracts. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1105, effective July 15, 2010. -- Amended 2005 Ky. Acts ch. 99, sec. 578, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 105, sec. 31, effective July 15, 2002. -- Amended 1998 Ky. Acts ch. 426, sec. 522, effective July 15, 1998. -- Created 1990 Ky. Acts ch. 443, sec. 54, effective July 13, 1990.

KRS 304.12-015 Repealed, effective July 15, 1986

304.12-015. Repealed, effective July 15, 1986 Catchline at repeal: Unfair methods of competition, unfair or deceptive acts or practices enumerated - Application of section. History: Repealed 1986 Ky. Acts ch. 437, sec. 40, effective July 15, 1986. -- Created 1984 Ky. Acts ch. 318, sec. 1, effective July 13, 1984.

KRS 304.12-020 Advertisements in general

304.12-020. Advertisements in general No person shall make or disseminate orally or in other manner any advertisement, information, matter, statement, or thing: (1) Misrepresenting the terms of any policy or the benefits or advantages thereof or dividends or share of surplus to be received thereon, or setting forth false or misleading information or estimates as to dividends or share of surplus previously paid on similar policies. (2) Using any name or title of any policy or class of policies misrepresenting the true nature thereof. (3) Setting forth any misleading representation or any misrepresentation as to the financial condition of an insurer, or as to the legal reserve system upon which any life insurer operates. (4) Containing any assertion, representation, or statement with respect to the business of insurance or with respect to any person in the conduct of his insurance business, which is untrue, deceptive, or misleading. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 2, effective June 18, 1970.

KRS 304.12-030 Replacement life insurance -- "Twisting" prohibited

304.12-030. Replacement life insurance -- "Twisting" prohibited (1) As used in this section: (a) "Replacement" means any transaction in which a new life insurance policy or annuity contract is to be purchased and it is known or should be known to the proposing producer, or to the proposing insurer if there is no producer, that by reason of the transaction, an existing life insurance policy or annuity contract has been or is to be: 1. Lapsed, forfeited, surrendered or partially surrendered, assigned to the replacing insurer, or otherwise terminated; 2. Converted to reduced paid-up insurance, continued as extended term insurance, or otherwise reduced in value by the use of nonforfeiture benefits or other policy values; 3. Amended so as to effect either a reduction in benefits or in the term for which coverage would otherwise remain in force or for which benefits would be paid; 4. Reissued with any reduction in cash value; or 5. Used in a financed purchase; (b) "Existing insurer" means the insurance company whose existing life insurance policy or annuity contract is or will be changed or affected in a manner described within the definition of replacement transaction; (c) "Replacing insurer" means the insurance company that issues or proposes to issue a new life insurance policy or annuity contract that replaces an existing policy or contract or is a financed purchase; (d) "Existing life insurance policy or annuity contract" means any individual life insurance policy or annuity in force, including a life insurance policy under a binding or conditional receipt or a life insurance policy or annuity contract that is within an unconditional refund period; (e) "Financed purchase" means the purchase of a new policy involving the actual or intended use of funds obtained by the withdrawal or surrender of, or by borrowing from values of, an existing policy to pay all or part of any premium due on the new policy. If a withdrawal, surrender, or borrowing involving the policy values of an existing policy is used to pay premiums on a new policy owned by the same policyholder and issued by the same company within four (4) months before or thirteen (13) months after the effective date of the new policy, it is prima facie evidence of the policyholder's intent to finance the purchase of the new policy with existing policy values. This prima facie standard does not affect the monitoring obligations of the existing insurer; and (f) "Direct-response solicitation" means a solicitation through a sponsoring or endorsing entity or individual solely through mails, telephone, the Internet. or mass communication media. (2) No replacing insurer shall issue any life insurance policy or annuity contract in a replacement transaction to replace an existing life insurance policy or annuity contract unless the replacing insurer shall agree in writing with the insured that: (a) The new life insurance policy or annuity contract issued by the replacing insurer will not be contestable by it in the event of such insured's death to any greater extent than the existing life insurance policy or annuity contract would have been contestable by the existing insurer had such replacement not taken place provided, however, that this paragraph shall not apply to that amount of insurance written and issued which exceeds the amount of the existing life insurance; and (b) The policy or contract owner shall have the right to return the policy or contract within thirty (30) days of the delivery of the policy or contract and receive an unconditional full refund of all premiums or considerations paid on it, including any policy fees or charges, or in the case of a variable or market adjustment policy or contract, a payment of the cash surrender value provided under the policy or contract plus the fees and other charges deducted from the gross premiums or considerations or imposed under such policy or contract. (3) Unless otherwise specifically included, subsection (2) of this section shall not apply to: (a) Credit life insurance; (b) Group life insurance or group annuities where there is no direct solicitation of individuals by an insurance producer. Direct solicitation shall not include any group meeting held by an insurance producer solely for the purpose of educating or enrolling individuals or, when initiated by an individual member of the group, assisting with the selection of investment options offered by a single annuity provider in connection with enrolling that individual. The commissioner shall promulgate administrative regulations for group life insurance or group annuity certificates marketed through direct response solicitation; (c) Group life insurance and annuities used to fund prearranged funeral contracts; (d) An application to the existing insurer that issued the existing policy or contract when a contractual policy change or conversion privilege is being exercised, or when the existing policy or contract is being replaced by the same insurer pursuant to a program filed with and approved by the commissioner; (e) Existing life insurance that is a nonconvertible term life insurance policy which will expire in five (5) years or less and cannot be renewed; or (f) Proposed life insurance that is to replace life insurance under a binding or conditional receipt issued by the same company; (g) Policies or contracts used to fund: 1. An employee pension or welfare benefit plan that is covered by the Employee Retirement and Income Security Act (ERISA); 2. A plan described by Sections 402(a), 401(k) or 403(b) of the Internal Revenue Code, where the plan, for purposes of ERISA, is established or maintained by an employer; 3. A governmental or church plan defined in Section 414 of the Internal Revenue Code, a governmental or church welfare benefit plan, or a deferred compensation plan of a state or local government or tax exempt organization under Section 457 of the Internal Revenue Code; or 4. A nonqualified deferred compensation arrangement established or maintained by an employer or plan sponsor. Notwithstanding the provisions of this paragraph, subsection (2) of this section shall apply to policies or contracts used to fund any plan or arrangement that is funded solely by contributions an employee elects to make, whether on a pre-tax or after-tax basis, and where the insurer has been notified that plan participants may choose from among two (2) or more insurers and there is a direct solicitation of an individual employee by an insurance producer for the purchase of a contract or policy. As used in this paragraph, direct solicitation shall not include any group meeting held by an insurance producer solely for the purpose of educating individuals about the plan or arrangement or enrolling individuals in the plan or arrangement or, when initiated by an individual employee, assisting with the selection of investment options offered by a single insurer in connection with enrolling that individual employee; (h) Where new coverage is provided under a life insurance policy or contract and the cost is borne wholly by the insured's employer or by an association of which the insured is a member; (i) Immediate annuities that are purchased with proceeds from an existing contract. Immediate annuities purchased with proceeds from an existing policy are not exempted from the requirements of this section; or (j) Structured settlements. (4) No person shall make or issue, or cause to be made or issued, any written or oral statement of a material fact which is untrue or omit to state a material fact necessary in order to make the statements made, in the light of circumstances under which they were made, not misleading with respect to comparisons as to the terms, conditions, or benefits contained in any policy for the purpose of inducing or attempting or tending to induce the policyholder to lapse, forfeit, borrow against, surrender, retain, exchange, modify, convert, or otherwise affect or dispose of any insurance policy. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1106, effective July 15, 2010. -- Amended 2005 Ky. Acts ch. 47, sec. 1, effective June 20, 2005. -- Amended 1986 Ky. Acts ch. 437, sec. 17, effective July 15, 1986. -- Amended 1984 Ky. Acts ch. 322, sec. 19, effective July 13, 1984. -- Amended 1980 Ky. Acts ch. 386, sec. 1, effective July 15, 1980. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 3, effective June 18, 1970. Legislative Research Commission Note (6/20/2005). Subsection (3)(g)2. of this statute contains a reference to Section 402(a) of the Internal Revenue Code. According to an executive agency that assisted in the drafting of this statute (2005 Ky. Acts ch. 47, sec. 1), the reference should be to Section 401(a) of the Internal Revenue Code.

KRS 304.12-035 Beneficiaries' Bill of Rights

304.12-035. Beneficiaries' Bill of Rights (1) As used in this section, "retained asset account" means any mechanism whereby the settlement of proceeds payable under a life insurance policy, including but not limited to the payment of cash surrender value, is accomplished by the insurer or an entity acting on behalf of the insurer depositing the proceeds into an account where those proceeds are retained by the insurer, pursuant to a supplementary contract not involving annuity benefits. (2) (a) An insurer may not use a retained asset account as the mode of settlement unless the insurer discloses the use of a retained asset account to the beneficiary or the beneficiary's legal representative prior to the transfer of life insurance proceeds to a retained asset account. (b) A beneficiary shall be informed, prior to the distribution of any life insurance proceeds, of his or her right to receive a lump-sum payment of life insurance proceeds in the form of a bank check or other form of immediate full payment of benefits. (3) (a) A complete listing and clear explanation of all life insurance proceeds payment options available to the beneficiary shall accompany, in written or electronic format, the use of a retained asset account. The complete listing and clear explanation of life insurance proceeds payment options shall accompany the disclosure required by subsection (2)(b) of this section. (b) Pursuant to paragraph (a) of this subsection, the use of a retained asset account shall require the following to be included in the complete listing and clear explanation disclosure: 1. The recommendation to consult a tax, investment, or other financial advisor regarding tax liability and investment options; 2. The initial interest rate, the circumstances and time frames under which interest rates may change, and any dividends and other gains that may be paid or distributed to the account holder; 3. The custodian of the funds or assets of the account; 4. The coverage guaranteed by the Federal Deposit Insurance Corporation (FDIC), if any, and the amount of the coverage; 5. The limitations, if any, on the number or amount of withdrawals or transfers of funds from the account, including any minimum or maximum withdrawal amounts for payment of life insurance proceeds; 6. The delays, if any, that the account holder may encounter in completing authorized transactions and the anticipated duration of such delays; 7. The services provided for a fee, including a list of the fees and the method of their calculation; 8. The nature and frequency of statements of account; 9. The payment of some or all of the life insurance proceeds may be by the delivery of checks, drafts, or other instruments to access the available funds; 10. The entire life insurance proceeds are available to the account holder by the use of one (1) check, draft, or other instrument; 11. The insurer or a related party may derive income, in addition to any fees charged on the account, from the total gains received on the investment of the balance of funds in the account; 12. The telephone number, address, and other contact information, including a Web site address, to obtain additional information regarding the account; and 13. The following statement, "FOR FURTHER INFORMATION, PLEASE CONTACT YOUR STATE DEPARTMENT OF INSURANCE." (c) The writings produced to satisfy the requirements of this subsection shall be written in plain language and printed in bold in no smaller than a twelve (12) point font. (4) (a) Insurers shall, on at least an annual basis, report the following information to the Department of Insurance: 1. The number and dollar amount of retained asset accounts: a. In force at the beginning of the year; b. Issued or added during the year; c. Closed or withdrawn during the year; d. In force at the end of the year; and e. That are transferred annually pursuant to KRS Chapter 393; 2. The dollar amount of investment earnings or interest credited to retained asset accounts during the year; 3. The dollar amount of fees and other charges assessed during the year; 4. A narrative description of how the retained asset accounts are structured. The description shall include: a. All of the interest rates paid to retained asset account holders during the reporting year, as well as the number of times changes were made to interest rates during the reporting year; b. A list of all applicable fees charged by the reporting entity directly or indirectly associated with the retained asset accounts; and c. Whether the retained asset accounts were the default method for satisfying life insurance claims; 5. The number and dollar amount of retained asset accounts in force at the end of the current year as compared to the prior year segregated by the following ages of the outstanding retained asset accounts: a. Zero (0) to twelve (12) months; b. Thirteen (13) to twenty-four (24) months; c. Twenty-five (25) to thirty-six (36) months; d. Thirty-seven (37) to forty-eight (48) months; e. Forty-nine (49) to sixty (60) months; and f. Greater than sixty (60) months; 6. The identity of any entity or financial institution that administers retained asset accounts on behalf of the insurer; and 7. Any other information relating to retained asset accounts as requested or required by the commissioner of the Department of Insurance. (b) All marketing materials, disclosure statements, and supplemental contract forms utilized in connection with retained asset accounts shall be filed with the Department of Insurance prior to their use. The commissioner shall disapprove any materials, statements, or forms submitted under this section that are inconsistent with subsection (3) of this section or are otherwise untrue, unfair, deceptive, false, or misleading. (5) An insurer shall immediately return any remaining balance held in a retained asset account to the beneficiary when the account becomes inactive. A retained asset account shall become inactive for purposes of this subsection if no funds are withdrawn from the account, or if no affirmative directive has been provided to the insurer by the beneficiary, during any continuous three (3) year period. (6) The commissioner may promulgate administrative regulations implementing this section. (7) This section may be cited as the Beneficiaries' Bill of Rights. Effective: June 8, 2011 History: Created 2011 Ky. Acts ch. 61, sec. 1, effective June 8, 2011.

KRS 304.12-040 False financial statements

304.12-040. False financial statements (1) No person shall file with any public official or make or disseminate any false statement of financial condition of any insurer with intent to deceive. (2) No person shall make any false entry in any record, report or statement of any insurer or other person required to have records under this code, with intent to deceive the commissioner or any examiner lawfully appointed to examine into its affairs, or with like intent willfully omit to make a true entry of any material fact pertaining to its business. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1107, effective July 15, 2010. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 4, effective June 18, 1970.

KRS 304.12-050 Advertisement of assets, liabilities

304.12-050. Advertisement of assets, liabilities Any advertisement or other dissemination of information by or on behalf of an insurer stating the insurer's assets shall in the same connection and with equal conspicuousness, state the insurer's liabilities, computed on the same basis. Any such statement purporting to show the insurer's capital shall state only the amount of actual paid-in capital. Effective: March 29, 1976 History: Amended 1976 Ky. Acts ch. 87, sec. 2, effective March 29, 1976. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 5, effective June 18, 1970.

KRS 304.12-060 Defamation

304.12-060. Defamation No person shall make, publish, disseminate or circulate directly or indirectly, or aid, abet or encourage the making, publishing, disseminating or circulating of any oral or written statement or any pamphlet, circular, article or literature which is false, or maliciously critical of or derogatory to the financial condition of an insurer, or of an organization proposing to become an insurer, and which is calculated to injure any person engaged or proposing to engage in the business of insurance. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 6, effective June 18, 1970.

KRS 304.12-070 Boycott, coercion and intimidation

304.12-070. Boycott, coercion and intimidation No person shall enter into any agreement to commit, or by any concerted action commit, any act of boycott, coercion or intimidation resulting in or tending to result in unreasonable restraint of, or monopoly in, the business of insurance. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 7, effective June 18, 1970.

KRS 304.12-080 Unfair discrimination prohibited

304.12-080. Unfair discrimination prohibited (1) No insurer, other than a life insurer or health insurer, shall make or permit any unfair discrimination in favor of particular persons, or between insureds or subjects of insurance having substantially like insuring risk, and exposure factors, or expense elements, in the terms or conditions of any insurance contract, or in the rate or amount of premium charged therefor. This subsection shall not apply as to any premium or premium rate in effect pursuant to Subtitle 13. (2) No insurer shall make or permit any unfair discrimination between individuals of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of such contract, except that in determining the class, consideration may be given to the nature of the risk, plan of insurance, the actual or expected expense of conducting the business or any other relevant factor. (3) No insurer shall make or permit any unfair discrimination between individuals of the same class involving essentially the same hazards in the amount of premium, policy fees, or rates charged for any policy or contract of health insurance or in the benefits payable thereunder, or in any of the terms or conditions of such contract, or in any other manner whatsoever, except that in determining the class, consideration may be given to the nature of the risk, plan of insurance, the actual or expected expense of conducting the business or any other relevant factor. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 8, effective June 18, 1970.

KRS 304.12-085 Denial of insurance because of race, color, religion, national origin, or sex prohibited -- Genetic tests

304.12-085. Denial of insurance because of race, color, religion, national origin, or sex prohibited -- Genetic tests (1) No person shall, whether acting for himself or another in connection with an insurance transaction, fail or refuse to issue or renew insurance to any person because of race, color, religion, national origin, or sex except that rates determined through valid actuarial tables shall not be violative of KRS Chapter 344. (2) In the case of benefits consisting of medical care provided under, offered by, or in connection with a group or individual health benefit plan, the plan or insurer may not deny, cancel, or refuse to renew the benefits or coverage, or vary the premiums, terms, or conditions for the benefits or coverage, for any participant or beneficiary under the plan: (a) On the basis of a genetic test, for which symptoms have not manifested; or (b) On the basis that the participant or beneficiary has requested or received genetic services. (3) A group or individual health benefit plan or insurer offering health insurance in connection with a health benefit plan or an insurer offering a disability income plan may not request or require an applicant, participant, or beneficiary to disclose to the plan or insurer any genetic test about the participant, beneficiary, or applicant. (4) A group or individual health benefit plan or insurer offering health insurance in connection with a health benefit plan may not disclose any genetic test about a participant or beneficiary without prior authorization by the participant. The authorization is required for each disclosure. (5) For purposes of this section, unless the context requires otherwise: (a) "Health benefit plan" has the meaning given it in KRS 304.17A-005; and (b) "Insurer" has the meaning given it in KRS 304.17A-005. Effective: April 10, 1998 History: Amended 1998 Ky. Acts ch. 496, sec. 55, effective April 10, 1998. -- Created 1974 Ky. Acts ch. 104, sec. 10, effective June 21, 1974.

KRS 304.12-087 Living Donor Protection Act of 2021

304.12-087. Living Donor Protection Act of 2021 (1) As used in this section: (a) "Insurance coverage" means coverage under a disability insurance, life insurance, or long-term care insurance policy; and (b) "Living donor" means an individual who: 1. Has donated all or part of an organ; and 2. Is not deceased. (2) Notwithstanding any other provision of law, it shall be unlawful to: (a) Limit or decline to issue or renew insurance coverage due solely to the status of an individual as a living donor; (b) Preclude an insured from donating all or part of an organ as a condition of continuing to receive insurance coverage; or (c) Otherwise discriminate in the offering, issuance, cancellation, amount of insurance coverage, price, or any other condition of insurance coverage provided under a policy, based solely and without any additional actuarial risks upon the status of an individual as a living donor. Effective: June 29, 2021 History: Created 2021 Ky. Acts ch. 55, sec. 1, effective June 29, 2021. Legislative Research Commission Note (6/29/2021). 2021 Ky. Acts ch. 55, sec. 3 provides that this statute applies to insurance policies issued, renewed, or declined on or after June 29, 2021.

KRS 304.12-090 Rebates prohibited

304.12-090. Rebates prohibited (1) No insurer or employee or representative thereof shall knowingly charge, demand, or receive a premium for any insurance policy except in accordance with the applicable filing on file with the commissioner. No such insurer, employee, or representative shall pay, allow, or give, or offer to pay, allow, or give, directly or indirectly, as an inducement to insurance or after insurance has been effected, any rebate, discount, abatement, credit or reduction of the premium named in a policy, or any special favor or advantage in the dividends or other benefits to accrue thereon, or any valuable consideration or inducements whatever, or give, sell, or purchase, or offer to give, sell, or purchase anything of value whatsoever not specified in the policy, except to the extent provided for in such applicable filing. (2) No insured named in a policy, nor any employee or representative thereof shall knowingly receive or accept, directly or indirectly, any such rebate, discount, abatement or reduction of premium, or any special favor or advantage or valuable consideration or inducement. (3) Subsection (1) and (2) of this section shall not apply as to life insurance and health insurance. Except as expressly provided by law no insurer, employee, or representative shall knowingly permit or offer to make or make any contract of life insurance, life annuity or health insurance, or agreement as to such contract other than as plainly expressed in the contract issued thereon, or pay or allow, or give or offer to pay, allow or give, directly or indirectly, as inducement to such insurance, or annuity, any rebate of premiums payable on the contract, or any special favor or advantage in the dividends or other benefits thereon, or any valuable consideration or inducement whatever not expressed in the contract. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1108, effective July 15, 2010. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 9, effective June 18, 1970.

KRS 304.12-092 Gifts, sweepstakes, and drawings -- When permitted

304.12-092. Gifts, sweepstakes, and drawings -- When permitted Notwithstanding any other provision of this chapter: (1) Except as provided in subsections (2) and (3) of this section, an insurer, by or through its employees, affiliates, or third-party representatives, or an insurance producer, as defined in KRS 304.9-020, may: (a) In connection with the marketing, purchase, or renewal of insurance: 1. Offer or provide gifts to any person, including any named insured, if: a. The gifts are not in the form of cash; b. The cost does not exceed two hundred fifty dollars ($250) per year; and c. Receipt of the gifts is not contingent on the purchase or renewal of an insurance policy; and 2. Conduct sweepstakes or drawings if: a. There is no participation cost to entrants; b. Either: i. The prizes do not exceed five hundred dollars ($500) in value; or ii. The combined value of all prizes divided by the number of entrants is less than ten dollars ($10); and c. The sweepstakes or drawings do not obligate entrants to purchase or renew an insurance policy; and (b) Offer or provide products or services that relate to, or in conjunction with, an insurance policy for free, or at a discounted price, if the products or services: 1. Are primarily intended to educate about, assess, monitor, control, mitigate, or prevent risk of loss to persons or their lives, health, property, or other insurable interests; or 2. Have a connection to, or enhance the value of, the insurance benefits. (2) The offer or provision of products or services under subsection (1)(b) of this section shall be exempt from the prohibitions set forth in subsection (1)(a) of this section. (3) This section shall not: (a) Apply to charitable contributions by an insurer or insurance producer unless the contributions are made in connection with the purchase or renewal of insurance; or (b) Be construed to limit or prohibit any conduct permitted under KRS 304.12- 100. Effective: July 14, 2022 History: Created 2022 Ky. Acts ch. 64, sec. 1, effective July 14, 2022. Legislative Research Commission Note (7/14/2022). 2022 Ky. Acts ch. 64, sec. 7, provides that this statute, which was created by that Act, may be cited as the Kentucky Rebate Reform Model Act.

KRS 304.12-100 Exceptions to discrimination and rebate prohibition

304.12-100. Exceptions to discrimination and rebate prohibition Nothing in KRS 304.12-080, 304.12-090, or 304.12-110 shall be construed as prohibiting: (1) Payment of lawfully earned commission or other lawful compensation to duly licensed insurance producers, as defined in KRS 304.9-020, or compensation disclosed in a written disclosure agreement, as described in KRS 304.11-042; (2) Distribution by a participating insurer to its participating policyholders of dividends, savings, or the unused or unabsorbed portion of premiums and premium deposits; (3) (a) Furnishing of information, advice, programs, products, or services that are intended to: 1. Reduce the future cost of insurance to the policyholder or the probability or severity of loss; 2. Assist in the efficient administration and management of the policyholder's insurance program; or 3. Assist the client in complying with any state or federal law. (b) Such information, advice, programs, products, or services shall include but are not limited to providing software to administer an insured's employee benefits or risk management programs, employee wellness programs, risk management services, loss control services, and workers' compensation analysis forecasting; (4) Life insurers from paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, if such bonus or abatement is fair and equitable to all policyholders and for the best interests of the insurer and its policyholders; (5) In the case of insurance policies issued on the debit plan, making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer in an amount which fairly represents the savings in collection expense or making allowance to policyholders who make premium payments at less frequent intervals than required; (6) Readjustment of the rate of premium for a group insurance policy based on the loss or expense experience thereunder, at the end of any policy year of insurance thereunder, which may be made retroactive only for such policy year; (7) An insurer from waiving, in whole or in part, a policyholder's deductible for food spoilage for an insured risk located in a county declared to be a federal disaster area; (8) Payment of any compensation, fee, or other consideration to an individual not licensed to sell insurance if such individual sells, solicits, or negotiates rental vehicle insurance in accordance with KRS 304.9-507 or for the referral of a consumer to a licensed individual in accordance with KRS 304.9-425; (9) Any conduct permitted under KRS 304.12-092; or (10) Charitable contributions by an insurer or insurance producer, as defined in KRS 304.9-020, unless the contributions are made in connection with the purchase or renewal of insurance. Effective: July 14, 2022 History: Amended 2022 Ky. Acts ch. 64, sec. 3, effective July 14, 2022. -- Amended 2013 Ky. Acts ch. 123, sec. 3, effective June 25, 2013. -- Amended 2010 Ky. Acts ch. 83, sec. 19, effective July 15, 2010. -- Amended 2009 Ky. Acts ch. 60, sec. 1, effective March 20, 2009. -- Amended 2008 Ky. Acts ch. 31, sec. 3, effective July 15, 2008. -- Amended 2005 Ky. Acts ch. 143, sec. 22, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 273, sec. 43, effective July 15, 2002. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 10, effective June 18, 1970.

KRS 304.12-110 Illegal inducements prohibited

304.12-110. Illegal inducements prohibited No insurer, insurance producer as defined in KRS 304.9-020, or other person shall, as an inducement to insurance, or in connection with any insurance transaction, provide in any policy for, or offer, sell, buy, or offer or promise to buy, sell, give, promise, or allow to the insured or prospective insured or to any other person on his or her behalf in any manner whatsoever: (1) Any employment; (2) Any shares of stock or other securities issued or at any time to be issued or any interest therein or rights thereto; or (3) Any advisory board contract, or any similar contract, agreement or understanding, offering, providing for, or promising any profits or special returns or special dividends. Effective: July 14, 2022 History: Amended 2022 Ky. Acts ch. 64, sec. 2, effective July 14, 2022. -- Amended 2010 Ky. Acts ch. 83, sec. 20, effective July 15, 2010. -- Amended 2005 Ky. Acts ch. 143, sec. 23, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 202, sec. 1, effective July 15, 2002; and ch. 273, sec. 44, effective July 15, 2002. -- Amended 1988 Ky. Acts ch. 99, sec. 1, effective July 15, 1988. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 11, effective June 18, 1970.

KRS 304.12-112 Prohibition against advertising, offering, or providing free insurance concerning consumer goods or related services

304.12-112. Prohibition against advertising, offering, or providing free insurance concerning consumer goods or related services (1) For purposes of this section, "free insurance" means: (a) Insurance for which no identifiable or additional charge is made to the purchaser or lessee of such consumer goods or services directly or indirectly connected with consumer goods; or (b) Insurance for which an identifiable or additional charge is made in an amount less than the cost of such insurance as to the seller, lessor, or other person, other than the insurer providing the insurance. (2) No person shall advertise, offer, or provide free insurance for damage, loss, or theft as an inducement to the purchase, sale, or rental of consumer goods or services directly or indirectly connected with consumer goods. Effective: July 15, 2008 History: Created 2008 Ky. Acts ch. 152, sec. 6, effective July 15, 2008.

KRS 304.12-120 Desist order for defined or prohibited practices

304.12-120. Desist order for defined or prohibited practices (1) If, after a hearing conducted in accordance with KRS Chapter 13B, the commissioner finds that any person in this state has engaged or is engaging in any act or practice defined in or prohibited under this subtitle, the commissioner shall order the person to desist from the act or practice. (2) A desist order shall become final upon expiration of the time allowed for appeals from the commissioner's final order, if no appeal is taken, or, in the event of an appeal, upon final decision of the court if the court affirms the commissioner's final order or dismisses the appeal. An intervenor in such hearing shall have the right to appeal as provided in subsection (3) of KRS 304.12-130. (3) In an appeal, to the extent that the commissioner's final order is affirmed, the court shall issue its own order commanding obedience to the terms of the commissioner's final order. (4) No final order of the commissioner pursuant to this section or order of court to enforce it shall in any way relieve or absolve any person affected by the order from any other liability, penalty, or forfeiture under law. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1109, effective July 15, 2010. -- Amended 1996 Ky. Acts ch. 318, sec. 232, effective July 15, 1996. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 12, effective June 18, 1970.

KRS 304.12-130 Curtailment of undefined practices

304.12-130. Curtailment of undefined practices (1) If the commissioner believes that any person engaged in the insurance business is engaging in this state in any method of competition or in any act or practice in the conduct of such business which is not defined in this subtitle but that such method of competition is unfair, deceptive, or not in the public interest, or that such act or practice is unfair or deceptive and that a proceeding by the commissioner in respect thereto would be in the public interest, the commissioner shall, after a hearing of which notice of the hearing and of the charges against the person are given such person, make a written report of his or her findings of fact relative to such charges and serve a copy thereof upon such person and any intervenor at the hearing. (2) If such report charges a violation of this subtitle and if such method of competition, act or practice has not been discontinued, the commissioner may, or through the Attorney General, at any time after the service of such report, cause an action to be instituted to enjoin and restrain such person from engaging in such method, act, or practice. In such action the court may grant a restraining order or injunction upon such terms as may be just; but the people of this Commonwealth shall not be required to give security before the issuance of any such order or injunction. If a stenographic record of the proceedings in the hearing before the commissioner was made, a certified transcript thereof including all evidence taken and the report and findings shall be received in evidence in such action. (3) If the commissioner's report made pursuant to subsection (1) of this section or order on hearing made pursuant to KRS 304.12-120 does not charge a violation of this subtitle, then any intervenor in the proceedings may appeal therefrom within the time and in the manner provided in this code for appeals from the commissioner generally. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1110, effective July 15, 2010. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 13, effective June 18, 1970.

KRS 304.12-140 Coercion in requiring insurance

304.12-140. Coercion in requiring insurance (1) No person engaged in the business of financing the purchase of real or personal property or of lending money on the security of real or personal property shall require, as a condition to financing or lending, or varying the terms and conditions of the financing or lending, or as a condition to the renewal or extension of any loan or credit or to the performance of any other act in connection with financing or lending, that the purchaser or borrower, or his successors, shall negotiate through a particular insurer, agent, or type of insurer, any policy of insurance or renewal insuring the property or the life or health of the borrower. (2) This section shall not prevent the reasonable exercise by any vendor or lender of its right to approve or disapprove the insurer selected to underwrite the insurance, and to determine the adequacy of the insurance offered. Effective: July 15, 2002 History: Amended 2002 Ky. Acts ch. 273, sec. 45, effective July 15, 2002. -- Amended 1982 Ky. Acts ch. 320, sec. 18, effective July 15, 1982. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 14, effective June 18, 1970.

KRS 304.12-150 Notice of free choice of agent or insurer

304.12-150. Notice of free choice of agent or insurer Every debtor, borrower, or purchaser of property with respect to which insurance of any kind is required in connection with a debt or loan on the property shall be informed by the creditor or lender of his or her right of free choice in the selection of the agent and insurer through or by which such insurance is to be placed. There shall be no interference either directly or indirectly with the borrower's, debtor's, or purchaser's free choice of an agent and of an insurer, the creditor or lender shall not collect a separate charge for the handling of insurance required in connection with a loan or extension of credit based on the consumer's choice of agent or insurer, and the creditor or lender shall not refuse an adequate policy so tendered by the borrower, debtor, or purchaser. Upon notice of any refusal of an adequate policy, the commissioner shall order the creditor or lender to accept the tendered policy, if he or she determines that such refusal is not in accordance with the requirements set out in subsection (2) of KRS 304.12-140. Failure to comply with the order of the commissioner shall be deemed a violation of this section. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1111, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 273, sec. 46, effective July 15, 2002. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 15, effective June 18, 1970.

KRS 304.12-160 Certain fees for handling insurance transactions in connection with loans prohibited

304.12-160. Certain fees for handling insurance transactions in connection with loans prohibited No person who makes a loan on real or personal property shall in connection with such a transaction make any separate charge or require a fee or payment of any money for the substitution by a borrower or a mortgagor or a purchaser of one insurance policy on the property for an existing policy on the property when the existing or substituted policy is provided through an insurer or insurance agent licensed to do business in the state. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 16, effective June 18, 1970.

KRS 304.12-170 Repealed, 2002

304.12-170. Repealed, 2002 Catchline at repeal: Using insurance information to detriment of another. History: Repealed 2002 Ky. Acts ch. 273, sec. 55, effective July 15, 2002. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 17, effective June 18, 1970.

KRS 304.12-180 Interlocking ownership, management

304.12-180. Interlocking ownership, management (1) Any insurer may retain, invest in or acquire the whole or any part of the capital stock of any other insurer or insurers, or have a common management with any other insurer or insurers, unless such retention, investment, acquisition or common management is inconsistent with any other provision of this code, or unless by reason thereof the business of such insurers with the public is conducted in a manner which substantially lessens competition generally in the insurance business or tends to create any monopoly therein. (2) Any person otherwise qualified may be a director of two (2) or more insurers which are competitors, unless the effect thereof is to lessen substantially competition between insurers generally or tends materially to create any monopoly. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 18, effective June 18, 1970.

KRS 304.12-190 Illegal dealing in premiums

304.12-190. Illegal dealing in premiums (1) No person shall willfully collect any sum as premium or charge for insurance, which insurance is not then provided or is not in due course to be provided (subject to acceptance of the risk by the insurer) by an insurance policy issued by an insurer as authorized by this code. (2) No person shall willfully collect as premium or charge for insurance any sum in excess of the amount actually expended or in due course to be expended for insurance applicable to the subject on account of which the premium was collected or charged. (3) No person shall willfully or knowingly fail to return to the person entitled thereto within a reasonable time any sum collected as premium or charge for insurance in excess of the amount actually expended for insurance, or for medical examination in the case of life insurance, applicable to the subject on account of which the premium or charge was collected. (4) Each violation of this section shall be punishable as provided in Subtitle 99. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 19, effective June 18, 1970.

KRS 304.12-200 Insurer name -- Deceptive use prohibited

304.12-200. Insurer name -- Deceptive use prohibited No person who is not an insurer shall assume or use any name which deceptively infers or suggests that it is an insurer. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 20, effective June 18, 1970.

KRS 304.12-210 Repealed, 1988

304.12-210. Repealed, 1988 Catchline at repeal: Discrimination in property, casualty or surety policies on group basis prohibited. History: Repealed 1988 Ky. Acts ch. 225, sec. 27, effective July 15, 1988. -- Amended 1986 Ky. Acts ch. 147, sec. 2, effective July 15, 1986. -- Amended 1984 Ky. Acts ch. 140, sec. 1, effective July 13, 1984. -- Created 1970 Ky. Acts ch. 301, subtit. 12, sec. 21, effective June 18, 1970.

KRS 304.12-211 Domestic violence and abuse as reason for insurer's limitation or denial of coverage

304.12-211. Domestic violence and abuse as reason for insurer's limitation or denial of coverage (1) As used in this section, unless the context requires otherwise: (a) "Casualty insurance" has the meaning set forth in KRS 304.5-070; (b) "Domestic violence and abuse" has the meaning set forth in KRS 403.720; (c) "Innocent co-insured" means an individual who did not cooperate in or contribute to the creation of the loss; (d) "Insurer" means an insurer licensed to write property or casualty insurance in Kentucky; and (e) "Property insurance" has the meaning set forth in KRS 304.5-050. (2) (a) No insurer shall use the fact that an applicant or insured incurred bodily injury as a result of domestic violence and abuse committed against him or her as the sole reason for rating or underwriting decisions, refusing to insure, refusing to continue to insure, or limiting the amount, extent, or kind of coverage available to an applicant or insured. (b) If a property or casualty insurance policy excludes property coverage for intentional acts, the insurer shall not deny payment to an innocent co-insured if the loss arose out of a pattern of domestic violence and abuse and the perpetrator of the loss is criminally prosecuted for the act causing the loss. Payment to the innocent co-insured may be limited to his or her ownership interests in the property as reduced by any payments to a mortgage or other secured interest. Effective: July 14, 2000 History: Created 2000 Ky. Acts ch. 17, sec. 1, effective July 14, 2000.

KRS 304.12-215 Discrimination on basis of blindness prohibited -- Application

304.12-215. Discrimination on basis of blindness prohibited -- Application (1) Unfair discrimination against individuals on the basis of blindness or partial blindness is prohibited. (2) For the purposes of this section, unfair discrimination against individuals on the basis of blindness or partial blindness consists of refusing to insure, refusing to continue to insure, limiting the amount, extent, or kind of coverage available to an individual, or charging an individual a different rate for the same coverage solely because of blindness or partial blindness. (3) This section shall only apply to life and health insurance and annuity contracts delivered, issued for delivery, or renewed in this state after July 15, 1986. Effective: July 15, 1986 History: Created 1986 Ky. Acts ch. 437, sec. 18, effective July 15, 1986.

KRS 304.12-220 Definition

304.12-220. Definition For the purpose of KRS 304.12-230, "person" shall not mean an insured. Effective: July 13, 1984 History: Created 1984 Ky. Acts ch. 171, sec. 1, effective July 13, 1984.

KRS 304.12-230 Unfair claims settlement practices

304.12-230. Unfair claims settlement practices It is an unfair claims settlement practice for any person to commit or perform any of the following acts or omissions: (1) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (2) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies; (3) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; (4) Refusing to pay claims without conducting a reasonable investigation based upon all available information; (5) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; (6) Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear; (7) Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds; (8) Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application; (9) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of the insured; (10) Making claims payments to insureds or beneficiaries not accompanied by statement setting forth the coverage under which the payments are being made; (11) Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration; (12) Delaying the investigation or payment of claims by requiring an insured, claimant, or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; (13) Failing to promptly settle claims, where liability has become reasonably clear, under one (1) portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; (14) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; (15) Failing to comply with the decision of an independent review entity to provide coverage for a covered person as a result of an external review in accordance with KRS 304.17A-621, 304.17A-623, and 304.17A-625; (16) Knowingly and willfully failing to comply with the provisions of KRS 304.17A-714 when collecting claim overpayments from providers; or (17) Knowingly and willfully failing to comply with the provisions of KRS 304.17A-708 on resolution of payment errors and retroactive denial of claims. Effective: July 15, 2008 History: Amended 2008 Ky. Acts ch. 169, sec. 7, effective July 15, 2008. -- Amended 2000 Ky. Acts ch. 262, sec. 18, effective July 14, 2000. -- Amended 1988 Ky. Acts ch. 225, sec. 19, effective July 15, 1988. -- Created 1984 Ky. Acts ch. 171, sec. 2, effective July 13, 1984.

KRS 304.12-235 Time of payment of claims

304.12-235. Time of payment of claims (1) All claims arising under the terms of any contract of insurance shall be paid to the named insured person or health care provider not more than thirty (30) days from the date upon which notice and proof of claim, in the substance and form required by the terms of the policy, are furnished the insurer. (2) If an insurer fails to make a good faith attempt to settle a claim within the time prescribed in subsection (1) of this section, the value of the final settlement shall bear interest at the rate of twelve percent (12%) per annum from and after the expiration of the thirty (30) day period. (3) If an insurer fails to settle a claim within the time prescribed in subsection (1) of this section and the delay was without reasonable foundation, the insured person or health care provider shall be entitled to be reimbursed for his reasonable attorney's fees incurred. No part of the fee for representing the claimant in connection with this claim shall be charged against benefits otherwise due the claimant. Effective: July 13, 1990 History: Amended 1990 Ky. Acts ch. 482, sec. 26, effective July 13, 1990. -- Created 1988 Ky. Acts ch. 225, sec. 17, effective July 15, 1988.

KRS 304.12-237 Reimbursement for pharmacist services and procedures

304.12-237. Reimbursement for pharmacist services and procedures (1) As used in this section: (a) "Insurer": 1. Means any insurer, self-insurer, self-insured plan, or self-insured group; and 2. Shall include any health maintenance organization, provider-sponsored integrated health delivery network, or nonprofit hospital, medical- surgical, dental, and health service corporation; and (b) "Practice of pharmacy" has the same meaning as in KRS 315.010. (2) To the extent permitted under federal law, for policies, plans, or contracts issued or renewed on or after June 29, 2021, an insurer, or a third-party administrator for such insurer, shall provide reimbursement to a pharmacist for a service or procedure at a rate not less than that provided to other nonphysician practitioners if the service or procedure: (a) Is within the scope of the practice of pharmacy; (b) Would otherwise be covered under the policy, plan, or contract if the service or procedure were provided by a: 1. Physician; 2. Advanced practice registered nurse; or 3. Physician assistant; and (c) Is performed by the pharmacist in strict compliance with laws and administrative regulations related to the pharmacist's license. (3) This section shall not be construed to limit coverage provided under a policy, plan, or contract, or required under any other law. Effective: June 29, 2021 History: Created 2021 Ky. Acts ch. 30, sec. 1, effective June 29, 2021.

KRS 304.12-240 Regulations relating to payment and disclosure by life insurers when funds are used for preneed funeral contracts or prearrangements

304.12-240. Regulations relating to payment and disclosure by life insurers when funds are used for preneed funeral contracts or prearrangements (1) As used in this section, unless the context requires otherwise: (a) "Preneed funeral contract or prearrangement" means an agreement by or for an individual before that individual's death relating to the purchase or provision of specific funeral or cemetery merchandise or services; and (b) "Agent" has the meaning provided in KRS 367.932. (2) The commissioner shall adopt regulations requiring life insurers to provide disclosure to consumers when life insurance or annuities are used to fund preneed funeral contracts or prearrangements. (3) Life insurance and annuity benefits used to fund preneed funeral contracts or prearrangements shall not be paid by a life insurer until the agent has proven the death of the person for whose service the premiums were paid by furnishing the life insurer with a verified or certified copy of a record verifying the death, issued by the state registrar of the Vital Statistics Branch or its successor agency as authorized by KRS Chapter 213, or a provisional certificate of death as described in KRS 213.076. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1112, effective July 15, 2010. -- Amended 2006 Ky. Acts ch. 102, sec. 3, effective July 12, 2006. -- Created 1990 Ky. Acts ch. 464, sec. 4, effective July 13, 1990.

KRS 304.12-250 Exclusion of work-related health condition as unfair or deceptive trade practice for health insurance policies

304.12-250. Exclusion of work-related health condition as unfair or deceptive trade practice for health insurance policies (1) It shall be an unfair or deceptive trade practice for a health insurance policy to exclude coverage for a health condition based solely on the fact that the health condition is work-related, unless the claimant is eligible for benefits under any workers' compensation act or similar law. (2) For purposes of this section, all employees shall be deemed to be eligible for benefits under any workers' compensation act or similar law, except for: (a) Any employee exempted from workers' compensation coverage pursuant to KRS 342.650(1), (2), (3), (5), or (7); and (b) The owner or owners of a business, including qualified partners as defined in KRS 342.012(3). Effective: July 15, 1994 History: Created 1994 Ky. Acts ch. 232, sec. 1, effective July 15, 1994.

KRS 304.12-255 Refusal to provide requested Medicaid information as unfair or deceptive trade practice for health insurer or administrator

304.12-255. Refusal to provide requested Medicaid information as unfair or deceptive trade practice for health insurer or administrator It shall be an unfair or deceptive trade practice for any health insurer or administrator as defined under KRS Chapter 304 to refuse to provide information requested by the Department for Medicaid Services under KRS 205.623, except when providing the requested information would violate any provision of federal law. Effective: July 15, 2008 History: Created 2008 Ky. Acts ch. 71, sec. 6, effective July 15, 2008.

KRS 304.12-257 Administrative regulations to protect Armed Forces service members from dishonest and predatory insurance sales practices

304.12-257. Administrative regulations to protect Armed Forces service members from dishonest and predatory insurance sales practices The commissioner shall have the authority to promulgate regulations to protect service members of the United States Armed Forces from dishonest and predatory insurance sales practices by declaring certain identified practices to be false, misleading, deceptive, or unfair in accordance with the Military Personnel Financial Services Protection Act of 2006, Pub. L. No. 109-290. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1113, effective July 15, 2010. -- Created 2008 Ky. Acts ch. 151, sec. 1, effective July 15, 2008.

KRS 304.12-260 Prohibition against refusal of liability insurer to pay on policy for school's posting of Ten Commandments

304.12-260. Prohibition against refusal of liability insurer to pay on policy for school's posting of Ten Commandments Because the posting of the Ten Commandments in a public school building is a lawful posting of a historical document under KRS 158.195, no liability insurer shall refuse to pay under the terms of the policy an insured who is sued for posting the Ten Commandments in compliance with KRS 158.195 in a public school building on the grounds that this act by the insured constitutes an illegal act for which the insurer is not liable to pay under the terms of the policy. Effective: July 14, 2000 History: Created 2000 Ky. Acts ch. 237, sec. 1, effective July 14, 2000.

KRS 304.12-270 Prohibited actions in connection with rental reimbursement coverage under automobile insurance policy

304.12-270. Prohibited actions in connection with rental reimbursement coverage under automobile insurance policy In connection with rental reimbursement coverage under an automobile insurance policy, an insurer, an employee or representative of an insurer, an agent of an insurer, a consultant, or an insurance adjuster shall not: (1) Solicit or accept a referral fee or gratuity in exchange for referring an insured or claimant to a rental vehicle agency; (2) State or suggest, either orally or in writing, to an insured or claimant that a specific rental vehicle agency must be used to be covered under the policy; or (3) In any way restrict the insured's or claimant's right to choose a rental vehicle agency. Effective: July 15, 2002 History: Created 2002 Ky. Acts ch. 351, sec. 14, effective July 15, 2002.

KRS 304.12-275 Claimant's right to repair facility of choice -- Appraisal of damaged vehicle to include notice of right to choose -- Exemption

304.12-275. Claimant's right to repair facility of choice -- Appraisal of damaged vehicle to include notice of right to choose -- Exemption (1) An insurer shall inform a claimant upon notification of a motor vehicle damage claim that he or she has the right to choose the repair facility of his or her choice to repair a damaged vehicle. (2) After July 12, 2012, all appraisals shall include the following notice, printed in not less than ten (10) point, boldfaced type: "NOTICE: UNDER KENTUCKY LAW, THE CONSUMER AND/OR LESSEE HAS THE RIGHT TO CHOOSE THE REPAIR FACILITY TO MAKE REPAIRS TO HIS OR HER MOTOR VEHICLE." (3) The obligations set forth in this section shall not apply to the replacement or repair of automobile glass. Effective: July 12, 2012 History: Created 2012 Ky. Acts ch. 64, sec. 5, effective July 12, 2012.

Source: Kentucky Legislative Research Commission (legislature.ky.gov)URL: https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38701Fetched: 10/20/2026