I
104TH CONGRESS
2D SESSION
H. R. 3590
To prevent discrimination against victims of domestic abuse in all lines
of insurance and in group health plans.
IN THE HOUSE OF REPRESENTATIVES
JUNE 5, 1996
Mr. POMEROY introduced the following bill; which was referred to the Commit-
tee on Commerce, and in addition to the Committee on Economic and
Educational Opportunities, for a period to be subsequently determined by
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisidiction of the committee concerned
A BILL
To prevent discrimination against victims of domestic abuse
in all lines of insurance and in group health plans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Victims of Domestic
Abuse Insurance Protection Act of 1996’’.
SEC. 2. DEFINITIONS.
As used in this Act:
(1) The term ‘‘domestic abuse’’ means the oc-
currence of one or more of the following acts be-
group insurance, such term includes a person who is
a beneficiary covered by a group policy or certificate.
(6) The term ‘‘insurer’’ means any person or
legal entity (including a health carrier or life, dis-
ability, and property and casualty insurer) engaged
in the business of insurance and subject to the in-
surance laws and regulations of a State, and in-
cludes agents, brokers, adjusters, and third party
administrators and includes health maintenance or-
ganizations and similar organizations subject to reg-
ulation by a State for insolvency.
(7) The term ‘‘subject of domestic abuse’’
means—
(A) a person to whom an act of domestic
abuse is directed,
(B) a person who has had prior or current
injuries, illnesses, or disorders that resulted
from domestic abuse, or
(C) a person who seeks, may have sought,
or had reason to seek—
(i) medical or psychological treatment
for domestic abuse, or
(ii) protection (including court-order
protection) or shelter from domestic abuse.
(8) The term ‘‘group health plan’’ has the
meaning given such term in section 607(1) of the
Employee Retirement Income Security Act of 1974
(29 U.S.C. 1167(1)).
(9) The terms ‘‘beneficiary’’ and ‘‘participant’’
have the meanings given such terms in section 3 of
the Employee Retirement Income Security Act of
1974.
SEC. 
3. 
PROHIBITION 
OF 
UNFAIR 
DISCRIMINATION
AGAINST SUBJECTS OF DOMESTIC ABUSE.
(a) IN GENERAL.—An insurer or group health plan
may not, directly or indirectly, engage in any of the follow-
ing acts or practices on the basis that the applicant or
insured, or any person employed by the applicant or in-
sured or with whom the applicant or insured is known to
have a relationship or association, or a beneficiary or par-
ticipant in the plan is, has been, or may be the subject
of domestic abuse:
(1) Denying, refusing to issue, renew or reissue,
or canceling or otherwise terminating an insurance
policy or coverage under the group health plan; or
restricting or excluding coverage under the policy or
plan; or adding a premium differential to any insur-
ance policy or for coverage under the plan on such
basis.
(2) Excluding or limiting coverage for losses or
denying a claim incurred by an insured or partici-
pant or beneficiary as a result of domestic abuse on
the basis of the insured’s, participant’s, or bene-
ficiary’s abuse status, except (in the case of an in-
surer) as otherwise permitted or required by State
laws relating to acts of abuse committed by life in-
surance beneficiaries.
(3)(A) Subject to subparagraph (B), terminat-
ing coverage for a subject of domestic abuse because
coverage was originally issued or provided in the
name of the abuser and the abuser has divorced,
separated from, or lost custody of the subject of do-
mestic abuse or the abuser’s coverage has termi-
nated voluntarily or involuntarily and, with respect
to health insurance coverage or coverage under a
group health plan, the subject of domestic abuse
does not qualify for extension of coverage under part
6 of subtitle B of title I or the Employee Retirement
Income Security Act of 1974, section 4980B of the
Internal Revenue Code of 1986, or title XXII of the
Public Health Service Act.
(B) Nothing in subparagraph (A) prohibits the
insurer or group health plan from requiring the sub-
ject of domestic abuse to pay the full premium for
the subject’s coverage under the policy or plan or
from requiring, as a condition of health insurance
coverage or coverage under the plan, that the subject
of domestic abuse reside or work within its service
area if such requirements are applied to all insureds
of the insurer with respect to such coverage or to all
participants and beneficiaries.
(C) The insurer may terminate group health in-
surance coverage after the continuation coverage re-
quired by this paragraph has been in force for 18
months if it offers conversion to an equivalent indi-
vidual plan.
(D) The continuation of health coverage re-
quired by this paragraph shall be satisfied by cov-
erage under part 6 of subtitle B of title I or the Em-
ployee Retirement Income Security Act of 1974 (29
U.S.C. 1161 et seq.), section 4980B of the Internal
Revenue Code of 1986, or title XXII of the Public
Health Service Act provided to a subject of domestic
abuse and is not intended to be in addition to any
extension of coverage provided under such part, sec-
tion, or title.
(b) LIMITATION ON USE OR TRANSFER OF INFORMA-
TION.—
(1) IN GENERAL.—An insurer or group health
plan (or a contractor with an insurer or group
health plan) may not use, disclose, or transfer infor-
mation relating to an individual’s abuse status, or
medical condition which the insurer or plan knows or
has reason to know is abuse-related, or an individ-
ual’s family, household, social, or employment rela-
tionship with a subject of domestic abuse except to
the extent necessary for the direct provision of
health care services, compliance with abuse reporting
laws, or (in the case of an insurer) compliance with
an order of an entity with authority to regulate in-
surance or an order of a court of competent jurisdic-
tion. Nothing in this paragraph shall be construed
as limiting or precluding a subject of domestic abuse
from obtaining the subject’s own medical records
from an insurer or group health plan.
(2) ACCESS TO INFORMATION BY SUBJECT OF
DOMESTIC
ABUSE.—A subject of domestic abuse
may provide evidence of domestic abuse to an in-
surer or group health plan for the limited purpose
of facilitating treatment of an domestic abuse-relat-
ed condition or demonstrating that a condition is do-
mestic abuse-related. Nothing in this paragraph
shall be construed as authorizing an insurer or plan
to disregard such provided evidence.
SEC. 4. EXPLANATION OF REASONS FOR ADVERSE AC-
TIONS.
An insurer or group health plan that takes any ad-
verse action relating to any insurance policy or coverage
under a group health plan of a subject of domestic abuse
on the basis of a claim or medical condition that the in-
surer or plan knows or has reason to know is abuse-relat-
ed, shall explain the reason for its action to the applicant
or insured or individual in writing. Reference to general
underwriting practices or guidelines does not constitute a
specific reason.
SEC. 5. SPECIAL RULE FOR LIFE INSURANCE.
Nothing in this Act shall be construed to prohibit a
life insurer from declining to issue a life insurance policy
on the life of an individual if the applicant or prospective
owner of the policy is or would be designated as a bene-
ficiary of the policy, and if—
(1) the applicant or prospective owner of the
policy lacks an insurable interest in the insured; or
(2) the applicant or prospective owner of the
policy is known, on the basis of police or court
records, to have committed an act of domestic abuse
in relation to the individual.