610.001(1)
(1) To provide an orderly procedure by which insurers may be created, governed and dissolved;
610.001(2)
(2) To provide for procedures to merge, consolidate or convert various kinds of insurers;
610.001(3)
(3) To provide for structure and management that will maximize democratic participation in the operation of insurers; and
610.001(4)
(4) To prevent or control self-dealing by management in order to protect the interests of shareholders, policyholders, members, subscribers and the public.
610.01
610.01
Definitions. In
chs. 610 to
620 and
644, unless the context requires otherwise:
610.01(2)
(2) "Officer" does not include "director".
610.01(3)
(3) "Promoter stock" means shares issued by a domestic stock corporation under
ss. 611.18 (2) (a) 2. and
611.32 (1), and shares issued within 5 years after the initial issuance of the certificate of authority, to incorporators, directors, principal officers, members of the families of any of these persons, and to any corporations controlled by, or any trustee acting in behalf of, any of these persons.
610.01(4)
(4) In any provision of
ch. 180 or
181 made applicable by any section of
chs. 600 to
646, "department" shall be read "commissioner of insurance".
610.11
610.11
Qualified insurers. No person may do an insurance business as defined in
s. 618.02 (2) on the person's own account in this state, either in person, or through agents or brokers, or through the mail or any other method of communication, except:
610.11(1)
(1) An insurer authorized to do business in this state, within the limits of its certificate of authority; or
610.11 History
History: 1971 c. 260;
1991 a. 316.
610.21(1)(1)
Prohibition for domestic insurers. No domestic insurer may engage, directly or indirectly, in any business other than insurance and business reasonably incidental to its insurance business, except as specifically authorized by
s. 611.26 (4),
611.26 (4) as incorporated by
s. 614.24 (1), or
s. 613.26 or any other provision of
chs. 600 to
646;except that a domestic insurer not restricted under
s. 620.03 may engage directly in any activity to the extent it is authorized to do so through a subsidiary.
610.21(2)
(2) Prohibition for nondomestic insurers. No nondomestic insurer may engage in this state in any business forbidden to a domestic insurer, nor may the insurer engage in such business elsewhere if:
610.21(2)(a)
(a) The law of the insurer's domicile forbids an insurer to engage in such business; or
610.21(2)(b)
(b) The statutes of this state specifically prohibit a nondomestic insurer to engage in such business elsewhere; or
610.21(2)(c)
(c) The commissioner orders it to cease doing such business upon finding that doing such business is not consistent with the interests of its insureds, creditors or the public in this state; or that it gives the insurer a substantial competitive advantage in relation to domestic insurers.
610.21(3)
(3) Incidental business. "Incidental business" includes:
610.21(3)(a)
(a) The business of preparing and selling abstracts of title and related documents, if done by an insurer authorized to transact title insurance;
610.21(3)(b)
(b) Business that could be done through ancillary subsidiaries authorized under
s. 611.26 (3), or, in the case of a nondomestic insurer, through corporations that would be so authorized if the insurer were domestic.
610.21(4)
(4) Annuities. For purposes of this section, "insurance" includes "annuities".
610.23
610.23
Power to hold property in other than own name. An insurer shall hold all investments and deposits of its funds in its own name except that:
610.23(1)
(1) Custodial or trust arrangements. Securities kept under a custodial agreement or trust arrangement with a bank or banking and trust company may be issued in the name of a nominee of the bank or banking and trust company; and
610.23(2)
(2) Bearer securities. Any insurer may acquire and hold securities in bearer form.
610.23 History
History: 1975 c. 373.
610.23 Annotation
Legislative Council Note, 1975: This section continues s. 201.24 (4), made applicable to all insurers. The power certainly exists under ss. 180.04 (17) and 181.04 (16) as incorporated in ss. 611.07 (1), 612.03 and 614.07 (1), but this section places it beyond doubt for all insurers and permits the repeal of s. 201.24 (4). [Bill 643-S]
610.24
610.24
Insurers as fundholders. All assets shall be held, invested and disbursed for the use and benefit of the insurer and no policyholder, member or beneficiary may have or acquire individual rights in such assets or become entitled to any apportionment or the surrender of any part of such assets, except as provided in the contract. An insurer may create, maintain, invest, disburse and apply any special funds necessary to carry out any purpose permitted by the laws of this state and the articles and bylaws of the insurer.
610.24 History
History: 1979 c. 102.
610.40
610.40
Continued effect of transitional provisions. Sections
610.41 to
610.53, 1981 stats., continue to apply to insurers affected by those sections before April 27, 1984.
610.40 History
History: 1983 a. 215.
610.50
610.50
Vital records. An insurer or an employee, agent or attorney of an insurer is not subject to
s. 69.24 (1) (a) for copying a certified copy of a vital record for the insurer's own internal administrative use in connection with the payment of insurance claims or benefits if the copy is marked "FOR ADMINISTRATIVE USE" and is retained in the files of the insurer or attorney.
610.50 History
History: 1987 a. 247.
610.61
610.61
Duty of life insurers to report abandoned property. An insurer doing a life insurance business shall report under
s. 177.17 any property presumed abandoned under
s. 177.07.
610.61 History
History: 1979 c. 102;
1983 a. 408 s.
16.
610.65
610.65
Uniform claim processing form. Beginning no later than July 1, 2004, every insurer shall use the uniform claim processing form developed by the commissioner under
s. 601.41 (9) (b) when processing a claim submitted by a health care provider, as defined in
s. 146.81 (1).
610.65 History
History: 2001 a. 109.
610.70
610.70
Disclosure of personal medical information. 610.70(1)(a)
(a) "Health care provider" means any person licensed, registered, permitted or certified by the department of health and family services or the department of regulation and licensing to provide health care services, items or supplies in this state.
610.70(1)(b)
(b) "Individual" means a natural person who is a resident of this state. For purposes of this paragraph, a person is a state resident if his or her last-known mailing address, according to the records of an insurer or insurance support organization, was in this state.
610.70(1)(c)1.1. "Insurance support organization" means any person that regularly engages in assembling or collecting personal medical information about natural persons for the primary purpose of providing the personal medical information to insurers for insurance transactions, including the collection of personal medical information from insurers and other insurance support organizations for the purpose of detecting or preventing fraud, material misrepresentation or material nondisclosure in connection with insurance underwriting or insurance claim activity.
610.70(1)(c)2.
2. Notwithstanding
subd. 1., "insurance support organization" does not include insurance agents, government institutions, insurers or health care providers.
610.70(1)(d)
(d) "Insurance transaction" means any of the following involving insurance that is primarily for personal, family or household needs:
610.70(1)(d)1.
1. The determination of an individual's eligibility for an insurance coverage, benefit or payment.
610.70(1)(d)2.
2. The servicing of an insurance application, policy, contract or certificate.
610.70(1)(e)
(e) "Medical care institution" means a facility, as defined in
s. 647.01 (4), or any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health center, adult family home, assisted living facility, rural medical center, hospice or other place licensed, certified or approved by the department of health and family services under
s. 49.70,
49.71,
49.72,
50.02,
50.03,
50.032,
50.033,
50.034,
50.35,
50.52,
50.90,
51.04,
51.08 or
51.09 or a facility under
s. 45.365,
51.05,
51.06 or
252.10 or under
ch. 233 or licensed or certified by a county department under
s. 50.032 or
50.033.
610.70(1)(f)1.1. "Personal medical information" means information concerning an individual that satisfies all of the following:
610.70(1)(f)1.a.
a. Relates to the individual's physical or mental health, medical history or medical treatment.
610.70(1)(f)1.b.
b. Is obtained from a health care provider, a medical care institution, the individual or the individual's spouse, parent or legal guardian.
610.70(1)(f)2.
2. "Personal medical information" does not include information that is obtained from the public records of a governmental authority and that is maintained by an insurer or its representatives for the purpose of insuring title to real property located in this state.
610.70(2)(a)(a) Any form that is used in connection with an insurance transaction and that authorizes the disclosure of personal medical information about an individual to an insurer shall comply with all of the following:
610.70(2)(a)1.
1. All instructions and other information contained in the form are presented in plain language.
610.70(2)(a)3.
3. The form specifies the types of persons that are authorized to disclose information about the individual.
610.70(2)(a)4.
4. The form specifies the nature of the information that is authorized to be disclosed.
610.70(2)(a)5.
5. The form names the insurer, and identifies by generic reference representatives of the insurer, to whom the information is authorized to be disclosed.
610.70(2)(a)6.
6. The form specifies the purposes for which the information is being obtained.
610.70(2)(a)7.
7. Subject to
par. (b), the form specifies the length of time for which the authorization remains valid.
610.70(2)(a)8.
8. The form advises that the individual, or an authorized representative of the individual, is entitled to receive a copy of the completed authorization form.
610.70(2)(b)1.1. For an authorization under this subsection that will be used for the purpose of obtaining information in connection with an insurance policy application, an insurance policy reinstatement or a request for a change in policy benefits, the length of time specified in
par. (a) 7. may not exceed 30 months from the date on which the authorization is signed.
610.70(2)(b)2.
2. For an authorization under this subsection that will be used for the purpose of obtaining information in connection with a claim for benefits under an insurance policy, the length of time specified in
par. (a) 7. may not exceed the policy term or the pendency of a claim for benefits under the policy, whichever is longer.
610.70(3)
(3) Access to recorded personal medical information. 610.70(3)(a)(a) If, after proper identification, an individual or an authorized representative of an individual submits a written request to an insurer for access to recorded personal medical information that concerns the individual and that is in the insurer's possession, within 30 business days after receiving the request the insurer shall do all of the following:
610.70(3)(a)1.
1. Inform the individual or authorized representative of the nature and substance of the recorded personal medical information in writing, by telephone or by any other means of communication at the discretion of the insurer.
610.70(3)(a)2.
2. At the option of the individual or authorized representative, permit the individual or authorized representative to inspect and copy the recorded personal medical information, in person and during the insurer's normal business hours, or provide by mail to the individual or authorized representative a copy of the recorded personal medical information. If the recorded personal medical information is in coded form, the insurer shall provide to the individual or authorized representative an accurate written translation in plain language.
610.70(3)(a)3.
3. Disclose to the individual or authorized representative the identities, if recorded, of any persons to whom the insurer has disclosed the recorded personal medical information within 2 years prior to the request. If the identities are not recorded, the insurer shall disclose to the individual or authorized representative the names of any insurance agents, insurance support organizations or other entities to whom such information is normally disclosed.
610.70(3)(a)4.
4. Provide to the individual or authorized representative a summary of the procedures by which the individual or authorized representative may request the correction, amendment or deletion of any recorded personal medical information in the possession of the insurer.
610.70(3)(b)
(b) Notwithstanding
par. (a), an insurer may, in the insurer's discretion, provide a copy of any recorded personal medical information requested by an individual or authorized representative under
par. (a) to a health care provider who is designated by the individual or authorized representative and who is licensed, registered, permitted or certified to provide health care services with respect to the condition to which the information relates. If the insurer chooses to provide the information to the designated health care provider under this paragraph, the insurer shall notify the individual or authorized representative, at the time of disclosure, that the information has been provided to the health care provider.
610.70(3)(c)
(c) An insurer is required to comply with
par. (a) or
(b) only if the individual or authorized representative provides a reasonable description of the information that is the subject of the request and if the information is reasonably easy to locate and retrieve by the insurer.
610.70(3)(d)
(d) If an insurer receives personal medical information from a health care provider or a medical care institution with instructions restricting disclosure of the information under
s. 51.30 (4) (d) 1. to the individual to whom the information relates, the insurer may not disclose the personal medical information to the individual under this subsection, but shall disclose to the individual the identity of the health care provider or a medical care institution that provided the information.
610.70(3)(e)
(e) Any copy of recorded personal medical information provided under
par. (a) or
(b) shall include the identity of the source of the information if the source is a health care provider or a medical care institution.
610.70(3)(f)
(f) An insurer may charge the individual a reasonable fee to cover the costs incurred in providing a copy of recorded personal medical information under
par. (a) or
(b).
610.70(3)(g)
(g) The requirements for an insurer under this subsection may be satisfied by another insurer, an insurance agent, an insurance support organization or any other entity authorized by the insurer to act on its behalf.
610.70(3)(h)
(h) The requirements under this subsection do not apply to information concerning an individual that relates to, and that is collected in connection with or in reasonable anticipation of, a claim or civil or criminal proceeding involving the individual.
610.70(4)
(4) Correction, amendment or deletion of recorded personal medical information. 610.70(4)(a)(a) Within 30 business days after receiving a written request from an individual to correct, amend or delete any recorded personal medical information that is in the insurer's possession, an insurer shall do either of the following:
