Or. Admin. Code § 836-050-0245 - Medical and Lifestyle Application Questions and Underwriting Standards

(1) No question shall be used that is designed to establish the sexual orientation of the applicant.

(2) The following provisions govern medical questions relating to HIV infection:

(a) Questions relating to the applicant's having or having been diagnosed as having HIV infection, including AIDS or ARC, are permissible if the questions are factual and designed to establish the existence of the condition. For example, insurer shall not ask such questions as "do you believe you may have...?", or "have you had any indications of...?", but insurers may ask "have you been diagnosed or treated for...?";

(b) Questions relating to HIV infection, including AIDS and ARC, may be asked, but only if questions related to other high risk medical conditions are also asked. The questions must be presented and asked, and the answers used, in the same manner as other questions and their answers relating to other high risk medical conditions. Additional questions may be asked in a supplement but the supplement must be used in conjunction with medical questions on the application form.

(3) Questions relating to medical and other factual matters that are intended to reveal the possible existence of a medical condition are permissible if they are not used to establish the sexual orientation of the applicant and if the applicant is given opportunity to provide a detailed explanation for any affirmative answers given in the application. For example, insurers may ask such questions as, "Have you had chronic cough, significant weight loss, chronic fatigue, diarrhea, enlarged glands,...?" Such questions must pertain to a finite period of time preceding completion of the application, not to exceed ten years. The finite period does not apply to questions concerning prior diagnosis, treatment or testing.

(4) Questions relating to the applicant's having, or having been diagnosed as having, or having been advised to seek treatment for, a sexually transmitted disease are permissible.

(5) Neither the marital status, the "living arrangements", the occupation, the gender, the medical history, the beneficiary designation nor the zip code or other territorial classification of an applicant may be used to establish, or aid in establishing, the applicant's sexual orientation.

(6) For purposes of rating an applicant for health and life insurance, an insurer may impose territorial rates, but only if the rates are based on sound actuarial principles and are related to actual or reasonably anticipated experience.

(7) No adverse underwriting decision shall be based on information that the applicant has demonstrated AIDS, ARC or other HIV infection-related concerns by seeking counseling from health care professionals. This section does not apply to an applicant seeking treatment or diagnosis.

Notes

Or. Admin. Code § 836-050-0245

ID 6-1987(Temp), f. & cert. ef. 11-9-88; ID 10-1988, f. & cert. ef. 6-10-88

Stat. Auth.: ORS 433, ORS 731, ORS 743 & ORS 746

Stats. Implemented: ORS 433.045(7), ORS 742.005 & ORS 746.240