2023 Illinois Compiled Statutes › Chapter 215 - INSURANCE › 215 ILCS 5/ - Illinois Insurance Code. › Article XL - Insurance Information And Privacy Protection

(215 ILCS 5/Art. XL heading)
ARTICLE XL.  
		INSURANCE INFORMATION
AND PRIVACY PROTECTION
(215 ILCS 5/1001) (from Ch. 73, par. 1065.701)
Sec. 1001. 
		Purpose. 
		The purpose of this Article is to establish standards
for the collection, use and disclosure of information gathered in connection
with insurance transactions by insurance institutions, agents or
insurance-support
organizations; to maintain a balance between the need for information by
those conducting the business of insurance and the public's need for fairness
in insurance information practices, including the need to minimize
intrusiveness;
to establish a regulatory mechanism to enable natural persons to ascertain
what information is being or has been collected about them in connection
with insurance transactions and to have access to such information for the
purpose of verifying or disputing its accuracy; to limit the disclosure
of information collected in connection with insurance transactions; and
to enable insurance applicants and policyholders to obtain the reasons for
any adverse underwriting decision.  Further, this Article shall grant the
Director the authority to enforce Title V of the Gramm-Leach-Bliley Act (Public
Law 106-102, 106th Congress).
(Source: P.A. 92-556, eff. 6-24-02.)
(215 ILCS 5/1002) (from Ch. 73, par. 1065.702)
Sec. 1002. 
		Scope. 
		(A) The obligations imposed by this Article shall
apply to those insurance institutions, agents or insurance-support organizations
which, on or after the effective date of this Article:
(1) in the case of life, health or disability insurance:
(a) collect, receive or maintain information in connection with insurance
transactions which pertains to natural persons who are residents of this State, or
(b) engage in insurance transactions with applicants, individuals or policyholders
who are residents of this State, and
(2) in the case of property or casualty insurance:
(a) collect, receive or maintain information in connection with insurance
transactions involving policies, contracts or certificates of insurance
delivered, issued for delivery or renewed in this State, or
(b) engage in insurance transactions involving policies, contracts or
certificates of insurance delivered, issued for delivery or renewed in this State.
(B) The rights granted by this Article shall extend to:
(1) in the case of life, health or disability insurance, the following
persons who are residents of this State:
(a) natural persons who are the subject of information collected, received
or maintained in connection with insurance transactions, and
(b) applicants, individuals or policyholders who engage in or seek to
engage in insurance transactions, and
(2) in the case of property or casualty insurance, the following persons:
(a) natural persons who are the subject of information collected, received
or maintained in connection with insurance transactions involving policies,
contracts or certificates of insurance delivered, issued for delivery or
renewed in this State, and
(b) applicants, individuals or policyholders who engage in or seek to
engage in insurance transactions involving policies, contracts or certificates
of insurance delivered, issued for delivery or renewed in this State.
(C) For purposes of this Section, a person shall be considered a resident
of this State if the person's last known mailing address, as shown in the
records of the insurance institution, agent or insurance-support organization,
is located in this State.
(D) Notwithstanding subsections (A) and (B) above, this Article shall not apply
to information collected from the public records of a governmental authority
and maintained by an insurance institution or its representatives for the
purpose of insuring the title to real property located in this State.
(Source: P.A. 81-1430.)
(215 ILCS 5/1003) (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.)
(215 ILCS 5/1004) (from Ch. 73, par. 1065.704)
Sec. 1004. 
		Pretext Interviews. 
		No insurance institution, agent or insurance-support
organization shall use or authorize the use of pretext interviews to obtain
information in connection with an insurance transaction; provided, however,
a pretext interview may be undertaken to obtain information
from a person or institution
that does not have a generally or statutorily recognized privileged relationship
with the person about whom the information relates for the
purpose of investigating a claim where, based upon specific information
available for review by the Director, there is a reasonable basis for
suspecting criminal activity, fraud, material misrepresentation or material
nondisclosure in connection with the claim.
(Source: P.A. 82-108.)
(215 ILCS 5/1005) (from Ch. 73, par. 1065.705)
Sec. 1005. 
		Notice of Insurance Information Practices. 
		(A) An insurance
institution or agent shall provide a notice of information practices
to all applicants or policyholders in connection with insurance transactions
as provided below:
(1) in the case of an application for insurance, a notice shall be provided
no later than:
(a) at the time of the delivery of the insurance policy or certificate
when personal information is collected only from the applicant or from
public records, or
(b) at the time the collection of personal information is initiated when
personal information is collected from a source other than
the applicant or public records;
(2) in the case of a policy renewal, a notice shall be provided no later
than the policy renewal date, except
that no notice shall be required in connection with a policy renewal if:
(a) personal information is collected only from the policyholder or
from public records, or
(b) a notice meeting the requirements of this Section has been given within
the previous 24 months; or
(3) in the case of a policy reinstatement or change in insurance benefits,
a notice shall be provided no later than the time a request for a policy
reinstatement or change in insurance benefits is received by the insurance
institution, except that no notice shall be required if personal information
is collected only from the policyholder or from public records.
(B) The notice required by subsection (A) shall be in writing
and shall state:
(1) whether personal information may be collected from persons other than
the individual or individuals proposed for coverage;
(2) the types of personal information that may be collected and the types
of sources and investigative techniques that may be used to collect such information;
(3) the types of disclosures identified in subsections
(B), (C), (D), (E), (F), (I),
(K), (L) and (N) of Section 1014 of this Article and the
circumstances under which such disclosures may be made without prior authorization;
provided, however,
only those circumstances need be described which occur with such frequency
as to indicate a general business practice;
(4) a description of the rights established under Sections 1009 and
1010 of this Article and the manner in which such rights may be exercised; and
(5) that information obtained from a report prepared by an
insurance-support organization may be retained by the insurance-support
organization and disclosed
to other persons.
(C) In lieu of the notice prescribed in subsection (B), the insurance
institution or agent may provide an abbreviated notice informing the applicant
or policyholder that:
(1) personal information may be collected from persons other than the
individual or individuals proposed for coverage,
(2) such information as well as other personal or privileged information
subsequently collected by the insurance institution or agent may in certain
circumstances be disclosed to third parties without authorization,
(3) a right of access and correction exists with respect to all personal
information collected, and
(4) the notice prescribed in subsection (B) will be furnished to the applicant
or policyholder upon request.
(D) The obligations imposed by this Section upon an insurance institution
or agent may be satisfied by another insurance institution or agent
authorized to act on its behalf.
(Source: P.A. 82-108.)
(215 ILCS 5/1006) (from Ch. 73, par. 1065.706)
Sec. 1006. 
		Marketing and Research Surveys. 
		An insurance institution or
agent shall clearly specify those questions designed to obtain information
solely for marketing or research purposes
from an individual in connection with an insurance transaction.
(Source: P.A. 82-108.)
(215 ILCS 5/1007) (from Ch. 73, par. 1065.707)
Sec. 1007. 
		Content of Disclosure Authorization Forms. 
		Notwithstanding
any other provision
of law of this State, no insurance institution, agent or insurance-support
organization may utilize as its disclosure authorization form
in connection with insurance transactions a
form or statement which authorizes the disclosure of personal or privileged
information about an individual to the insurance institution,
agent or insurance-support organization unless the form or statement:
(A) is written in plain language;
(B) is dated;
(C) specifies the types of persons authorized to disclose information
about the individual;
(D) specifies the nature of the information authorized to be disclosed;
(E) names the insurance institution or agent and identifies
by generic reference representatives of the insurance institution to whom
the individual is authorizing information to be disclosed;
(F) specifies the purposes for which the information is collected;
(G) specifies the length of time such authorization shall remain valid,
which shall be no longer than:
(1) in the case of authorizations signed for the purpose of collecting
information in connection with an application for an insurance policy, a
policy reinstatement or a request for change in policy benefits:
(a) 30 months from the date the authorization is signed if the application
or request involves life, health or disability insurance,
(b) one year from the date the authorization is signed if the application
or request involves property or casualty insurance;
(2) in the case of authorizations signed for the purpose of collecting
information in connection with a claim for benefits under an insurance policy,
(a) the term of coverage of the policy if the claim is for a health insurance benefit,
(b) the duration of the claim if the claim is not for a health insurance
benefit; and
(H) advises the individual or a person authorized to act on behalf of
the individual that the individual or the individual's authorized representative
is entitled to receive a copy of the authorization form.
(Source: P.A. 82-108.)
(215 ILCS 5/1008) (from Ch. 73, par. 1065.708)
Sec. 1008. 
		Investigative Consumer Reports. 
		(A) No insurance institution,
agent or insurance-support organization may prepare or request an investigative
consumer report about an individual in connection with an insurance transaction
involving
an application for insurance, a policy renewal, a policy reinstatement or
a change in insurance benefits unless the insurance institution or agent
informs the individual:
(1) that he or she may request to be interviewed in connection with the
preparation of the investigative consumer report, and
(2) that upon a request pursuant to Section 1009, he or she is entitled to
receive a copy of the investigative consumer report.
(B) If an investigative consumer report is to be prepared by an insurance
institution or agent, the insurance institution or agent shall institute
reasonable procedures to conduct a personal interview requested by an individual.
(C) If an investigative consumer report is to be prepared by an insurance-support
organization, the insurance institution or agent desiring such report shall
inform the insurance-support organization whether a personal interview has
been requested by the individual.  The insurance-support organization shall
institute reasonable procedures to conduct such interviews, if requested.
(Source: P.A. 82-108.)
(215 ILCS 5/1009) (from Ch. 73, par. 1065.709)
Sec. 1009. 
		Access to Recorded Personal Information. 
		
(A) If any individual, after proper identification, submits a written request
to an insurance institution, agent or insurance-support organization for
access to recorded personal information about the individual which is
reasonably described
by the individual and reasonably locatable and retrievable by the insurance
institution, agent or insurance-support organization, the insurance institution,
agent or insurance-support organization shall within 30 business days from
the date such request is received:
(1) inform the individual of the nature and substance of such recorded
personal information in writing, by telephone or by other oral communication,
whichever the insurance institution, agent or insurance-support organization prefers;
(2) permit the individual to see and copy, in person, such recorded personal
information pertaining to him or her or to obtain a copy of such recorded
personal information by mail, whichever the individual prefers, unless such
recorded personal information is in coded form, in which case an accurate
translation in plain language shall be provided in writing;
(3) disclose to the individual the identity, if recorded, of those persons
to whom the insurance institution, agent or insurance-support organization
has disclosed such personal information within 2 years prior to such
request, and if the identity is not recorded, the names of those insurance
institutions, agents, insurance-support organizations or other persons to
whom such information is normally disclosed; and
(4) provide the individual with a summary of the procedures by which he
or she may request correction, amendment or deletion of recorded personal information.
(B) Any personal information provided pursuant to subsection (A) above
shall identify the source of the information if such source is an institutional source.
(C) Medical-record information supplied by a medical-care institution
or medical professional and requested under subsection (A), together with
the identity of the medical professional or medical care institution which
provided such information, shall be supplied either directly to the individual
or to a medical professional designated by the individual and licensed to
provide medical care with respect to the condition to which the information
relates, whichever the insurance institution, agent or insurance-support
organization prefers.  If it elects to disclose the information to a medical
professional designated by the individual, the insurance institution, agent
or insurance-support organization shall notify the individual, at the time
of the disclosure, that it has provided the information to the medical professional.
(D) Except for personal information provided under Section 1011, an insurance
institution, agent or insurance-support organization may charge a reasonable
fee to cover the costs incurred in providing a copy of recorded personal
information to individuals.
(E) The obligations imposed by this Section upon an insurance institution
or agent may be satisfied by another insurance institution or agent authorized
to act on its behalf.  With respect to the copying and disclosure of recorded
personal information pursuant to a request under subsection (A), an insurance
institution, agent or insurance-support organization may make arrangements
with an insurance-support organization or a consumer reporting agency
to copy and disclose recorded personal
information on its behalf.
(F) The rights granted to individuals in this Section shall extend to
all natural persons to the extent information about them is collected and
maintained by an insurance institution, agent or insurance-support organization
in connection with an insurance transaction.  The rights granted to all natural
persons by this subsection shall not extend to information about them that
relates to and is collected in connection with or in reasonable anticipation
of a claim or civil or criminal proceeding involving them.
(G) For purposes of this Section, the term "insurance-support organization"
does not include "consumer reporting agency".
(Source: P.A. 82-108.)
(215 ILCS 5/1010) (from Ch. 73, par. 1065.710)
Sec. 1010. 
		Correction, Amendment or Deletion of Recorded Personal Information. 
		(A) Within 30 business days from the date of receipt of a written
request from an individual to correct, amend or delete any recorded
personal information
about the individual within its possession, an insurance institution, agent
or insurance-support organization shall either:
(1) correct, amend or delete the portion of the recorded personal information
in dispute; or
(2) notify the individual of:
(a) its refusal to make such correction, amendment or deletion,
(b) the reasons for the refusal, and
(c) the individual's right to file a statement as provided
in subsection (C).
(B) If the insurance institution, agent or insurance-support organization
corrects, amends or deletes recorded personal information in accordance
with paragraph (1) of subsection (A) above, the insurance institution, agent
or insurance-support organization shall so notify the individual in writing
and furnish the correction, amendment or fact of deletion to:
(1) any person specifically designated by the individual who may have,
within the preceding 2 years, received such recorded personal information;
(2) any insurance-support organization whose primary source of personal
information is insurance institutions, if the insurance-support organization
has systematically received such recorded personal information from the
insurance institution within the preceding 7 years; provided, however, that
the correction, amendment or fact of deletion need not be furnished
if the insurance-support organization no longer maintains recorded personal
information about the individual; and
(3) any insurance-support organization that furnished the personal information
that has been corrected, amended or deleted.
(C) Whenever an individual disagrees with an insurance institution's,
 agent's or insurance-support organization's refusal to correct, amend or
delete recorded personal information, the individual shall be permitted
to file with the insurance institution, agent or insurance-support organization:
(1) a concise statement setting forth what the individual thinks is the
correct, relevant or fair information, and
(2) a concise statement of the reasons why the individual disagrees with
the insurance institution's, agent's or insurance-support organization's
refusal to correct, amend or delete recorded personal information.
(D) In the event an individual files either statement as described in
subsection (C) above, the insurance institution, agent or support organization shall:
(1) file the statement with the disputed personal information and provide
a means by which anyone reviewing the disputed personal information will
be made aware of the individual's statement and have access to it, and
(2) in any subsequent disclosure by the insurance institution, agent or
support organization of the recorded personal information that is the subject
of disagreement, clearly identify the matter or matters in  dispute and
provide the individual's statement along with the recorded personal information
being disclosed; and
(3) furnish the statement to the persons and in the manner specified in
subsection (B) above.
(E) The rights granted to individuals in this Section shall extend to
all natural persons to the extent information about them is collected and
maintained by an insurance institution, agent or insurance-support organization
in connection with an insurance transaction.  The rights granted to all
natural persons by this subsection shall not extend to information about
them that relates to and is collected in connection with or in reasonable
anticipation of a claim or civil or criminal proceeding involving them.
(F) For purposes of this Section, the term "insurance-support organization"
does not include "consumer reporting agency".
(Source: P.A. 82-108.)
(215 ILCS 5/1011) (from Ch. 73, par. 1065.711)
Sec. 1011. 
		Reasons for Adverse Underwriting Decisions. 
		(A) In the event
of an adverse underwriting decision the insurance institution or agent responsible
for the decision shall:
(1) either provide the applicant, policyholder or individual proposed
for coverage with the specific reason or reasons for the adverse underwriting
decision in writing or advise such person that upon written request he or
she may receive the specific reason or reasons in writing, and
(2) provide the applicant, policyholder or individual proposed for coverage
with a summary of the rights established under subsection (B) and Sections
1009 and 1010 of this Article.
(B) Upon receipt of a written request within 90 business days from the
date of the mailing of notice or other communication of an adverse underwriting
decision to an applicant, policyholder or individual proposed for coverage,
the insurance institution or agent shall furnish to such person within 21
business days from the date of receipt of such written request:
(1) the specific reason or reasons for the adverse underwriting decision,
in writing, if such information was not initially furnished in writing pursuant
to paragraph (1) of subsection (A);
(2) the specific items of personal and privileged information that
support those reasons; provided, however:
(a) the insurance institution or agent shall not be required to furnish
specific items of privileged information if it has reasonable suspicion,
based upon specific information available for review by the Director, that
the applicant, policyholder
or individual proposed for coverage has engaged in criminal activity,
fraud, material misrepresentation
or material nondisclosure, and
(b) specific items of medical-record information supplied by a medical-care
institution or medical professional shall be disclosed either directly to
the individual about whom the information relates or to a medical professional
designated by the individual and licensed to provide medical care with respect
to the condition to which the information relates, whichever the insurance
institution or agent prefers; and
(3) the names and addresses of the institutional sources that supplied
the specific items of information pursuant to paragraph (2) of
subsection (B); provided, however, that the identity of any medical professional
or medical-care institution shall be disclosed either directly to the individual
or to the
designated medical professional, whichever the insurance institution or agent prefers.
(C) The obligations imposed by this Section upon an insurance institution
or agent may be satisfied by another insurance institution or agent authorized
to act on its behalf.
(D) When an adverse underwriting decision results solely from an oral
request or inquiry, the explanation of reasons and summary of rights required
by subsection (A) may be given orally.
(Source: P.A. 82-108.)
(215 ILCS 5/1012) (from Ch. 73, par. 1065.712)
Sec. 1012. 
		Information Concerning Previous Adverse Underwriting Decisions. 
		
No insurance institution, agent or insurance-support organization may seek
information in connection with an insurance transaction concerning:
(A) any previous adverse underwriting decision experienced by an individual, or
(B) any previous insurance coverage obtained by an individual through
a residual market mechanism,
unless such inquiry also requests the reasons for any previous adverse underwriting
decision or the reasons why insurance coverage was previously obtained through
a residual market mechanism.
(Source: P.A. 81-1430.)
(215 ILCS 5/1013) (from Ch. 73, par. 1065.713)
Sec. 1013. 
		Previous Adverse Underwriting Decisions. 
		No insurance institution
or agent may base an adverse underwriting decision in whole or in part:
(A) on the fact of a previous adverse underwriting decision or on
the fact that an individual previously obtained insurance coverage through
a residual market mechanism; provided, however, an insurance institution
or agent may base an adverse underwriting decision on further information
obtained from an
insurance institution or agent responsible for a previous adverse underwriting decision;
(B) on personal information received from an insurance-support organization
whose primary source of information is insurance institutions; provided,
however, an insurance institution or agent may base an adverse underwriting
decision on further personal information obtained as the result of information
received from such insurance-support organization.
(Source: P.A. 82-108.)
(215 ILCS 5/1014) (from Ch. 73, par. 1065.714)
Sec. 1014. 
		Disclosure Limitations and Conditions. 
		An insurance institution,
agent or insurance-support organization shall not disclose any personal
or privileged information about an individual collected or received in connection
with an insurance transaction unless the disclosure is:
(A) with the written authorization of the individual, provided:
(1) if such authorization is submitted by another insurance institution,
agent or insurance-support organization, the
authorization meets the requirements of Section 1007 of this Article, or
(2) if such authorization is submitted by a person other
than an insurance
institution, agent or insurance-support organization, the authorization is:
(a) dated,
(b) signed by the individual, and
(c) obtained one year or less prior to the date a disclosure is sought
pursuant to this subsection; or
(B) to a person other than an insurance institution, agent or insurance-support
organization, provided such disclosure is reasonably necessary:
(1) to enable such person to perform a business, professional or insurance
function for the disclosing insurance institution, agent or insurance-support
organization and such person agrees not to disclose the information further
without the individual's written authorization unless the further disclosure:
(a) would otherwise be permitted by this Section if made by an insurance
institution, agent, or insurance-support organization, or
(b) is reasonably necessary for such person to perform its function for
the disclosing insurance institution, agent, or insurance-support organization, or
(2) to enable such person to provide information to the disclosing insurance
institution, agent, or insurance-support organization for the purpose of:
(a) determining an individual's eligibility for an insurance benefit or payment, or
(b) detecting or preventing criminal activity, fraud, material misrepresentation
or material nondisclosure in connection with an insurance transaction; or
(C) to an insurance institution, agent, insurance-support organization
or self-insurer, provided the information disclosed is limited to that which
is reasonably necessary:
(1) to detect or prevent criminal activity, fraud, material misrepresentation
or material nondisclosure in connection with insurance transactions, or
(2) for either the disclosing or receiving insurance institution, agent
or insurance-support organization to perform its function in connection
with an insurance transaction involving the individual; or
(D) to a medical care institution or medical professional for the purpose of:
(1) verifying insurance coverage or benefits,
(2) informing an individual of a medical problem of which the individual
may not be aware, or
(3) conducting an operations or services audit,
provided only such information
is disclosed as is reasonably necessary to accomplish the foregoing purposes; or
(E) to an insurance regulatory authority; or
(F) to a law enforcement or other governmental authority:
(1) to protect the interests of the insurance  institution, agent or insurance-support
organization in preventing or prosecuting the perpetration of
fraud upon it, or
(2) if the insurance institution, agent or insurance-support organization
reasonably believes that illegal activities have been conducted by the individual; or
(G) otherwise permitted or required by law; or
(H) in response to a facially valid administrative or judicial order,
including a search warrant or subpoena; or
(I) made for the purpose of conducting actuarial or
research studies provided:
(1) no individual may be identified in any actuarial or research
report,
(2) materials allowing the individual to be identified are returned or
destroyed as soon as they are no longer needed, and
(3) the actuarial or research organization agrees not to disclose the
information unless the disclosure would otherwise be permitted by this Section
if made by an insurance institution, agent or insurance-support organization; or
(J) to a party or a representative of a party to a proposed or consummated
sale, transfer, merger or consolidation of all or part of the business of
the insurance institution, agent or insurance support organization, provided:
(1) prior to the consummation of the sale, transfer, merger or consolidation
only such information is disclosed as is reasonably necessary to enable the
recipient to make business decisions about the purchase, transfer, merger
or consolidation, and
(2) the recipient agrees not to disclose the information unless the disclosure
would otherwise be permitted by this Section if made by an insurance institution,
agent or insurance-support organization; or
(K) to a person whose only use of such information will be in
connection with the marketing of a product or service, provided:
(1) no medical-record information, privileged information,
or personal information relating to an individual's character, personal
habits, mode of living or general reputation is disclosed, and no classification
derived from such information is disclosed,
(2) the individual has been given an opportunity to indicate
that he or she does not want personal information disclosed for marketing purposes and
has given no indication that he or she does not want the information disclosed, and
(3) the person receiving such information agrees not to use
it except in connection with the marketing of a product or service; or
(L) to an affiliate whose only use of the information will be in connection
with an audit of the insurance institution or agent or the marketing
of an insurance product or service, provided the affiliate agrees not to
disclose the information for any other purpose or to unaffiliated
persons; or
(M) by a consumer reporting agency, provided:
the disclosure is to a person other than an insurance institution or agent; or
(N) to a group policyholder for the purpose of reporting claims experience
or conducting an audit of the insurance institution's or agent's operations
or services, provided the information disclosed is reasonably necessary
for the group policyholder to conduct the review or audit; or
(O) to a professional peer review organization for the purpose of reviewing
the service or conduct of a medical-care institution or medical professional; or
(P) to a governmental authority for the purpose of determining the individual's
eligibility for health benefits for which the governmental authority may be liable; or
(Q) to a certificateholder or policyholder for the purpose of providing
information regarding the status of an insurance transaction; or
(R) to a lienholder, mortgagee, assignee, lessee, or other person shown
on the records of an insurance institution or agent as having a legal or
beneficial interest in a policy of insurance; provided that information
disclosed is limited to that which is reasonably necessary to permit such
person to protect its interest in such policy.
(Source: P.A. 82-108.)
(215 ILCS 5/1015) (from Ch. 73, par. 1065.715)
Sec. 1015. 
		Powers of Director. 
		
(A) The Director shall have power to examine and investigate into the affairs
of every insurance institution or agent doing business in this State to
determine whether the insurance institution or agent has been or is engaged
in any conduct in violation of this Article.
(B) The Director shall have the power to examine and investigate into
the affairs of every insurance-support organization acting on behalf of
an insurance institution or agent which either transacts business in this
State or transacts business outside this State that has an effect on a person
residing in this State, in order to determine whether such insurance-support
organization has been or is engaged in any conduct in violation of this Article.
(Source: P.A. 81-1430.)
(215 ILCS 5/1016) (from Ch. 73, par. 1065.716)
Sec. 1016. 
		
		Hearings, Witnesses, Appearances, Production of Books and Service
of Process.
(A) Whenever the Director has reason to believe that an insurance institution,
agent or insurance-support organization has been or is engaged in conduct
in this State which violates this Article, or if the Director believes that
an insurance-support organization has been or is engaged in conduct outside
this State which has an effect on a person residing in this State and violates
this Article, the Director shall issue and serve upon such insurance institution,
agent or insurance-support organization a statement of charges and notice
of hearing to be held at a time and place fixed in the notice.  Such hearing
shall be conducted pursuant to Sections 401, 402 and 403 of this Act, and any
applicable rules of the Department.
(B) At the time and place fixed for such hearing the insurance institution,
agent or insurance-support organization charged shall have an opportunity
to answer the charges against it and present evidence on its behalf.  Upon
good cause shown, the Director shall permit any adversely affected person
to intervene, appear and be heard at such hearing by counsel or in person.
(Source: P.A. 81-1430.)
(215 ILCS 5/1017) (from Ch. 73, par. 1065.717)
Sec. 1017. 
		Service of Process - Insurance-Support Organizations. 
		For
the purpose of this Article, an insurance-support organization transacting
business outside this State which has an effect on a person residing in
this State shall be
deemed to have appointed the Director to accept service of process on its
behalf, provided the Director causes a copy of such service to be mailed
forthwith by registered mail to the insurance-support organization at its
last known principal place of business.  The return postcard receipt for
such mailing shall be sufficient proof that the same was properly mailed
by the Director.
(Source: P.A. 81-1430.)
(215 ILCS 5/1018) (from Ch. 73, par. 1065.718)
Sec. 1018. 
		Cease and Desist Orders and Reports. 
		(A) If, after a hearing, the Director determines that the insurance institution,
agent or insurance-support organization charged has engaged in conduct or
practices in violation of this Article, he shall reduce his findings to
writing and shall issue and cause to be served upon such insurance institution,
agent or insurance-support organization a copy of such findings and an order
requiring such insurance institution, agent or insurance-support organization
to cease and desist from the conduct or practices constituting a violation
of this Article.
(B) If, after a hearing, the Director determines that the insurance institution,
agent or insurance-support organization charged has not engaged in conduct
or practices in violation of this Article, he shall prepare a written report
which sets forth findings of fact and conclusions of law.  Such report shall
be served upon the insurance institution, agent or insurance-support organization
charged and upon the person or persons, if any, whose rights under this
Article were allegedly violated.
(Source: P.A. 81-1430.)
(215 ILCS 5/1019) (from Ch. 73, par. 1065.719)
Sec. 1019. 
		Judicial Review. 
		(1) Any order or decision made, issued or
executed by the Director under this Article whereby any person or company
is aggrieved is subject to review by the Circuit Court of Sangamon County.
(2) The Administrative Review Law, as now or hereafter amended, and the
rules adopted pursuant thereto, applies to and governs all proceedings for
review of final administrative decisions of the Director provided for in
this Section.  The term "administrative decision" is defined as in Section
3-101 of the Code of Civil Procedure.
(Source: P.A. 82-783.)
(215 ILCS 5/1020) (from Ch. 73, par. 1065.720)
Sec. 1020. 
		Penalties.
(A) In any case where a hearing pursuant to Section
1016 results in the finding of a knowing violation of  this Article, the
Director may, in addition to the issuance of a cease and desist order as
prescribed in Section 1018, order payment of a monetary penalty of not more
than $1,000 for each violation but not to exceed $20,000 in the aggregate
for multiple violations.
(B) Any person who violates a cease and desist order of the Director under
Section 1018 of this Article may, after notice and hearing and upon order
of the Director, be subject to one or more of the following penalties, at
the discretion of the Director:
(1) a monetary fine of not more than $20,000 for each     violation,
(2) a monetary fine of not more than $100,000 if the     Director finds that violations have occurred with such frequency as to constitute a general business practice, or
(3) suspension or revocation of an insurance     institution's or agent's license.
(Source: P.A. 93-32, eff. 7-1-03.)
(215 ILCS 5/1021) (from Ch. 73, par. 1065.721)
Sec. 1021. 
		Individual Remedies. 
		(A) If
any insurance institution, agent or insurance-support organization fails
to comply with Sections 1009, 1010 or 1011 of this Article with respect
to the rights granted under those Sections, any person whose rights are
violated may apply to the circuit court of this State, or any other court
of competent jurisdiction, for appropriate equitable relief.
(B) An insurance institution, agent or insurance-support organization
which discloses information in violation of Section 1014 of this Article
shall be liable for damages sustained by the individual about whom the information
relates; provided, however, that no individual shall be  entitled to a monetary
award which exceeds the actual damages sustained by the individual as a
result of a violation of Section 1014 of this Article.
(C) In any action brought pursuant to this Section, the court may award
the cost of the action and reasonable attorney's fees to the prevailing party.
(D) An action under this Section must be brought within 2 years from the
date the alleged violation is or should have been discovered.
(E) Except as specifically provided in this Section, there shall be no
remedy or recovery available to individuals, in law or in equity, for occurrences
constituting a violation of any provision of this Article.
(Source: P.A. 82-108.)
(215 ILCS 5/1022) (from Ch. 73, par. 1065.722)
Sec. 1022. 
		Immunity. 
		No cause of action in the nature of defamation,
invasion of privacy or negligence shall arise against any person for disclosing
personal or privileged information in accordance with this Article, nor
shall such a cause of action arise against any person for furnishing personal
or privileged information to an insurance institution, agent or insurance-support
organization; provided, however, this Section shall provide no immunity
for disclosing or furnishing false information with malice or willful intent
to injure any person.
(Source: P.A. 82-108.)
(215 ILCS 5/1023) (from Ch. 73, par. 1065.723)
Sec. 1023. 
		Obtaining Information Under False Pretenses. 
		Any person
who knowingly and willfully obtains information about an individual from
an insurance institution, agent or insurance-support organization under
false pretenses shall be guilty of a Class 4 felony.
(Source: P.A. 81-1430.)
(215 ILCS 5/1023.5)
Sec. 1023.5. 
		Federal privacy protections.
(A) In addition to the requirements of this Article, licensees shall comply
with the privacy protection provisions of Title V of the federal
Gramm-Leach-Bliley Act (Public Law 106-102, 106th Congress).
(B) The Director shall have authority to enforce the requirements of the
privacy protection provisions of Title V of the federal Gramm-Leach-Bliley Act,
employing powers granted to him under this Article and this Code.
(C) The Director shall make reasonable rules as may be necessary to make
effective the privacy provisions of Title V of the federal Gramm-Leach-Bliley
Act (Public Law 106-102, 106th Congress).
(D) For purposes of this Section, "licensee" means all insurers, insurance
producers, and other persons licensed or required to be licensed, authorized or
required to be authorized, registered or required to be registered, or
domiciled, pursuant to this Code or any other insurance law
of this State administered by the Department.  "Licensee" also includes
unauthorized insurers who accept business placed through a licensed surplus
line
producer in this State, but only in regard to the surplus line placements
placed pursuant to Section 445 of this Code.  However, this Section does not
apply to "service contract providers" as defined by the Service Contract Act.
(Source: P.A. 92-556, eff. 6-24-02.)
(215 ILCS 5/1024) (from Ch. 73, par. 1065.724)
Sec. 1024. 
		This Article takes effect on July 1, 1981. 
		The rights granted
under Sections 1009, 1010 and 1014 of this Article shall take effect on July 1, 1981,
regardless of the date of the collection or receipt of the information which
is the subject of such Sections.
(Source: P.A. 81-1430.)