{"data":{"id":"us-ky/krs-304.12-013","jurisdiction":"us-ky","citation":"KRS 304.12-013","heading":"Prohibited unfair or deceptive practices in the writing of insurance.","body":"(1) The purpose of this section is to prohibit unfair or deceptive practices in the\ntransaction of life and health insurance with respect to the human\nimmunodeficiency virus infection and related matters. This section applies to all life\nand health insuran ce contracts which are delivered or issued for delivery in\nKentucky on or after July 13, 1990.\n(2) This section shall not prohibit an insurer from contesting the validity of an\ninsurance contract or whether a claim is covered under an insurance contract to  the\nextent allowed by law.\n(3) As used in this section:\n(a) \"Human immunodeficiency virus\" (HIV) means the causative agent of\nacquired immunodeficiency syndrome (AIDS) or any other type of\nimmunosuppression caused by the human immunodeficiency virus;\n(b) \"Insurance contract\" means a contract issued by an insurer as defined in this\nsection; and\n(c) \"Insurer\" means an insurer, a nonprofit hospital, medical -surgical, dental, and\nhealth service corporation, a health maintenance organization, or a prepaid\ndental plan organization.\n(4) (a) In the underwriting of an insurance contract regarding human\nimmunodeficiency virus infection and health conditions derived from such\ninfection, the insurer shall utilize medical tests which are reliable predictors of\nrisk. Only a test which is recommended by the Centers for Disease Control or\nby the Food and Drug Administration is deemed to be reliable for the purposes\nof this section. If a specific Centers for Disease Control or Food and Drug\nAdministration-recommended test in dicates the existence or possible\nexistence of human immunodeficiency virus infection or a health condition\nrelated to the human immunodeficiency virus infection, before relying on a\nsingle test to deny issuance of an insurance contract, limit coverage und er an\ninsurance contract, or to establish the premium for an insurance contract, the\ninsurer shall follow the applicable Centers for Disease Control or Food and\nDrug Administration -recommended test protocol and shall utilize any\napplicable Centers for Dise ase Control or Food and Drug Administration -\nrecommended follow-up tests or series of tests to confirm the indication.\n(b) Prior to testing, the insurer shall disclose in writing its intent to test the\napplicant for the human immunodeficiency virus infectio n or for a specific\nhealth condition derived therefrom and shall obtain the applicant's written\ninformed consent to administer the test. Written informed consent shall\ninclude a fair explanation of the test, including its purpose, potential uses and\nlimitations, the meaning of its results, and the right to confidential treatment\nof information. Use of a form prescribed by the department shall raise a\nconclusive presumption of informed consent.\n(c) An applicant shall be notified of a positive test result by a physician\ndesignated by the applicant, or, in the absence of such designation, by the\nCabinet for Health and Family Services. The notification shall include:\n1. Face-to-face post-test counseling on the meaning of the test results, the\npossible need for a dditional testing, and the need to eliminate behavior\nwhich might spread the disease to others;\n2. The availability in the geographic area of any appropriate health -care\nservices, including mental health care, and appropriate social and\nsupport services;\n3. The benefits of locating and counseling any person by whom the\ninfected person may have been exposed to human immunodeficiency\nvirus and any person whom the infected person may have exposed to the\nvirus; and\n4. The availability, if any, of the services of public health authorities with\nrespect to locating and counseling any person described in subparagraph\n3. of this paragraph.\n(d) A medical test for human immunodeficiency virus infection or for a health\ncondition derived from the infection shall only be  required or given to an\napplicant for an insurance contract on the basis of the applicant's health\ncondition or health history, on the basis of the amount of insurance applied\nfor, or if the test is required of all applicants.\n(e) An insurer may ask wheth er an applicant for an insurance contract has been\ntested positive for human immunodeficiency virus infection or other health\nconditions derived from such infection. Insurers shall not inquire whether the\napplicant has been tested for or has received a neg ative result from a specific\ntest for human immunodeficiency virus infection or for a health condition\nderived from such infection.\n(f) Insurers shall maintain strict confidentiality of the results of tests for human\nimmunodeficiency virus infection or a s pecific health condition derived from\nhuman immunodeficiency virus infection. Information regarding specific test\nresults shall be disclosed only as required by law or pursuant to a written\nrequest or authorization by the applicant. Insurers may disclose r esults\npursuant to a specific written request only to the following persons:\n1. The applicant;\n2. A licensed physician or other person designated by the applicant;\n3. An insurance medical -information exchange under procedures that are\nused to assure confid entiality, such as the use of general codes that also\ncover results of tests for other diseases or conditions not related to\nhuman immunodeficiency virus infection;\n4. For the preparation of statistical reports that do not disclose the identity\nof any particular applicant;\n5. Reinsurers, contractually retained medical personnel, and insurer\naffiliates if these entities are involved solely in the underwriting process\nand under procedures that are designed to assure confidentiality;\n6. To insurer personnel wh o have the responsibility to make underwriting\ndecisions; and\n7. To outside legal counsel who needs the information to represent the\ninsurer effectively in regard to matters concerning the applicant.\n(g) Insurers shall use for the processing of human immunodeficiency virus-related\ntests only those laboratories that are certified by the United States Department\nof Health and Human Services under the Clinical Laboratory Improvement\nAct of 1967, which permit testing of specimens in interstate commerce, and\nwhich subject themselves to ongoing proficiency testing by the College of\nAmerican Pathologists, the American Association of Bioanalysts, or an\nequivalent program approved by the Centers for Disease Control.\n(5) (a) An insurance contract shall not exclude cov erage for human\nimmunodeficiency virus infection. An insurance contract shall not contain\nbenefit provisions, terms, or conditions which apply to human\nimmunodeficiency virus infection in a different manner than those which\napply to any other health condit ion. Insurance contracts which violate this\nparagraph shall be disapproved by the commissioner pursuant to KRS 304.14 -\n130(1)(a), 304.32-160, and 304.38-050.\n(b) A health insurance contract shall not be canceled or nonrenewed solely\nbecause a person or pers ons covered by the contract has been diagnosed as\nhaving or has been treated for human immunodeficiency virus infection.\n(c) Sexual orientation shall not be used in the underwriting process or in the\ndetermination of which applicants shall be tested for ex posure to the human\nimmunodeficiency virus infection. Neither the marital status, the living\narrangements, the occupation, the gender, the beneficiary designation, nor the\nzip code or other territorial classification of an applicant's sexual orientation.\n(d) This subsection does not prohibit the issuance of accident only or specified\ndisease insurance contracts.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17010","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:41Z","sha256":"7baa054f2239b698e87134f6e16065082c625af9f3d30e127d41b17e7c73e202","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.12-010","next":"us-ky/krs-304.12-015"},"notice":"GroundRules: Original legal text. Not legal advice."}