SB2453 94TH GENERAL ASSEMBLY

LRB094 17465 LJB 52760 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB2453

Introduced 1/18/2006, by Sen. John J. Cullerton

SYNOPSIS AS INTRODUCED:

215 ILCS 5/357.14	from Ch. 73, par. 969.14
215 ILCS 5/367k new
215 ILCS 5/357.25 rep.

Amends the Illinois Insurance Code. Prohibits health benefit plans from excluding coverage for treatment related to an injury acquired while an insured was intoxicated or under the influence of narcotics when the exclusion is based solely on the insured being intoxicated or under the influence of narcotics. Provides that coverage may be subject to additional terms of the health benefit plan. Repeals a provision allowing accident and health policies to contain an exclusion for losses caused by an insured being intoxicated or under the influence of narcotics.

A BILL FOR

AN ACT concerning insurance.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by changing Section 357.14 and by adding Section 367k as follows:

(215 ILCS 5/357.14) (from Ch. 73, par. 969.14)

Sec. 357.14. Except as provided in section 357.26, no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth in sections 357.15 through 357.24 357.25 unless such provisions are in the words in which the same appear in this article; provided, however, that the company may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the Director which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption appearing in the following sections or, at the option of the company, by such appropriate individual or group captions or subcaptions as the Director may approve.

(Source: Laws 1967, p. 1735.)

(215 ILCS 5/367k new)

Sec. 367k. Intoxication and narcotics; exclusion of coverage prohibited.

(a) A health benefit plan shall not, solely on the basis of the insured being intoxicated or under the influence of a narcotic, exclude coverage for any emergency or other medical, hospital, or surgical expenses incurred by an insured as a result of and related to an injury acquired while the insured is intoxicated or under the influence of any narcotic, regardless of whether the intoxicant or narcotic is administered on the advice of a health care practitioner.

(b) Coverage required under this Section may be subject to deductibles, copayments, coinsurance, or annual or maximum payment limits that are consistent with deductibles, copayments, coinsurance, or annual or maximum payments limits applicable to other similar coverage under the plan.

(215 ILCS 5/357.25 rep.)

Section 10. The Illinois Insurance Code is amended by repealing Section 357.25.