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Illinois Compiled Statutes
Information maintained by the Legislative Reference Bureau Updating the database of the Illinois Compiled Statutes (ILCS) is an ongoing process. Recent laws may not yet be included in the ILCS database, but they are found on this site as Public Acts soon after they become law. For information concerning the relationship between statutes and Public Acts, refer to the Guide. Because the statute database is maintained primarily for legislative drafting purposes, statutory changes are sometimes included in the statute database before they take effect. If the source note at the end of a Section of the statutes includes a Public Act that has not yet taken effect, the version of the law that is currently in effect may have already been removed from the database and you should refer to that Public Act to see the changes made to the current law.
INSURANCE (215 ILCS 5/) Illinois Insurance Code. 215 ILCS 5/155.18a
(215 ILCS 5/155.18a)
Sec. 155.18a. (Repealed).
(Source: P.A. 94-677, eff. 8-25-05. Repealed by P.A. 103-426, eff. 8-4-23.)
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215 ILCS 5/155.19
(215 ILCS 5/155.19) (from Ch. 73, par. 767.19)
Sec. 155.19. All claims filed after December 31, 1976 with any insurer
and all suits filed after December 31, 1976 in any court in this State,
alleging liability on the part of any physician, hospital or other health
care provider for medically related injuries, shall be reported to the
Director
of Insurance in such form and under such terms and conditions as may be
prescribed by the
Director. The
Director shall maintain complete and accurate
records of all such claims and suits including their nature, amount, disposition
and other information as he may deem useful or desirable in observing and
reporting on health care provider liability trends in this State. The Director
shall release to appropriate disciplinary and licensing agencies any such
data or information which may assist such agencies in
improving the quality of health care or which may be useful to such agencies
for the purpose of professional discipline.
With due regard for appropriate maintenance of the confidentiality thereof,
the
Director
may
release
from time to time to the Governor, the General
Assembly and the general public statistical reports based on such data and information.
The
Director may promulgate such rules and regulations as may be necessary
to carry out the provisions of this Section.
(Source: P.A. 103-426, eff. 8-4-23.) |
215 ILCS 5/155.20
(215 ILCS 5/155.20) (from Ch. 73, par. 767.20)
Sec. 155.20.
All final arbitration decisions rendered in relation to disputes
or controversies arising out of injuries allegedly caused by reason of hospital
or health care provider malpractice shall be recognized by any insurance
company doing business in the State of Illinois and all findings of facts
relating to liability and awards of damages in relation thereto which are
a part of the final arbitration decision shall be binding on such insurance companies.
(Source: P.A. 79-1435.)
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215 ILCS 5/155.21
(215 ILCS 5/155.21) (from Ch. 73, par. 767.21)
Sec. 155.21. A company writing medical liability insurance shall not refuse
to offer insurance to a physician, hospital or other health care provider
on the grounds that the physician, hospital or health care provider has
entered or intends to enter an arbitration agreement pursuant to the Health Care
Arbitration Act.
As used in this Section, medical liability insurance means insurance on
risks based upon negligence by a physician, hospital or other health care provider.
(Source: P.A. 95-331, eff. 8-21-07.)
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215 ILCS 5/155.22
(215 ILCS 5/155.22) (from Ch. 73, par. 767.22)
Sec. 155.22.
No company authorized to transact in this State the kinds
of business described in Classes 2 and 3 of Section 4, and no officer, director,
agent, clerk, employee or broker of such company shall upon proper application
refuse to provide insurance solely on the basis of
the specific geographic location
of the risk sought to be insured unless
such refusal is for a business purpose which is not a mere pretext for
unfair discrimination.
(Source: P.A. 84-1431.)
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215 ILCS 5/155.22a
(215 ILCS 5/155.22a)
Sec. 155.22a.
Coverage for subjects of abuse.
(a) No company authorized to
transact life, health,
disability income, or property and casualty insurance in this State may:
(1) Deny, refuse to issue, refuse to renew, refuse to | | reissue, cancel, or otherwise terminate an insurance policy or restrict coverage on an individual because that individual is or has been the subject of abuse or because that individual seeks or has sought: (i) medical or psychological treatment for abuse; or (ii) protection or shelter from abuse;
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(2) Charge a different rate for the same coverage for
| | an insurance policy because an individual insured under such policy has a history of or is a subject of abuse;
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(3) Deny a claim by an insured as a result of his or
| | her status as being or having been a subject of abuse, except as otherwise permitted or required by the laws of this State; or
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(4) Ask an insured or an applicant for insurance
| | whether that individual is or has been a subject of abuse or whether that individual seeks or has sought: (i) medical or psychological treatment specifically for abuse; or (ii) protection or shelter from abuse.
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(b) No company authorized to transact life, health, disability
income,
or property and casualty
insurance in this State may fail to maintain strict confidentiality of
information, as defined in the Insurance Information and Privacy Protection
Article of this Code, relating to an applicant's or insured's abuse status or
to a medical or psychological condition that the company knows is
abuse-related. Disclosure of such abuse-related information shall be subject
to the disclosure limitations and conditions contained in Section 1014 of this
Code.
(c) Nothing in this Section shall be construed to prohibit a company
specified in subsection (a) from (i) refusing to insure, refusing to
continue to insure, limiting the amount, extent, or kind of coverage available
to an individual, or charging a different rate for the same coverage on the
basis of that individual's physical or mental condition regardless of the
underlying cause of such condition; (ii) declining to issue a life
insurance policy
insuring an individual who is or has been the subject of abuse if the
perpetrator of the
abuse is the applicant or would be the owner of the insurance policy; or (iii)
inquiring about a physical or mental condition, even if that condition was
caused by or is related in any manner to
abuse.
(d) As used in this Section, "abuse" means the occurrence of one or more of
the following acts between family members, current or former household members,
or current or former intimate partners:
(1) Attempting to cause or intentionally, knowingly,
| | or recklessly causing another person, including a minor child, to be harassed or intimidated or subject to bodily injury, physical harm, rape, sexual assault, or involuntary sexual intercourse; or
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(2) Knowingly engaging in a course of conduct or
| | repeatedly committing acts without proper authority that place the person toward whom such acts are directed, including a minor child, in a reasonable fear of bodily injury or physical harm; or
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(3) Subjecting another person, including a minor
| | child, to false imprisonment.
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(e) No company specified in subsection (a) above shall be held civilly or
criminally liable for any cause of action that may be brought because of
compliance with this Section. Nothing in
this Section, however, shall preclude the jurisdiction of any administrative
agency to carry out its statutory authority.
(Source: P.A. 93-200, eff. 1-1-04.)
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215 ILCS 5/155.22b
(215 ILCS 5/155.22b)
Sec. 155.22b.
Rating, claims handling, and underwriting decisions.
(a) No company issuing a policy of property and casualty insurance may use
the fact that an applicant or insured incurred
bodily
injury as a result of a battery
or other violent act committed against him or her by a spouse or person in
the same household as a
sole reason for a rating, underwriting, or claims handling decision.
(b) If a policy excludes property coverage for intentional acts, the
insurer may not deny payment to an innocent co-insured who did not cooperate in
or contribute to the creation of the loss if the loss arose out of a pattern of
criminal domestic violence and the perpetrator of the loss is criminally
prosecuted for the act causing the loss. Payment to the innocent co-insured
may be limited to his or her ownership interest in the property as reduced by
any payments to a mortgagor or other secured interest.
(Source: P.A. 93-200, eff. 1-1-04.)
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215 ILCS 5/155.23
(215 ILCS 5/155.23) (from Ch. 73, par. 767.23)
Sec. 155.23.
Fraud reporting.
(1) The Director is authorized to promulgate | | reasonable rules requiring insurers, as defined in Section 155.24, doing business in the State of Illinois to report factual information in their possession that is pertinent to suspected fraudulent insurance claims, fraudulent insurance applications, or premium fraud after he has made a determination that the information is necessary to detect fraud or arson. Claim information may include:
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(a) Dates and description of accident or loss.
(b) Any insurance policy relevant to the accident or
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(c) Name of the insurance company claims adjustor and
| | claims adjustor supervisor processing or reviewing any claim or claims made under any insurance policy relevant to the accident or loss.
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(d) Name of claimant's or insured's attorney.
(e) Name of claimant's or insured's physician, or any
| | person rendering or purporting to render medical treatment.
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(f) Description of alleged injuries, damage or loss.
(g) History of previous claims made by the claimant
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(h) Places of medical treatment.
(i) Policy premium payment record.
(j) Material relating to the investigation of the
| | accident or loss, including statements of any person, proof of loss, and any other relevant evidence.
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(k) any facts evidencing fraud or arson.
The Director shall establish reporting requirements for application and
premium fraud information reporting by rule.
(2) The Director of Insurance may designate one or more data processing
organizations or governmental agencies to assist him in gathering such
information
and making
compilations thereof, and may by rule establish the form and procedure
for gathering and compiling such information. The rules may name any
organization or agency designated by the Director to provide this service,
and may in such case provide for a fee to be paid by the
reporting insurers
directly to the designated organization or agency to cover any of the costs
associated with providing this service. After determination by the
Director of substantial
evidence of false
or fraudulent claims, fraudulent applications, or premium fraud, the
information shall be forwarded by the Director
or the Director's designee to the proper law enforcement agency
or prosecutor. Insurers shall have
access to, and may use, the information compiled under the
provisions
of this Section. Insurers shall release
information to, and shall cooperate with, any law enforcement agency
requesting such information.
In the absence of malice, no insurer, or person who
furnishes
information on its behalf, is liable for damages in a civil action or subject
to criminal prosecution for any oral or written statement made or any other
action taken that is necessary to supply information required pursuant to
this Section.
(Source: P.A. 92-233, eff. 1-1-02.)
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215 ILCS 5/155.24
(215 ILCS 5/155.24) (from Ch. 73, par. 767.24)
Sec. 155.24.
Motor Vehicle Theft and Motor Insurance Fraud
Reporting and Immunity Law.
(a) As used in this Section:
(1) "authorized governmental agency" means the | | Illinois State Police, a local governmental police department, a county sheriff's office, a State's Attorney, the Attorney General, a municipal attorney, a United States district attorney, a duly constituted criminal investigative agency of the United States government, the Illinois Department of Insurance, the Illinois Department of Professional Regulation and the office of the Illinois Secretary of State;
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(2) "relevant" means having a tendency to make the
| | existence of any information that is of consequence to an investigation of motor vehicle theft or insurance fraud investigation or a determination of such issue more probable or less probable than it would be without such information;
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(3) information will be "deemed important" if within
| | the sole discretion of the authorized governmental agency such information is requested by that authorized governmental agency;
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(4) "Illinois authorized governmental agency" means
| | an authorized governmental agency as defined in item (1) that is a part of the government of the State of Illinois or any of the counties or municipalities of this State or any other authorized entity; and
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(5) For the purposes of this Section and Section
| | 155.23, "insurer" means insurance companies, insurance support organizations, self-insured entities, and other providers of insurance products and services doing business in the State of Illinois.
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(b) Upon written request to an insurer by an authorized governmental agency,
an insurer or agent authorized by an insurer to act on its behalf shall
release to the requesting authorized governmental agency any or all relevant
information deemed important to the authorized governmental agency which
the insurer may possess relating to any specific motor vehicle theft or motor
vehicle insurance fraud. Relevant information may include, but is not limited
to:
(1) Insurance policy information relevant to the
| | motor vehicle theft or motor vehicle insurance fraud under investigation, including any application for such a policy.
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(2) Policy premium payment records which are
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(3) History of previous claims made by the insured.
(4) Information relating to the investigation of the
| | motor vehicle theft or motor vehicle insurance fraud, including statements of any person, proofs of loss and notice of loss.
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(c) When an insurer knows or reasonably believes to know the identity
of a person whom it has reason to believe committed a criminal or fraudulent
act relating to a motor vehicle theft or a motor vehicle insurance claim
or has knowledge of such a criminal or fraudulent act which is reasonably
believed not to have been reported to an authorized governmental agency,
then for the purpose of notification and investigation, the insurer or an
agent authorized by an insurer to act on its behalf shall notify an authorized
governmental agency of such knowledge or reasonable belief and provide any
additional relevant information in accordance with subsection
(b) of this Section. When the motor vehicle
theft or motor vehicle claim that gives rise to the suspected criminal or
fraudulent act has already generated an incident report to an Illinois
authorized governmental agency, the insurer shall report the suspected
criminal or fraudulent act to that agency. When no prior
incident report has been made, the insurer shall report the suspected criminal
or
fraudulent act to the Attorney General or State's Attorney in the county or
counties where the incident is claimed to have occurred. When the incident
that gives rise to the suspected criminal or fraudulent act is claimed to have
occurred outside the State of Illinois, but the suspected criminal or
fraudulent act occurs within the State of Illinois, the insurer shall make the
report to the Attorney General or State's Attorney in the county or counties
where the suspected criminal or fraudulent act occurred. When the fraud occurs
in multiple counties the report shall also be sent to the Attorney General.
(d) When an insurer provides any of the authorized governmental agencies
with notice pursuant to this Section it shall be deemed sufficient notice
to all authorized governmental agencies for the purpose of this Act.
(e) The authorized governmental agency provided with information pursuant
to this Section may release or provide such information to any other authorized
governmental agency.
(f) Any insurer providing information to an authorized governmental agency
pursuant to this Section shall have the right to request and receive relevant
information from such authorized governmental agency, and receive within
a reasonable time after the completion of the investigation, not to exceed
30 days, the information requested.
(g) Any information furnished pursuant to this Section shall be privileged
and not a part of any public record. Except as otherwise provided by law,
any authorized governmental agency, insurer, or an agent authorized by an
insurer to act on its behalf which receives any information furnished pursuant
to this Section, shall not release such information to public inspection.
Such evidence or information shall not be subject to subpoena duces tecum
in a civil or criminal proceeding unless, after reasonable notice to any
insurer, agent authorized by an insurer to act on its behalf and authorized
governmental agency which has an interest in such information and a hearing,
the court determines that the public interest and any ongoing investigation
by the authorized governmental agency, insurer, or any agent authorized
by an insurer to act on its behalf will not be jeopardized by obedience to
such a subpoena duces tecum.
(h) No insurer, or agent authorized by an insurer on its behalf, authorized
governmental agency or their respective employees shall be subject to any
civil or criminal liability in a cause of action of any kind for releasing
or receiving any information pursuant to this Section. Nothing herein is
intended to or does in any way or manner abrogate or lessen the common and
statutory law privileges and immunities of an insurer, agent authorized
by an insurer to act on its behalf or authorized governmental agency or
any of their respective employees.
(Source: P.A. 102-538, eff. 8-20-21.)
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215 ILCS 5/155.25
(215 ILCS 5/155.25) (from Ch. 73, par. 767.25)
Sec. 155.25.
Reports by certain property and casualty insurers.
(A) The Director shall promulgate rules and regulations which shall
require, at the request of the Director, any insurer licensed to write medical
liability insurance in this State to file a report on a form furnished by the
Director showing its direct experience in this State. All experience shall
be on a direct basis, prior to reinsurance, and shall be required only in
the aggregate. Individual claim reports shall not be required.
(B) The reports required under subsection (A) shall include the
following data for the previous year ending on the 31st of December:
(1) Direct premium written for the prior 12 months.
(2) Direct premium earned for the prior 12 months.
(3) (a) Incurred claims by accident year, showing the | | most recent 8 accident years, and a subtotal combining all accident years prior to the most recent 8, valued as of the most recent December 31, valued as of the prior December 31, each developed as the sum of, and with figures provided for under division (b) of this paragraph (3).
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(b) Show for each such item, the difference between 2
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(i) dollar amount of claim payments, cumulated
| | from the beginning of each accident year, where the dollar amount of claim payments shall be separately reported for closed claims under paragraph (3) (a) and for open and reopened claims under paragraph (3) (a), plus
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(ii) reserves for reported claims as of the
| | valuation dates, open or reopened, plus
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(iii) reserves for claims incurred but not
| | reported as the valuation dates, plus
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(iv) any other loss reserves carried by the
| | company as of the valuation dates and not reported in (3) (ii) or (3) (iii).
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(v) number of claims, cumulated from the
| | beginning of each accident year, showing the most recent 8 accident years, and a subtotal combining all accident years prior to the most recent 8 valued as of the most recent December 31, land valued as of the prior December 31, with figures provided for the number of closed claims under paragraph (3) (a) and the number of open and unopened claims under paragraph (3) (a). Show for each such item, the difference between the 2 valuations.
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(4) Actual incurred expenses allocated separately to
| | loss adjustment, commissions, or other acquisition costs, general office expenses, taxes, licenses and fees, and all other expenses.
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(5) Net underwriting gain or loss.
(Source: P.A. 87-1090.)
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215 ILCS 5/155.25a
(215 ILCS 5/155.25a) (from Ch. 73, par. 767.25a)
Sec. 155.25a.
Notwithstanding the provisions of subsection (D) of
Section 123B-9, a purchasing group may purchase insurance providing for a
group aggregate limit from an insurer licensed to write medical liability
insurance in this State if (1) such group is domiciled in Illinois and all
or substantially all of such group's members are residents of Illinois, (2)
each insured in the purchasing group is specifically informed prior to
issuance of the policy to such insured of the existence of the group
aggregate limit, and (3) either (a) the amount of the group aggregate limit
is determined by the Director in his discretion to be sufficiently high
(when considered in conjunction with other factors such as each individual
insured's per claim limit and each individual insured's aggregate limit),
such that the risk that the group aggregate limit will be exhausted is not
substantial, or (b) (i) each individual insured's aggregate limit is not
more than 300% of such individual insured's per claim limit and (ii) the
group aggregate limit (at the time of the insured's claim) is equal to or
exceeds the amount set forth in the following table:
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Number of Insureds |
Required Purchasing |
in Purchasing |
Group Aggregate Limit |
Group |
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Less than 10 |
Individual claim limit X |
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Number of Insureds |
10 to 24 |
The sum of (i) 3 X the |
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individual claim limit, |
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plus (ii) the individual |
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claim limit X the Number |
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of Insureds X 2/3 |
25 to 50 |
The sum of (i) 7 X the |
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individual claim |
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limit, plus (ii) the individual |
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claim limit X the Number of |
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Insureds X 1/2 |
Over 50 |
The sum of (i) 17 X the individual |
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claim limit, plus (ii) the |
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individual claim limit X the |
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Number of Insureds X 3/10. |
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(Source: P.A. 86-632 .)
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215 ILCS 5/155.26
(215 ILCS 5/155.26) (from Ch. 73, par. 767.26)
Sec. 155.26.
No insurance company authorized to do business in
Illinois may increase the premium rates for a renewal policy which insures
an individual with a personal lines automobile insurance policy against any
loss or liability resulting from or incident to the ownership, maintenance
or use of any motor vehicle if the sole basis for the proposed increase is
that the insured was convicted of no more than one offense for speeding
where such speeding was not in
excess of 10 miles an hour over the posted speed limit, and no claim
for recovery of damages or loss has been paid by the insurer because of such offense.
(Source: P.A. 85-332.)
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215 ILCS 5/155.27
(215 ILCS 5/155.27) (from Ch. 73, par. 767.27)
Sec. 155.27.
No insurance company authorized to transact business in
this State may impose a surcharge upon an applicant for
a policy of automobile insurance or refuse to insure the applicant solely
based upon the identity of the
applicant's prior automobile insurance carrier, unless the applicant fails
to provide the company with the applicant's
loss experience with the prior carrier within 21 calendar days after the
application for automobile insurance is filed.
(Source: P.A. 86-1408.)
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215 ILCS 5/155.28
(215 ILCS 5/155.28) (from Ch. 73, par. 767.28)
Sec. 155.28.
(a) Any individual who is a potential applicant for a
policy of personal automobile insurance as defined in subsection (a) of
Section 143.13 of this Code shall be provided an oral estimate of premium
charges based on the information provided to an insurance producer or
designated representative who maintains an office within any municipality
with 500,000 or more inhabitants. Such an estimate shall be given
by any such insurance producer or designated representative of an insurer but
shall not be binding.
(b) No such insurer, insurance producer or designated representative
shall require that an individual described in subsection (a) of this
Section shall be present in person in order to obtain the estimate
described in subsection (a).
(c) Nothing in this Section shall be construed to prohibit an insurer,
insurance producer or designated representative from requiring that an
individual be present in person to complete a final application for a
policy of personal automobile insurance as defined in subsection (a) of
Section 143.13 of this Code.
(Source: P.A. 86-1408.)
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215 ILCS 5/155.29
(215 ILCS 5/155.29) (from Ch. 73, par. 767.29)
Sec. 155.29.
(a) Purpose. The purpose of this Section
is to regulate the use of
aftermarket crash parts by requiring disclosure when any use of
an aftermarket non-original equipment manufacturer's crash part is proposed and by
requiring that the manufacturers of such aftermarket crash parts be identified.
(b) Definitions. As used in this Section the following terms have
the following meanings:
"Aftermarket crash part" means a replacement for any of the nonmechanical
sheet metal or plastic parts that generally constitute the exterior of a
motor vehicle, including inner and outer panels.
"Non-original equipment manufacturer (Non-OEM) aftermarket crash part"
means an aftermarket crash part not made for or by the manufacturer of the motor vehicle.
"Repair facility" means any motor vehicle dealer, garage, body shop, or
other commercial entity that undertakes the repair or replacement of those
parts that generally constitute the exterior of a motor vehicle.
"Installer" means an individual who actually does the work of replacing
or repairing parts of a motor vehicle.
(c) Identification. Any aftermarket crash part supplied by a
non-original equipment manufacturer for use in this State after the
effective date of this Act shall have affixed thereto or inscribed thereon
the logo or name of its
manufacturer. The manufacturer's logo or name shall be visible after
installation whenever practicable.
(d) Disclosure. No insurer shall specify the use of non-OEM
aftermarket crash parts in the repair of an insured's motor vehicle, nor
shall any repair facility or installer use non-OEM aftermarket crash parts
to repair a vehicle unless the customer is advised of that fact in
writing. In all instances where an insurer intends that non-OEM
aftermarket crash parts be used in the repair of a motor vehicle, the
insurer shall provide the customer with the following information:
(1) a written estimate that clearly identifies each | | non-OEM aftermarket crash part; and
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(2) a disclosure settlement incorporated into or
| | attached to the estimate that reads as follows: "This estimate has been prepared based on the use of crash parts supplied by a source other than the manufacturer of your motor vehicle. Warranties applicable to these replacement parts are provided by the manufacturer or distributor of these parts rather than the manufacturer of your vehicle."
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(Source: P.A. 86-1234; 86-1475 .)
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215 ILCS 5/155.30
(215 ILCS 5/155.30) (from Ch. 73, par. 767.30)
Sec. 155.30.
For purposes of determining premium rates to be charged
for personal multi-peril property insurance policies covering real property
used principally for residential purposes or any household or personal
property that is usual or incidental to the occupancy of any premises used
for residential purposes (commonly known as "homeowners" or "renters"
insurance), an insurance company authorized to do business in this State
shall not treat a child placed in the household by the Illinois Department
of Children and Family Services or a private child welfare agency
differently from a natural or adopted child of the policy owner. An
insurance company authorized to do business in this State shall not
consider a policy owner's acceptance of the placement of a foster child in
his or her household as a use of the family dwelling for a business purpose.
(Source: P.A. 86-1482.)
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215 ILCS 5/155.31
(215 ILCS 5/155.31)
Sec. 155.31.
Day care and group day care homes; coverage.
(a) No insurer providing insurance coverage, as defined in subsection (b)
of
Section 143.13 of this Code, shall nonrenew or cancel an insurance policy on a
day care home or group day care home, as defined in the Child Care Act of 1969,
solely on the basis that the insured operates a duly licensed day care home or
group day care home on the insured premises.
(b) An insurer providing such insurance coverage to a licensed day care home
or licensed group day care home may provide such coverage with a separate
policy or endorsement to a policy of fire and extended coverage insurance, as
defined in subsection (b) of Section 143.13.
(c) Notwithstanding subsections (a) and (b) of this Section, the insurer
providing such coverage shall be allowed to cancel or nonrenew an insurance
policy on a day care home or group day care home based upon the authority
provided under Sections 143.21 and 143.21.1 of this Code.
(Source: P.A. 90-401, eff. 1-1-98; 90-655, eff. 7-30-98.)
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215 ILCS 5/155.32
(215 ILCS 5/155.32)
Sec. 155.32.
Policy explanations; language other than English.
(a) A company, as defined in Section 132.2 of this Code, may conduct
transactions in a language other than English through an employee or agent
acting as interpreter or through an interpreter provided by the customer.
(b) An insurance carrier licensed to provide insurance as defined in
subsections
(a) and (b) of Section 143.13 of this Code may provide insurance policies,
endorsements, riders, and any explanatory or advertising material in a language
other than English. In the event of a dispute or complaint regarding the
insurance or advertising material, the English language version of the
insurance coverage shall control the resolution of the dispute or
complaint.
(Source: P.A. 92-578, eff. 6-26-02.)
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215 ILCS 5/155.33
(215 ILCS 5/155.33)
Sec. 155.33.
Illinois Health Insurance Portability and
Accountability Act.
The provisions of this Code are subject to the Illinois Health Insurance
Portability and Accountability Act as provided in Section 15 of that Act.
(Source: P.A. 90-30, eff. 7-1-97; 90-655, eff. 7-30-98.)
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215 ILCS 5/155.34
(215 ILCS 5/155.34)
Sec. 155.34.
(Repealed).
(Source: P.A. 90-655, eff. 7-30-98. Repealed by P.A. 93-502, eff.
1-1-04.)
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215 ILCS 5/155.35
(215 ILCS 5/155.35)
Sec. 155.35.
Insurance compliance self-evaluative privilege.
(a) To encourage insurance companies and persons conducting activities
regulated under this Code, both to conduct voluntary internal audits of their
compliance programs and management systems and to assess and improve compliance
with State and federal statutes, rules, and orders, an insurance compliance
self-evaluative privilege is recognized to protect the confidentiality of
communications relating to voluntary internal compliance audits. The General
Assembly hereby finds and declares that protection of insurance consumers is
enhanced by companies' voluntary compliance with this State's insurance and
other laws and that the public will benefit from incentives to identify and
remedy insurance and other compliance issues. It is further declared that
limited expansion of the protection against disclosure will encourage voluntary
compliance and improve insurance market conduct quality and that the voluntary
provisions of this Section will not inhibit the exercise of the regulatory
authority by those entrusted with protecting insurance consumers.
(b)(1) An insurance compliance self-evaluative audit document is privileged
information and is not admissible as evidence in any legal action in any
civil, criminal, or administrative proceeding, except as provided in
subsections (c) and (d) of this Section. Documents, communications, data,
reports, or other information created as a result of a claim involving personal
injury or workers' compensation made against an insurance policy are not
insurance compliance self-evaluative audit documents and are admissible as
evidence in civil proceedings as otherwise provided by applicable rules of
evidence or civil procedure, subject to any applicable statutory or common law
privilege, including but not limited to the work product doctrine, the
attorney-client privilege, or the subsequent remedial measures exclusion.
(2) If any company, person, or entity performs or directs the performance
of an insurance compliance audit, an officer or employee involved with the
insurance compliance audit, or any consultant who is hired for the purpose of
performing the insurance compliance audit, may not be examined in any civil,
criminal, or administrative proceeding as to the insurance compliance audit or
any insurance compliance self-evaluative audit document, as defined in this
Section. This subsection (b)(2) does not apply if the privilege set forth in
subsection (b)(1) of this Section is determined under subsection (c) or (d) not
to apply.
(3) A company may voluntarily submit, in connection with examinations
conducted under this Article, an insurance compliance self-evaluative audit
document to the Director, or his or her designee, as a confidential document
under subsection (f) of Section 132.5 of this Code without waiving the
privilege set forth in this Section to which the company would otherwise be
entitled;
provided, however, that the provisions in subsection (f) of Section 132.5
permitting the Director to make confidential documents public pursuant to
subsection (e) of Section 132.5 and access to the National Association of
Insurance Commissioners shall not apply to the insurance compliance
self-evaluative audit
document so voluntarily submitted. Nothing contained in this subsection shall
give the Director any authority to compel a company to disclose involuntarily
or otherwise provide an insurance compliance self-evaluative audit document.
(c)(1) The privilege set forth in subsection (b) of this Section does not
apply to the extent that it is expressly waived by the company that prepared
or caused to be prepared the insurance compliance self-evaluative audit
document.
(2) In a civil or administrative proceeding, a court of record may, after
an in camera review, require disclosure of material for which the privilege set
forth in subsection (b) of this Section is asserted, if the court determines
one of the following:
(A) the privilege is asserted for a fraudulent | |
(B) the material is not subject to the privilege; or
(C) even if subject to the privilege, the material
| | shows evidence of noncompliance with State and federal statutes, rules and orders and the company failed to undertake reasonable corrective action or eliminate the noncompliance within a reasonable time.
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(3) In a criminal proceeding, a court of record may, after an in camera
review, require disclosure of material for which the privilege described in
subsection (b) of this Section is asserted, if the court determines one of the
following:
(A) the privilege is asserted for a fraudulent
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(B) the material is not subject to the privilege;
(C) even if subject to the privilege, the material
| | shows evidence of noncompliance with State and federal statutes, rules and orders and the company failed to undertake reasonable corrective action or eliminate such noncompliance within a reasonable time; or
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(D) the material contains evidence relevant to
| | commission of a criminal offense under this Code, and all of the following factors are present:
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(i) the Director, State's Attorney, or Attorney
| | General has a compelling need for the information;
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(ii) the information is not otherwise available;
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(iii) the Director, State's Attorney, or Attorney
| | General is unable to obtain the substantial equivalent of the information by any means without incurring unreasonable cost and delay.
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(d)(1) Within 30 days after the Director, State's Attorney, or Attorney
General makes a written request by certified mail for disclosure of an
insurance compliance self-evaluative audit document under this subsection, the
company that
prepared or caused the document to be prepared may file with the appropriate
court a petition requesting an in camera hearing on whether the insurance
compliance self-evaluative audit document or portions of the document are
privileged under this Section or subject to disclosure. The court has
jurisdiction over a petition filed by a company under this subsection
requesting an in camera hearing on whether the insurance compliance
self-evaluative audit document or portions of the document are privileged or
subject
to disclosure. Failure by the company to file a petition waives the privilege.
(2) A company asserting the insurance compliance self-evaluative privilege
in response to a request for disclosure under this subsection shall include in
its request for an in camera hearing all of the information set forth in
subsection (d)(5) of this Section.
(3) Upon the filing of a petition under this subsection, the court shall
issue an order scheduling, within 45 days after the filing of the petition, an
in camera hearing to determine whether the insurance compliance self-evaluative
audit document or portions of the document are privileged under this Section or
subject to disclosure.
(4) The court, after an in camera review, may require disclosure of
material for which the privilege in subsection (b) of this Section is asserted
if the court determines, based upon its in camera review, that any one of the
conditions set forth in subsection (c)(2)(A) through (C) is applicable as to a
civil or administrative proceeding or that any one of the conditions set forth
in subsection (c)(3)(A) through (D) is applicable as to a criminal proceeding.
Upon making such a determination, the court may only compel the disclosure of
those portions of an insurance compliance self-evaluative audit document
relevant to issues in dispute in the underlying proceeding.
Any compelled disclosure will not be considered to be a public document or be
deemed to be a waiver of the privilege for any other civil, criminal, or
administrative proceeding. A party unsuccessfully opposing disclosure may
apply to the court for an appropriate order protecting the document from
further disclosure.
(5) A company asserting the insurance compliance self-evaluative privilege
in response to a request for disclosure under this subsection (d) shall provide
to the Director, State's Attorney, or Attorney General, as the case may be, at
the time of
filing any objection to the disclosure, all of the following information:
(A) The date of the insurance compliance
| | self-evaluative audit document.
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(B) The identity of the entity conducting the audit.
(C) The general nature of the activities covered by
| | the insurance compliance audit.
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(D) An identification of the portions of the
| | insurance compliance self-evaluative audit document for which the privilege is being asserted.
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(e) (1) A company asserting the insurance compliance self-evaluative
privilege set forth in subsection (b) of this Section has the burden of
demonstrating the applicability of the privilege. Once a company has
established the applicability of the privilege, a party
seeking disclosure under subsections (c)(2)(A) or (C) of this Section has the
burden of proving that the privilege is asserted for
a fraudulent purpose or that the company failed to
undertake reasonable corrective action or eliminate the noncompliance with a
reasonable time. The Director, State's Attorney, or Attorney General seeking
disclosure under subsection (c)(3) of this Section has the burden of proving
the elements set forth in subsection (c)(3) of this Section.
(2) The parties may at any time stipulate in proceedings under subsections
(c) or (d) of this Section to entry of an order directing that specific
information contained in an insurance compliance self-evaluative audit document
is or is not subject to the privilege provided under subsection (b) of this
Section.
(f) The privilege set forth in subsection (b) of this Section shall not
extend to any of the following:
(1) documents, communications, data, reports, or
| | other information required to be collected, developed, maintained, reported, or otherwise made available to a regulatory agency pursuant to this Code, or other federal or State law, rule, or order;
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(2) information obtained by observation or monitoring
| | by any regulatory agency; or
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(3) information obtained from a source independent of
| | the insurance compliance audit.
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(g) As used in this Section:
(1) "Insurance compliance audit" means a voluntary,
| | internal evaluation, review, assessment, or audit not otherwise expressly required by law of a company or an activity regulated under this Code, or other State or federal law applicable to a company, or of management systems related to the company or activity, that is designed to identify and prevent noncompliance and to improve compliance with those statutes, rules, or orders. An insurance compliance audit may be conducted by the company, its employees, or by independent contractors.
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(2) "Insurance compliance self-evaluative audit
| | document" means documents prepared as a result of or in connection with and not prior to an insurance compliance audit. An insurance compliance self-evaluation audit document may include a written response to the findings of an insurance compliance audit. An insurance compliance self-evaluative audit document may include, but is not limited to, as applicable, field notes and records of observations, findings, opinions, suggestions, conclusions, drafts, memoranda, drawings, photographs, computer-generated or electronically recorded information, phone records, maps, charts, graphs, and surveys, provided this supporting information is collected or developed for the primary purpose and in the course of an insurance compliance audit. An insurance compliance self-evaluative audit document may also include any of the following:
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(A) an insurance compliance audit report prepared
| | by an auditor, who may be an employee of the company or an independent contractor, which may include the scope of the audit, the information gained in the audit, and conclusions and recommendations, with exhibits and appendices;
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(B) memoranda and documents analyzing portions or
| | all of the insurance compliance audit report and discussing potential implementation issues;
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(C) an implementation plan that addresses
| | correcting past noncompliance, improving current compliance, and preventing future noncompliance; or
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(D) analytic data generated in the course of
| | conducting the insurance compliance audit.
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(3) "Company" has the same meaning as provided in
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(h) Nothing in this Section shall limit, waive, or abrogate the scope or
nature of any statutory or common law privilege including, but not limited to,
the work product doctrine, the attorney-client privilege, or the subsequent
remedial measures exclusion.
(Source: P.A. 90-499, eff. 8-19-97; 90-655, eff. 7-30-98.)
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