Stop Re-Victimizing the Victims: A Call For Stronger State Laws Prohibiting Insurance Discrimination Against Victims of Domestic Violence

INTRODUCTIONIn the mid-1990s, insurance discrimination against victims of domestic violence first attracted national media and political attention.1 Despite this scrutiny, many states still permit insurers to consider whether someone has been a victim of domestic violence when making access, coverage, and insurance rating determinations.2 This discrimination is often based on insurers' incorrect and offensive assertion that domestic violence victims voluntarily choose to engage in high-risk behavior.3 Such victim-blaming ignores the fact that domestic violence is a crime and re-victimizes individuals seeking insurance protections for themselves and their children.4 Insurance discrimination denies help to victims seeking to rebuild their lives and could mean the difference between a victim successfully escaping her abuser or continuing to suffer in silence.5Parts I and II of this paper will examine the prevalence and costs of domestic violence and explore how insurance discrimination against victims of domestic violence occurs. Part III will outline and respond to the insurance industry's arguments in favor of using domestic violence as a factor in insurance classification, including voluntariness, actuarial fairness, moral hazard, and adverse selection. Part IV will provide an overview of the current state and federal regulations on this issue. Part V will conclude by proposing four legislative reforms to state laws that will better protect victims of domestic violence from insurance discrimination.I. PREVALENCE AND COST OF DOMESTIC VIOLENCEDomestic violence6 is a widespread problem that has substantial costs- both financial and emotional-on individuals and society at large. One in four women7 will experience domestic violence at some point in her life,8 and, every year, approximately 1.3 million women are physically assaulted by an intimate partner.9 In the United States, nearly 5.3 million domestic violence victimizations occur each year, resulting in nearly 2 million injuries and 1,300 deaths.10 Of those injuries, over 555,000 require medical attention, and more than 145,000 are serious enough to warrant hospitalization.11 In addition to physical injury, domestic violence results in over 18.5 million mental health care visits every year.12The prevalence of domestic violence exacts financial costs on victims. A report in the American Journal of Preventative Medicine found that women with a history of domestic violence had significantly higher health care utilization and costs, which continued long after the domestic violence ended.13 Compared to women with no history of abuse, domestic violence victims were more likely to use mental health services, substance abuse services, hospital outpatient visits, emergency department visits, and acute inpatient care during and after their domestic abuse.14 After adjusting for age, education, and the presence of major unrelated illnesses, the report found that annual health care costs were nineteen percent higher for women with a history of domestic violence than for women without a history of domestic violence.15 This difference in costs amounts to $439 per year per woman with a history of domestic violence.16 It should come as no surprise, therefore, that the annual health care costs for domestic violence-including medical and mental health services-are estimated to total almost $4.1 billion.17II. HOW INSURANCE DISCRIMINATION OCCURSInsurance companies detect domestic violence in three primary ways. First, insurance companies require applicants to grant them access to their medical records, which often contain information about past abuse.18 In fact, the increased awareness of and responsiveness to domestic violence injuries among medical professionals in recent years has made medical records richer and more reliable sources for insurance companies to obtain such information.19 Second, insurance companies can share information about applicants' risk factors-both medical and non-medical-through databases such as Equifax and the Medical Information Bureau. …