                                 CODE OF VIRGINIA

DEFINITIONS (§ 38.2-602)

As used in this article:		&#8220;Adverse underwriting decision&#8221; means:

1. Any of the following actions with respect to insurance transactions involving
insurance coverage that 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 that an agent represents and that is requested by
an applicant;			d. In the case of a property or casualty insurance coverage:

   1. Placement by an insurance institution or agent of a risk with a residual
   market mechanism or an unlicensed insurer; or

   2. The charging of a higher rate on the basis of information that differs from
   that which the applicant or policyholder furnished; or
   				e. In the case of a life or accident and sickness insurance coverage, an
   offer to insure at higher than standard rates, or with limitations, exceptions
   or benefits other than those applied for.

2. Notwithstanding subdivision 1 of this definition, the following actions shall
not be considered adverse underwriting decisions, but the insurance institution
or agent responsible for their occurrence shall 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;			c. The rescission of a
policy.			&#8220;Affiliate&#8221; or &#8220;affiliated&#8221; means a person
that directly, or indirectly through one or more intermediaries, controls, is
controlled by, or is under common control with another
person.			&#8220;Agent&#8221; shall have the meaning as set forth in &#xA7;
38.2-1800 and shall include surplus lines brokers.			&#8220;Applicant&#8221;
means any person who seeks to contract for insurance coverage other than a
person seeking group insurance that is not individually
underwritten.			&#8220;Clear and conspicuous notice&#8221; means a notice that
is reasonably understandable and designed to call attention to the nature and
significance of the information in the notice.			&#8220;Consumer report&#8221;
means any written, oral, or other communication of information bearing on a
natural person&#8217;s credit worthiness, credit standing, credit capacity,
character, general reputation, personal characteristics or mode of living that
is used or expected to be used in connection with an insurance
transaction.			&#8220;Consumer reporting agency&#8221; 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.
			&#8220;Control,&#8221; including the terms &#8220;controlled by&#8221; or
&#8220;under common control with,&#8221; 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.			&#8220;Declination of insurance
coverage&#8221; means a denial, in whole or in part, by an insurance institution
or agent of requested insurance coverage.			&#8220;Financial information&#8221;
means personal information other than medical record information or records of
payment for the provision of health care to an individual.			&#8220;Financial
institution&#8221; means any institution the business of which is engaging in
financial activities as described in Section 4(k) of the Bank Holding Company
Act of 1956 (12 U.S.C. &#xA7; 1843 (k)).			&#8220;Financial product or
service&#8221; means any product or service that a financial holding company
could offer by engaging in an activity that is financial in nature or incidental
to such a financial activity under Section 4(k) of the Bank Holding Company Act
of 1956 (12 U.S.C. &#xA7; 1843 (k)).			&#8220;Individual&#8221; means any
natural person who:

1. In the case of property or casualty insurance, is a past, present, or
proposed named insured or certificate holder;

2. In the case of life or accident and sickness insurance, is a past, present,
or proposed principal insured or certificate holder;

3. Is a past, present or proposed policyowner;

4. Is a past or present applicant;

5. Is a past or present claimant;

6. Derived, derives, or is proposed to derive insurance coverage under an
insurance policy or certificate subject to this article;

7. For the purposes of &#xA7;&#xA7; 38.2-612.1 and 38.2-613, is a beneficiary of
a life insurance policy;

8. For the purposes of &#xA7;&#xA7; 38.2-612.1 and 38.2-613, is a mortgagor of a
mortgage covered under a mortgage guaranty insurance policy; or

9. For the purposes of &#xA7;&#xA7; 38.2-612.1 and 38.2-613, is an owner of
property used as security for an indebtedness for which single interest
insurance is required by a lender.
			Notwithstanding any provision of this definition to the contrary, for
purposes of &#xA7; 38.2-612.1, &#8220;individual&#8221; shall not include any
natural person who is covered under an employee benefit plan, group or blanket
insurance contract, or group annuity contract when the insurance institution or
agent that provides such plan or contract: (i) furnishes the notice required
under &#xA7; 38.2-604.1 to the employee benefit plan sponsor, group or blanket
insurance contract holder, or group annuity contract holder; and (ii) does not
disclose the financial information of the person to a nonaffiliated third party
other than as permitted under &#xA7; 38.2-613.			&#8220;Institutional
source&#8221; 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.
			&#8220;Insurance institution&#8221; means any corporation, association,
partnership, reciprocal exchange, inter-insurer, Lloyd&#8217;s type of
organization, fraternal benefit society, or other person engaged in the business
of insurance, including health maintenance organizations, and health, legal,
dental, and optometric service plans. &#8220;Insurance institution&#8221; shall
not include agents or insurance-support
organizations.			&#8220;Insurance-support organization&#8221; means 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 (i) the furnishing of consumer reports or investigative
consumer reports to an insurance institution or agent for use in connection with
an insurance transaction or (ii) 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. However, the following persons shall not be considered
&#8220;insurance-support organizations&#8221; for purposes of this article:
agents, governmental institutions, insurance institutions, medical-care
institutions and medical professionals.			&#8220;Insurance transaction&#8221;
means any transaction involving insurance primarily for personal, family, or
household needs rather than business or professional needs that entails:

1. The determination of an individual&#8217;s eligibility for an insurance
coverage, benefit or payment; or

2. The servicing of an insurance application, policy, contract, or certificate.
			&#8220;Investigative consumer report&#8221; means a consumer report or a
portion thereof in which information about a natural person&#8217;s character,
general reputation, personal characteristics, or mode of living is obtained
through personal interviews with the person&#8217;s neighbors, friends,
associates, acquaintances, or others who may have knowledge concerning such
items of information.			&#8220;Joint marketing agreement&#8221; means a formal
written contract pursuant to which an insurance institution jointly offers,
endorses, or sponsors a financial product or service with another financial
institution.			&#8220;Life insurance&#8221; includes
annuities.			&#8220;Medical-care institution&#8221; 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
or health-maintenance organizations.			&#8220;Medical professional&#8221; means
any person licensed or certified to provide health care services to natural
persons, including but not limited to, a physician, dentist, nurse,
chiropractor, optometrist, physical or occupational therapist, social worker,
clinical dietitian, clinical psychologist, licensed professional counselor,
licensed marriage and family therapist, pharmacist, or speech
therapist.			&#8220;Medical-record information&#8221; means personal information
that:

1. Relates to an individual&#8217;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&#8217;s spouse, parent, or legal guardian.
			&#8220;Nonaffiliated third party&#8221; means any person who is not an
affiliate of an insurance institution but does not mean (i) an agent who is
selling or servicing a product on behalf of the insurance institution or (ii) a
person who is employed jointly by the insurance institution and the company that
is not an affiliate.			&#8220;Personal information&#8221; means any individually
identifiable information gathered in connection with an insurance transaction
from which judgments can be made about an individual&#8217;s character, habits,
avocations, finances, occupation, general reputation, credit, health, or any
other personal characteristics. &#8220;Personal information&#8221; includes an
individual&#8217;s name and address and medical-record information, but does not
include (i) privileged information or (ii) any information that is publicly
available.			&#8220;Policyholder&#8221; 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 or accident and sickness insurance, is a
present policyowner; or

3. In the case of group insurance that is individually underwritten, is a
present group certificate holder.
			&#8220;Policyholder information&#8221; means personal information about a
policyholder, whether in paper, electronic, or other form, that is maintained by
or on behalf of an insurance institution, agent, or insurance-support
organization.			&#8220;Pretext interview&#8221; 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.
			&#8220;Privileged information&#8221; means any individually identifiable
information that (i) relates to a claim for insurance benefits or a civil or
criminal proceeding involving an individual, and (ii) is collected in connection
with or in reasonable anticipation of a claim for insurance benefits or civil or
criminal proceeding involving an individual.			&#8220;Residual market
mechanism&#8221; means an association, organization, or other entity defined,
described, or provided for in the Virginia Automobile Insurance Plan as set
forth in &#xA7; 38.2-2015, or in the Virginia Property Insurance Association as
set forth in Chapter 27 (&#xA7; 38.2-2700 et seq.) of this
title.			&#8220;Termination of insurance coverage&#8221; or &#8220;termination
of an insurance policy&#8221; means either a cancellation or nonrenewal of an
insurance policy other than by the policyholder&#8217;s request, in whole or in
part, for any reason other than the failure to pay a premium as required by the
policy.			&#8220;Unlicensed insurer&#8221; means an insurance institution that
has not been granted a license by the Commission to transact the business of
insurance in Virginia.

HISTORY: 1981, c. 389, § 38.1-57.5; 1986, c. 562; 2001, c. 371; 2003, c. 729;
2006, c. 638; 2020, c. 264.