Domestic Violence in Insurance
States can protect survivors of domestic violence who face discrimination in all “lines” of insurance: health, life, disability and property/casualty.1 Insurance companies have used a history of abuse to deny coverage or to increase premiums, and have refused to cover abuse-related medical conditions and claims.2 These practices can discourage survivors from seeking help for fear of losing their insurance coverage if the abuse is discovered; they may also have the effect of penalizing survivors of domestic abuse for the violence they have experienced—by denying them coverage or treating domestic abuse as a pre-existing condition. Although federal law offers some protections against discrimination,3 several states offer more comprehensive protection by enacting laws that explicitly prohibit insurance discrimination against domestic violence survivors.
Starting in 2010, every state has established a high-risk insurance pool (called a "pre-existing condition insurance plan") through which uninsured people with pre-exisiting conditions--including domestic violence survivors--can obtain coverage. This is a temporary measure until 2014, when all new health plans must accept anyone who applies for coverage, cannot exclude coverage based on pre-existing conditions, and are prohibited from charging higher premiums based on gender or health status. The new law explicity prohibits health insurance companies from discriminating against applicants on the basis of domestic violence survivorship, starting in 2014.
Although federal law offers some protection against discrimination, several states offer more comprehensive protection by enacting laws that prohibit discrimination against domestic violence survivors. States that prohibit discrimination in all four lines of insurance receive a "meets policy." States that do so in three lines of insurance receive a "limited policy," while states that cover only one or two lines receive a "weak policy." States with no protections receive a "no policy."
More current data for this indicator are not available, and the 2007 Report Card therefore uses the data from the 2004 Report Card.
|State||Strength of Policy||Change from 2007|
|District of Columbia 4||No Policy||Same|
|New Hampshire||Meets Policy||Same|
|New Jersey||Limited Policy||Better|
|New Mexico||Meets Policy||Same|
|New York||Meets Policy||Same|
|North Carolina||No Policy||Same|
|North Dakota 5||Weak Policy||Same|
|Rhode Island||Weak Policy||Same|
|South Carolina||No Policy||Same|
|South Dakota 6||No Policy||Same|
|Vermont 7||No Policy||Same|
|West Virginia||Limited Policy||Same|
Data Source: Women's Law Project, "State Laws Prohibiting Insurance Discrimination on the Basis of Domestic Violence," February 2010, available at http://www.womenslawproject.org/resources/StateStatutes_Prohibit_Insuran..., accessed September 10, 2010. Report supplemented with NWLC unpublished research.
1 Studies in 1994 and 1995 indicated that approximately one out of four insurance companies engaged in these practices, and one study (in Pennsylvania) reported that 74% of life insurers and 65% of health insurers used domestic violence as a criterion in review of new applications. Terry Fromson and Nancy Durburow, Insurance Discrimination Against Victims of Domestic Violence (Harrisburg: Pennsylvania Coalition Against Domestic Violence Publications, 1998), 2 (updated with unpublished data from Terry Fromson, Women’s Law Project, June 2001).
2 Terry Fromson and Nancy Durburow, Insurance Discrimination Against Victims of Domestic Violence (Harrisburg: Pennsylvania Coalition Against Domestic Violence Publications, 1998), 3-4 (updated with unpublished data from Terry Fromson, Women’s Law Project, June 2001).
3 The Health Insurance Portability and Accountability Act, 26 U.S.C. § 9801 (2009); 29 U.S.C. § 1181 (2009); 42 U.S.C. § 300gg (2009).
4 In October 2009, the District of Columbia Department of Insurance, Securities and Banking issued a bulletin warning insurers not to use domestic violence as a factor when issuing health insurance policies. (Department of Insurance, Securities and Banking, DISB Issues Bulletin That Prohibits the Use of Domestic Violence for Underwriting Insurance (October 14, 2009), http://newsroom.dc.gov/show.aspx/agency/disr/section/2/release/18340.)
5 The North Carolina insurance commissioner has put forth administrative rules (24 N.C. Reg. 627) to prohibit insurers from discriminating against domestic violence survivors in the individual market, which took effect April 1, 2010.
6 While the state recently passed a law prohibiting health insurers from inquiring about domestic violence, the law does not prohibit insurers from using information in an individual’s medical records to conclude that an individual is likely a domestic violence survivor, and to deny coverage based on that determination. (H.B. 1189, 85th Leg. Assem., 2010 Leg. Sess. (S.D. 2010)).
7 Although Vermont lacks legislation specifically prohibiting discrimination against domestic violence survivors, the state requires guaranteed issue of all individual insurance plans. (VT. STAT. ANN. tit. 8, § 4080b(d)(1) (2008)).