Maine Code § 24-A-2212

Reasons for adverse underwriting decisions
Open in Lexace · Ask the AI about this section
1. Notice to consumer. In the event of an adverse underwriting decision, the carrier or producer
responsible for the decision shall:

A. Comply with the federal Fair Credit Reporting Act, 15 United States Code, Section 1681m if
the decision is based in whole or in part on any information contained in a consumer report; [PL
2013, c. 588, Pt. D, §6 (AMD).]
B. Either provide the consumer with the specific reason or reasons for the adverse underwriting
decision in writing or advise the consumer that upon written request the consumer may receive the
specific reason or reasons in writing; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5
(AFF).]
C. Provide the consumer with a summary of the rights established under subsection 2 and sections
2210 and 2211. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
[PL 2013, c. 588, Pt. D, §6 (AMD).]
2. Request for explanation. If a consumer makes a written request for explanation of an adverse
underwriting decision within 90 days after receiving written notice of the decision, the carrier or
producer shall furnish to the consumer within 21 days after receiving the request:
A. The specific reason or reasons for the adverse underwriting decision, in writing, if such
information was not initially furnished in writing pursuant to subsection 1, paragraph A or B; [PL
1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
B. The specific items of personal information that support those reasons, except that:
(1) The carrier or producer is not required to furnish confidential investigative information if
it has a reasonable suspicion, based upon specific information available for review by the
superintendent, that the consumer has engaged in criminal activity, fraud, material
misrepresentation or material nondisclosure; and
(2) In lieu of disclosure directly to the consumer, the carrier or producer may elect to disclose
health care information to a person designated by the consumer who is licensed to provide
health care with respect to the condition to which the information relates; and [PL 1997, c.
677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
C. The names and addresses of the institutional sources that supplied the specific items of
information pursuant to paragraph B, except that the carrier may elect to disclose the identity of
any health care provider to the consumer's designated health care practitioner. [PL 1997, c. 677,
§3 (NEW); PL 1997, c. 677, §5 (AFF).]
[PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
3. Satisfaction by other carrier, producer or administrator. The obligations imposed by this
section upon a carrier or producer may be satisfied by another carrier, producer or administrator
authorized to act on its behalf.
[PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

‹ Prev All Maine sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.