215 ILCS 5/1003
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XL - Insurance Information And Privacy Protection

 (from Ch. 73, par. 1065.703)Sec. 1003.     Definitions.     As used in this Article:(A) "Adverse underwriting decision" means:(1) any of the following actions with respect to     insurance transactions involving insurance coverage which is individually underwritten:(a) a declination of insurance coverage,(b) a termination of insurance coverage,(c) failure of an agent to apply for insurance         coverage with a specific insurance institution which the agent represents and which is requested by an applicant,(d) in the case of a property or casualty         insurance coverage:(i) placement by an insurance institution or             agent of a risk with a residual market mechanism, an unauthorized insurer or an insurance institution which specializes in substandard risks, or(ii) the charging of a higher rate on the             basis of information which differs from that which the applicant or policyholder furnished, or(e) in the case of life, health or disability         insurance coverage, an offer to insure at higher than standard rates.(2) Notwithstanding paragraph (1) above, the     following actions shall not be considered adverse underwriting decisions but the insurance institution or agent responsible for their occurrence shall nevertheless provide the applicant or policyholder with the specific reason or reasons for their occurrence:(a) the termination of an individual policy form         on a class or statewide basis,(b) a declination of insurance coverage solely         because such coverage is not available on a class or statewide basis, or(c) the rescission of a policy.(B) "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.(C) "Agent" means an individual, firm, partnership, association or  corporation who is involved in the solicitation, negotiation or binding of  coverages for or on applications or policies of insurance, covering property or  risks located in this State.  For the purposes of this Article, both "Insurance  Agent" and "Insurance Broker", as defined in Section 490, shall be considered  an agent.(D) "Applicant" means any person who seeks to contract for insurance  coverage other than a person seeking group insurance that is not individually  underwritten.(E) "Director" means the Director of Insurance.(F) "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 which is used or expected to be used in connection with  an insurance transaction.(G) "Consumer reporting agency" means any person who:(1) regularly engages, in whole or in part, in the     practice of assembling or preparing consumer reports for a monetary fee,(2) obtains information primarily from sources other     than insurance institutions, and(3) furnishes consumer reports to other persons.(H) "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.(I) "Declination of insurance coverage" means a denial, in  whole or in part, by an insurance institution or agent of requested insurance  coverage.(J) "Individual" means any natural person who:(1) in the case of property or casualty insurance, is     a past, present or proposed named insured or certificateholder;(2) in the case of life, health or disability     insurance, is a past, present or proposed principal insured or certificateholder;(3) is a past, present or proposed policyowner;(4) is a past or present applicant;(5) is a past or present claimant; or(6) derived, derives or is proposed to derive     insurance coverage under an insurance policy or certificate subject to this Article.(K) "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:(1) an agent,(2) the individual who is the subject of the     information, or(3) a natural person acting in a personal capacity     rather than in a business or professional capacity.(L) "Insurance institution" means any corporation, association, partnership,  reciprocal exchange, inter-insurer, Lloyd's insurer, fraternal benefit society  or other person engaged in the business of insurance, health maintenance  organizations as defined in Section 2 of the Health Maintenance Organization  Act,  voluntary health services plans as defined in Section 2 of the Voluntary Health  Services Plans Act, and dental service plans as defined in Section 4 of the  Dental Service Plan Act.  "Insurance institution" shall not include agents or  insurance-support organizations.(M) "Insurance-support organization" means:(1) 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:(a) the furnishing of consumer reports or         investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction, or(b) 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.(2) Notwithstanding paragraph (1) above, the     following persons shall not be considered "insurance-support organizations" for purposes of this Article: agents, government institutions, insurance institutions, medical care institutions and medical professionals.(N) "Insurance transaction" means any transaction involving  insurance primarily for personal, family or household needs rather than  business or professional needs which entails:(1) the determination of an individual's eligibility     for an insurance coverage, benefit or payment, or(2) the servicing of an insurance application,     policy, contract or certificate.(O) "Investigative consumer report" means a consumer report  or 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.(P) "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 and health-maintenance organizations.(Q) "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, optometrist, chiropractor, naprapath,  pharmacist, physical or occupational therapist, psychiatric social worker,  speech therapist, clinical dietitian or clinical psychologist.(R) "Medical-record information" means personal information which:(1) relates to an individual's physical or mental     condition, medical history or medical treatment, and(2) is obtained from a medical professional or     medical-care institution, from the individual, or from the individual's spouse, parent or legal guardian.(S) "Person" means any natural person, corporation, association,  partnership or other legal entity.(T) "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 "privileged  information".(U) "Policyholder" means any person who:(1) in the case of individual property or casualty     insurance, is a present named insured;(2) in the case of individual life, health or     disability insurance, is a present policyowner; or(3) in the case of group insurance which is     individually underwritten, is a present group certificateholder.(V) "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:(1) pretends to be someone he or she is not,(2) pretends to represent a person he or she is not     in fact representing,(3) misrepresents the true purpose of the interview,     or(4) refuses to identify himself or herself upon     request.(W) "Privileged information" means any individually identifiable  information that: (1) relates to a claim for insurance benefits or  a civil or criminal proceeding involving an individual, and (2) is  collected in connection with or in reasonable anticipation  of a claim for insurance benefits or civil or criminal proceeding involving  an individual; provided,  however, information otherwise meeting the requirements of this subsection  shall nevertheless be considered "personal information" under this Article  if it is disclosed in violation of Section 1014 of this Article.(X) "Residual market mechanism" means an association, organization  or other entity described in Article XXXIII  of this Act, or Section 7-501 of The  Illinois Vehicle Code.(Y) "Termination of insurance coverage" or "termination of  an insurance policy" means either a cancellation or nonrenewal of an insurance  policy, in whole or in part, for any reason other than the failure to pay  a premium as required by the policy.(Z) "Unauthorized insurer" means an insurance institution that has not  been granted a certificate of authority by the Director to transact the  business of insurance in this State.    (Source: P.A. 90-7, eff. 6-10-97; 90-177, eff. 7-23-97; 90-372,  eff. 7-1-98; 90-655, eff. 7-30-98.)