(A) Making, issuing, circulating, or causing or permitting
to | 10 |
be made, issued, or circulated, or preparing with intent to so | 11 |
use, any estimate, illustration, circular, or statement | 12 |
misrepresenting the terms of any policy issued or to be issued or | 13 |
the benefits or advantages promised thereby or the dividends or | 14 |
share of the surplus to be received thereon, or making any false | 15 |
or misleading statements as to the dividends or share of surplus | 16 |
previously paid on similar policies, or making any misleading | 17 |
representation or any misrepresentation as to the financial | 18 |
condition of any insurer as shown by the last preceding verified | 19 |
statement made by it to the insurance department of this state,
or | 20 |
as to the legal reserve system upon which any life insurer | 21 |
operates, or using any name or title of any policy or class of | 22 |
policies misrepresenting the true nature thereof, or making any | 23 |
misrepresentation or incomplete comparison to any person for the | 24 |
purpose of inducing or tending to induce such person to purchase, | 25 |
amend, lapse, forfeit, change, or surrender insurance. | 26 |
Any written statement concerning the premiums for a policy | 27 |
which refers to the net cost after credit for an assumed
dividend, | 28 |
without an accurate written statement of the gross
premiums, cash | 29 |
values, and dividends based on the insurer's
current dividend | 30 |
scale, which are used to compute the net cost
for such policy, and | 31 |
a prominent warning that the rate of
dividend is not guaranteed, | 32 |
is a misrepresentation for the
purposes of this division. | 33 |
(B) Making, publishing, disseminating, circulating, or | 34 |
placing before the public or causing, directly or indirectly, to | 35 |
be made, published, disseminated, circulated, or placed before
the | 36 |
public, in a newspaper, magazine, or other publication, or in
the | 37 |
form of a notice, circular, pamphlet, letter, or poster, or
over | 38 |
any radio station, or in any other way, or preparing with
intent | 39 |
to so use, an advertisement, announcement, or statement
containing | 40 |
any assertion, representation, or statement, with
respect to the | 41 |
business of insurance or with respect to any
person in the conduct | 42 |
of the person's insurance business,
which is untrue,
deceptive, or | 43 |
misleading. | 44 |
(C) Making, publishing, disseminating, or circulating, | 45 |
directly or indirectly, or aiding, abetting, or encouraging the | 46 |
making, publishing, disseminating, or circulating, or preparing | 47 |
with intent to so use, any statement, pamphlet, circular,
article, | 48 |
or literature, which is false as to the financial
condition of an | 49 |
insurer and which is calculated to injure any
person engaged in | 50 |
the business of insurance. | 51 |
(D) Filing with any supervisory or other public official,
or | 52 |
making, publishing, disseminating, circulating, or delivering
to | 53 |
any person, or placing before the public, or causing directly
or | 54 |
indirectly to be made, published, disseminated, circulated, | 55 |
delivered to any person, or placed before the public, any false | 56 |
statement of financial condition of an insurer. | 57 |
Making any false entry in any book, report, or statement of | 58 |
any insurer with intent to deceive any agent or examiner lawfully | 59 |
appointed to examine into its condition or into any of its | 60 |
affairs, or any public official to whom such insurer is required | 61 |
by law to report, or who has authority by law to examine into its | 62 |
condition or into any of its affairs, or, with like intent, | 63 |
willfully omitting to make a true entry of any material fact | 64 |
pertaining to the business of such insurer in any book, report,
or | 65 |
statement of such insurer, or mutilating, destroying,
suppressing, | 66 |
withholding, or concealing any of its records. | 67 |
(G)(1) Except as otherwise expressly provided by law, | 79 |
knowingly permitting or offering to make or making any contract
of | 80 |
life insurance, life annuity or accident and health insurance,
or | 81 |
agreement as to such contract other than as plainly expressed
in | 82 |
the contract issued thereon, or paying or allowing, or giving
or | 83 |
offering to pay, allow, or give, directly or indirectly, as | 84 |
inducement to such insurance, or annuity, any rebate of premiums | 85 |
payable on the contract, or any special favor or advantage in the | 86 |
dividends or other benefits thereon, or any valuable
consideration | 87 |
or inducement whatever not specified in the
contract; or giving, | 88 |
or selling, or purchasing, or offering to
give, sell, or purchase, | 89 |
as inducement to such insurance or
annuity or in connection | 90 |
therewith, any stocks, bonds, or other
securities, or other | 91 |
obligations of any insurance company or
other corporation, | 92 |
association, or partnership, or any dividends
or profits accrued | 93 |
thereon, or anything of value whatsoever not
specified in the | 94 |
contract. | 95 |
(2) Nothing in division (F) or division (G)(1) of this | 96 |
section shall be construed as prohibiting any of the following | 97 |
practices: (a) in the case of any contract of life insurance or | 98 |
life annuity, paying bonuses to policyholders or otherwise
abating | 99 |
their premiums in whole or in part out of surplus
accumulated from | 100 |
nonparticipating insurance, provided that any
such bonuses or | 101 |
abatement of premiums shall be fair and equitable
to policyholders | 102 |
and for the best interests of the company and
its policyholders; | 103 |
(b) in the case of life insurance policies
issued on the | 104 |
industrial debit plan, making allowance to
policyholders who have | 105 |
continuously for a specified period made
premium payments directly | 106 |
to an office of the insurer in an
amount which fairly represents | 107 |
the saving in collection expenses;
(c) readjustment of the rate of | 108 |
premium for a group insurance
policy based on the loss or expense | 109 |
experience thereunder, at the
end of the first or any subsequent | 110 |
policy year of insurance
thereunder, which may be made retroactive | 111 |
only for such policy
year. | 112 |
(H) Making, issuing, circulating, or causing or permitting
to | 113 |
be made, issued, or circulated, or preparing with intent to so | 114 |
use, any statement to the effect that a policy of life insurance | 115 |
is, is the equivalent of, or represents shares of capital stock
or | 116 |
any rights or options to subscribe for or otherwise acquire
any | 117 |
such shares in the life insurance company issuing that policy
or | 118 |
any other company. | 119 |
(J) Making, issuing, circulating, or causing or permitting
to | 126 |
be made, issued, or circulated, or preparing with intent to so | 127 |
use, any statement to the effect that any insurance company was | 128 |
required to change a policy form or related material to comply | 129 |
with Title XXXIX of the Revised Code or any regulation of the | 130 |
superintendent of insurance, for the purpose of inducing or | 131 |
intending to induce any policyholder or prospective policyholder | 132 |
to purchase, amend, lapse, forfeit, change, or surrender | 133 |
insurance. | 134 |
(M) Making or permitting any unfair discrimination between | 140 |
individuals of the same class and of essentially the same hazard | 141 |
in the amount of premium, policy fees, or rates charged for any | 142 |
policy or contract of insurance, other than life insurance, or in | 143 |
the benefits payable thereunder, or in underwriting standards and | 144 |
practices or eligibility requirements, or in any of the terms or | 145 |
conditions of such contract, or in any other manner whatever. | 146 |
(O) Refusing, when offering maternity benefits under any | 150 |
individual or group sickness and accident insurance policy, to | 151 |
make maternity benefits available to the policyholder for the | 152 |
individual or individuals to be covered under any comparable | 153 |
policy to be issued for delivery in this state, including family | 154 |
members if the policy otherwise provides coverage for family | 155 |
members. Nothing in this division shall be construed to prohibit | 156 |
an insurer from imposing a reasonable waiting period for such | 157 |
benefits under an individual sickness
and accident insurance | 158 |
policy
issued to an individual who is not a federally eligible | 159 |
individual or a
nonemployer-related group sickness and accident | 160 |
insurance policy, but in no
event shall such waiting period exceed | 161 |
two hundred seventy days. | 162 |
(P) Using, or permitting to be used, a pattern settlement
as | 166 |
the basis of any offer of settlement. As used in this
division, | 167 |
"pattern settlement" means a method by which liability
is | 168 |
routinely imputed to a claimant without an investigation of
the | 169 |
particular occurrence upon which the claim is based and by
using a | 170 |
predetermined formula for the assignment of liability
arising out | 171 |
of occurrences of a similar nature. Nothing in this
division shall | 172 |
be construed to prohibit an insurer from
determining a claimant's | 173 |
liability by applying formulas or
guidelines to the facts and | 174 |
circumstances disclosed by the
insurer's investigation of the | 175 |
particular occurrence upon which a
claim is based. | 176 |
(Q) Refusing to insure, or refusing to continue to insure,
or | 177 |
limiting the amount, extent, or kind of life or sickness and | 178 |
accident insurance or annuity coverage available to an
individual, | 179 |
or charging an individual a different rate for the
same coverage | 180 |
solely because of blindness or partial blindness.
With respect to | 181 |
all other conditions, including the underlying
cause of blindness | 182 |
or partial blindness, persons who are blind or
partially blind | 183 |
shall be subject to the same standards of sound
actuarial | 184 |
principles or actual or reasonably anticipated
actuarial | 185 |
experience as are sighted persons. Refusal to insure
includes, but | 186 |
is not limited to, denial by an insurer of
disability insurance | 187 |
coverage on the grounds that the policy
defines "disability" as | 188 |
being presumed in the event that the
eyesight of the insured is | 189 |
lost. However, an insurer may exclude
from coverage disabilities | 190 |
consisting solely of blindness or
partial blindness when such | 191 |
conditions existed at the time the
policy was issued. To the | 192 |
extent that the provisions of this
division may appear to conflict | 193 |
with any provision of section
3999.16 of the Revised Code, this | 194 |
division applies. | 195 |
(R)(1) Directly or indirectly offering to sell, selling,
or | 196 |
delivering, issuing for delivery, renewing, or using or
otherwise | 197 |
marketing any policy of insurance or insurance product
in | 198 |
connection with or in any way related to the grant of a
student | 199 |
loan guaranteed in whole or in part by an agency or
commission of | 200 |
this state or the United States, except insurance
that is required | 201 |
under federal or state law as a condition for
obtaining such a | 202 |
loan and the premium for which is included in
the fees and charges | 203 |
applicable to the loan; or, in the case of
an insurer or insurance | 204 |
agent, knowingly permitting any lender
making such loans to engage | 205 |
in such acts or practices in
connection with the insurer's or | 206 |
agent's insurance business. | 207 |
(b) Acts or practices of an insurer, its agents, | 216 |
representatives, or employees in connection with the
solicitation, | 217 |
processing, or issuance of an insurance policy or
product covering | 218 |
the student loan borrower or the borrower's
spouse or
dependent | 219 |
children, where such acts or practices take place more
than one | 220 |
hundred eighty days after the date on which the borrower
is | 221 |
notified that the student loan was approved. | 222 |
(Y)(1)(a) Limiting coverage under, refusing to issue, | 270 |
canceling,
or refusing to renew, any individual policy or contract | 271 |
of life
insurance, or limiting coverage under or refusing to issue | 272 |
any individual
policy or contract of health insurance, for the | 273 |
reason that the insured or
applicant for insurance is or has
been | 274 |
a victim of domestic violence; | 275 |
(d) Inquiring, directly or indirectly, of an insured under, | 284 |
or of an
applicant for, a policy or contract of life or health | 285 |
insurance, as to whether
the insured or applicant is or has been a | 286 |
victim of domestic violence,
or inquiring as to whether the | 287 |
insured or applicant has sought shelter or
protection from | 288 |
domestic violence or has sought medical or psychological
treatment | 289 |
as a victim of domestic violence. | 290 |
(b) Nothing in division (Y)(2) of this section
shall be | 319 |
construed to permit an insurer to cancel or refuse to
renew any | 320 |
policy or contract of health insurance in violation of
the "Health | 321 |
Insurance Portability and
Accountability Act of 1996," 110 Stat. | 322 |
1955, 42 U.S.C.A.
300gg-41(b), as amended, or in a manner that | 323 |
violates or is inconsistent with any provision of the
Revised Code | 324 |
that implements the "Health
Insurance Portability and | 325 |
Accountability
Act of 1996." | 326 |