(A) Making, issuing, circulating, or causing or permitting to | 11 |
be made, issued, or circulated, or preparing with intent to so | 12 |
use, any estimate, illustration, circular, or statement | 13 |
misrepresenting the terms of any policy issued or to be issued or | 14 |
the benefits or advantages promised thereby or the dividends or | 15 |
share of the surplus to be received thereon, or making any false | 16 |
or misleading statements as to the dividends or share of surplus | 17 |
previously paid on similar policies, or making any misleading | 18 |
representation or any misrepresentation as to the financial | 19 |
condition of any insurer as shown by the last preceding verified | 20 |
statement made by it to the insurance department of this state, or | 21 |
as to the legal reserve system upon which any life insurer | 22 |
operates, or using any name or title of any policy or class of | 23 |
policies misrepresenting the true nature thereof, or making any | 24 |
misrepresentation or incomplete comparison to any person for the | 25 |
purpose of inducing or tending to induce such person to purchase, | 26 |
amend, lapse, forfeit, change, or surrender insurance. | 27 |
Any written statement concerning the premiums for a policy | 28 |
which refers to the net cost after credit for an assumed dividend, | 29 |
without an accurate written statement of the gross premiums, cash | 30 |
values, and dividends based on the insurer's current dividend | 31 |
scale, which are used to compute the net cost for such policy, and | 32 |
a prominent warning that the rate of dividend is not guaranteed, | 33 |
is a misrepresentation for the purposes of this division. | 34 |
(B) Making, publishing, disseminating, circulating, or | 35 |
placing before the public or causing, directly or indirectly, to | 36 |
be made, published, disseminated, circulated, or placed before the | 37 |
public, in a newspaper, magazine, or other publication, or in the | 38 |
form of a notice, circular, pamphlet, letter, or poster, or over | 39 |
any radio station, or in any other way, or preparing with intent | 40 |
to so use, an advertisement, announcement, or statement containing | 41 |
any assertion, representation, or statement, with respect to the | 42 |
business of insurance or with respect to any person in the conduct | 43 |
of the person's insurance business, which is untrue, deceptive, or | 44 |
misleading. | 45 |
(C) Making, publishing, disseminating, or circulating, | 46 |
directly or indirectly, or aiding, abetting, or encouraging the | 47 |
making, publishing, disseminating, or circulating, or preparing | 48 |
with intent to so use, any statement, pamphlet, circular, article, | 49 |
or literature, which is false as to the financial condition of an | 50 |
insurer and which is calculated to injure any person engaged in | 51 |
the business of insurance. | 52 |
(D) Filing with any supervisory or other public official, or | 53 |
making, publishing, disseminating, circulating, or delivering to | 54 |
any person, or placing before the public, or causing directly or | 55 |
indirectly to be made, published, disseminated, circulated, | 56 |
delivered to any person, or placed before the public, any false | 57 |
statement of financial condition of an insurer. | 58 |
Making any false entry in any book, report, or statement of | 59 |
any insurer with intent to deceive any agent or examiner lawfully | 60 |
appointed to examine into its condition or into any of its | 61 |
affairs, or any public official to whom such insurer is required | 62 |
by law to report, or who has authority by law to examine into its | 63 |
condition or into any of its affairs, or, with like intent, | 64 |
willfully omitting to make a true entry of any material fact | 65 |
pertaining to the business of such insurer in any book, report, or | 66 |
statement of such insurer, or mutilating, destroying, suppressing, | 67 |
withholding, or concealing any of its records. | 68 |
(G)(1) Except as otherwise expressly provided by law, | 80 |
knowingly permitting or offering to make or making any contract of | 81 |
life insurance, life annuity or accident and health insurance, or | 82 |
agreement as to such contract other than as plainly expressed in | 83 |
the contract issued thereon, or paying or allowing, or giving or | 84 |
offering to pay, allow, or give, directly or indirectly, as | 85 |
inducement to such insurance, or annuity, any rebate of premiums | 86 |
payable on the contract, or any special favor or advantage in the | 87 |
dividends or other benefits thereon, or any valuable consideration | 88 |
or inducement whatever not specified in the contract; or giving, | 89 |
or selling, or purchasing, or offering to give, sell, or purchase, | 90 |
as inducement to such insurance or annuity or in connection | 91 |
therewith, any stocks, bonds, or other securities, or other | 92 |
obligations of any insurance company or other corporation, | 93 |
association, or partnership, or any dividends or profits accrued | 94 |
thereon, or anything of value whatsoever not specified in the | 95 |
contract. | 96 |
(2) Nothing in division (F) or division (G)(1) of this | 97 |
section shall be construed as prohibiting any of the following | 98 |
practices: (a) in the case of any contract of life insurance or | 99 |
life annuity, paying bonuses to policyholders or otherwise abating | 100 |
their premiums in whole or in part out of surplus accumulated from | 101 |
nonparticipating insurance, provided that any such bonuses or | 102 |
abatement of premiums shall be fair and equitable to policyholders | 103 |
and for the best interests of the company and its policyholders; | 104 |
(b) in the case of life insurance policies issued on the | 105 |
industrial debit plan, making allowance to policyholders who have | 106 |
continuously for a specified period made premium payments directly | 107 |
to an office of the insurer in an amount which fairly represents | 108 |
the saving in collection expenses; (c) readjustment of the rate of | 109 |
premium for a group insurance policy based on the loss or expense | 110 |
experience thereunder, at the end of the first or any subsequent | 111 |
policy year of insurance thereunder, which may be made retroactive | 112 |
only for such policy year. | 113 |
(H) Making, issuing, circulating, or causing or permitting to | 114 |
be made, issued, or circulated, or preparing with intent to so | 115 |
use, any statement to the effect that a policy of life insurance | 116 |
is, is the equivalent of, or represents shares of capital stock or | 117 |
any rights or options to subscribe for or otherwise acquire any | 118 |
such shares in the life insurance company issuing that policy or | 119 |
any other company. | 120 |
(J) Making, issuing, circulating, or causing or permitting to | 127 |
be made, issued, or circulated, or preparing with intent to so | 128 |
use, any statement to the effect that any insurance company was | 129 |
required to change a policy form or related material to comply | 130 |
with Title XXXIX of the Revised Code or any regulation of the | 131 |
superintendent of insurance, for the purpose of inducing or | 132 |
intending to induce any policyholder or prospective policyholder | 133 |
to purchase, amend, lapse, forfeit, change, or surrender | 134 |
insurance. | 135 |
(M)(1) Making or permitting any unfair discrimination between | 141 |
individuals of the same class and of essentially the same hazard | 142 |
in the amount of premium, policy fees, or rates charged for any | 143 |
policy or contract of insurance, other than life insurance, or in | 144 |
the benefits payable thereunder, or in underwriting standards and | 145 |
practices or eligibility requirements, or in any of the terms or | 146 |
conditions of such contract, or in any other manner whatever. | 147 |
(2) Considering an individual's credit score, credit report, | 148 |
or credit history in determining a premium, policy fee, or rate | 149 |
charged for, in setting the coverage provided by, benefits payable | 150 |
under, or other terms and conditions of, or in refusing to issue, | 151 |
canceling, or refusing to renew, any policy or contract of | 152 |
insurance. | 153 |
(O) Refusing, when offering maternity benefits under any | 161 |
individual or group sickness and accident insurance policy, to | 162 |
make maternity benefits available to the policyholder for the | 163 |
individual or individuals to be covered under any comparable | 164 |
policy to be issued for delivery in this state, including family | 165 |
members if the policy otherwise provides coverage for family | 166 |
members. Nothing in this division shall be construed to prohibit | 167 |
an insurer from imposing a reasonable waiting period for such | 168 |
benefits under an individual sickness and accident insurance | 169 |
policy issued to an individual who is not a federally eligible | 170 |
individual or a nonemployer-related group sickness and accident | 171 |
insurance policy, but in no event shall such waiting period exceed | 172 |
two hundred seventy days. | 173 |
(P) Using, or permitting to be used, a pattern settlement as | 177 |
the basis of any offer of settlement. As used in this division, | 178 |
"pattern settlement" means a method by which liability is | 179 |
routinely imputed to a claimant without an investigation of the | 180 |
particular occurrence upon which the claim is based and by using a | 181 |
predetermined formula for the assignment of liability arising out | 182 |
of occurrences of a similar nature. Nothing in this division shall | 183 |
be construed to prohibit an insurer from determining a claimant's | 184 |
liability by applying formulas or guidelines to the facts and | 185 |
circumstances disclosed by the insurer's investigation of the | 186 |
particular occurrence upon which a claim is based. | 187 |
(Q) Refusing to insure, or refusing to continue to insure, or | 188 |
limiting the amount, extent, or kind of life or sickness and | 189 |
accident insurance or annuity coverage available to an individual, | 190 |
or charging an individual a different rate for the same coverage | 191 |
solely because of blindness or partial blindness. With respect to | 192 |
all other conditions, including the underlying cause of blindness | 193 |
or partial blindness, persons who are blind or partially blind | 194 |
shall be subject to the same standards of sound actuarial | 195 |
principles or actual or reasonably anticipated actuarial | 196 |
experience as are sighted persons. Refusal to insure includes, but | 197 |
is not limited to, denial by an insurer of disability insurance | 198 |
coverage on the grounds that the policy defines "disability" as | 199 |
being presumed in the event that the eyesight of the insured is | 200 |
lost. However, an insurer may exclude from coverage disabilities | 201 |
consisting solely of blindness or partial blindness when such | 202 |
conditions existed at the time the policy was issued. To the | 203 |
extent that the provisions of this division may appear to conflict | 204 |
with any provision of section 3999.16 of the Revised Code, this | 205 |
division applies. | 206 |
(R)(1) Directly or indirectly offering to sell, selling, or | 207 |
delivering, issuing for delivery, renewing, or using or otherwise | 208 |
marketing any policy of insurance or insurance product in | 209 |
connection with or in any way related to the grant of a student | 210 |
loan guaranteed in whole or in part by an agency or commission of | 211 |
this state or the United States, except insurance that is required | 212 |
under federal or state law as a condition for obtaining such a | 213 |
loan and the premium for which is included in the fees and charges | 214 |
applicable to the loan; or, in the case of an insurer or insurance | 215 |
agent, knowingly permitting any lender making such loans to engage | 216 |
in such acts or practices in connection with the insurer's or | 217 |
agent's insurance business. | 218 |
(b) Acts or practices of an insurer, its agents, | 227 |
representatives, or employees in connection with the solicitation, | 228 |
processing, or issuance of an insurance policy or product covering | 229 |
the student loan borrower or the borrower's spouse or dependent | 230 |
children, where such acts or practices take place more than one | 231 |
hundred eighty days after the date on which the borrower is | 232 |
notified that the student loan was approved. | 233 |
(Y)(1)(a) Limiting coverage under, refusing to issue, | 281 |
canceling, or refusing to renew, any individual policy or contract | 282 |
of life insurance, or limiting coverage under or refusing to issue | 283 |
any individual policy or contract of health insurance, for the | 284 |
reason that the insured or applicant for insurance is or has been | 285 |
a victim of domestic violence; | 286 |
(d) Inquiring, directly or indirectly, of an insured under, | 295 |
or of an applicant for, a policy or contract of life or health | 296 |
insurance, as to whether the insured or applicant is or has been a | 297 |
victim of domestic violence, or inquiring as to whether the | 298 |
insured or applicant has sought shelter or protection from | 299 |
domestic violence or has sought medical or psychological treatment | 300 |
as a victim of domestic violence. | 301 |
(b) Nothing in division (Y)(2) of this section shall be | 330 |
construed to permit an insurer to cancel or refuse to renew any | 331 |
policy or contract of health insurance in violation of the "Health | 332 |
Insurance Portability and Accountability Act of 1996," 110 Stat. | 333 |
1955, 42 U.S.C.A. 300gg-41(b), as amended, or in a manner that | 334 |
violates or is inconsistent with any provision of the Revised Code | 335 |
that implements the "Health Insurance Portability and | 336 |
Accountability Act of 1996." | 337 |