Title 31, Insurance and Securities.

(a) Within 90 days of September 19, 2013, a company authorized to sell or negotiate homeowner’s or renter’s insurance in the District of Columbia shall provide a written notice that states that a standard homeowner’s or renter’s insurance policy does not cover losses from sewer-l…

Discrimination between individual risks of the same class or hazard in the amount of premiums or rates charged for any policy, or in the benefits or amount of insurance payable thereon, or in any of the terms or conditions of such policy, or in any other manner whatsoever, is pro…

No company, policy-writing agent, soliciting agent, broker, or salaried employee shall pay any money or commission or brokerage or give or allow any valuable consideration to any person for or because of service in the District in negotiating or effecting a policy on any person, …

The provisions of this chapter relating to the licensing of policy-writing agents, soliciting agents, salaried company employees, and brokers shall not apply to the sale of personal accident insurance in the ticket offices of railroad companies or other common carriers, or in the…

Except as provided in § 31-2502.40, no person shall act as agent in the District for any company which is not authorized to do business in the District, nor shall any person directly or indirectly negotiate for or solicit applications for policies of, or for membership in, any co…

(a) Any person may be licensed as a surplus lines insurance producer under Chapter 11A of this title to procure policies from companies which are not authorized to do business in the District where such person is, after diligent effort, unable to procure policies to cover the kin…

(a) Annual fees to be paid through the Commissioner to the District of Columbia for licenses issued under this chapter shall include a $250 annual renewal fee for registration and certification for Risk Retention and Purchasing Groups and any other fee established pursuant to sub…

(a) Any person who violates any of the provisions of this chapter, or fails to comply with any duty imposed upon such person by any of the provisions of this chapter, for which violation or failure no penalty is elsewhere provided by this chapter, or by the laws of the District, …

No insurance shall be made by any person or persons, bodies politic or corporate, on any ship or ships, or on any goods, merchandise, or effects laden or to be laden on board of any ship or ships, interest or no interest, or without further proof of interest than the policy, or b…

In this chapter, unless the context otherwise requires: (1) “District” means the District of Columbia. (2) “Commissioner” means the Commissioner of the Department of Insurance, Securities, and Banking. (3) “Insurance” includes (but is not limited to) fidelity, surety, and guarant…

This chapter shall apply to all forms of fire, casualty, motor vehicle, explosion, sprinkler leakage, and inland marine insurance in the District and to all forms of insurance within the scope of Chapter 25 of this title; provided, that this chapter shall not apply to reinsurance…

(a) Rates for insurance within the scope of this chapter shall not be excessive, inadequate, or unfairly discriminatory. (b) Due consideration shall be given to past and prospective loss experience within and outside the District, to physical hazards, to safety and loss preventio…

(a) A medical malpractice insurer or a medical professional liability insurer shall not take an adverse action, including refusing to issue or renew a medical malpractice or medical professional liability policy, charging a higher rate for a medical malpractice or medical profess…

(a) On and after July 1, 1948, every company shall file with the Commissioner, either directly or through a licensed rating organization of which it is a member or subscriber, except as to rates on inland marine risks which are not made by a rating organization and which by gener…

(a) Subject to the provisions of this chapter, 2 or more companies may cooperate or act in concert with each other: (1) As a rating organization, for the purpose of making rates, rating plans, or rating systems. No company shall be deemed to be a rating organization; (2) As an ad…

(a) Every rating organization and every company which makes its own rates shall, within a reasonable time after receiving written request therefor and upon payment of such reasonable charge as it may make, furnish to any insured affected by a rate made by it, or to the authorized…

(a) In addition to any powers hereinbefore expressly enumerated in this chapter, the Commissioner shall have full power and authority, and it shall be his duty, to enforce by regulations made and promulgated by the Council of the District of Columbia, by orders, or otherwise all …

Any company, broker, or agent guilty of violating any of the provisions of this chapter or any order, rule, or regulation issued pursuant to this chapter shall be subject to the provisions of §§ 31-2502.03 and 31-2502.36 [repealed], respectively.

Any person, firm or corporation aggrieved by any order, ruling, proceeding, or action of the Commissioner may contest the validity of such order, ruling, proceeding, or action in any court of competent jurisdiction by appeal or through any other appropriate proceedings, as provid…

(a) An insurer shall not be required to file with, or to receive approval from, the Commissioner, for rates and policy forms used in the insurance of exempt commercial risks. (b) The filing and review exemption set forth in subsection (a) of this section shall not apply to worker…

For the purposes of this chapter, the term: (1) “Ancillary services” means standard medical procedures that are reasonably necessary for the diagnosis and treatment of a patient. (2) “Emergency services” means: (A) Health care services furnished in the emergency department of a h…

(a)(1) All health insurers, hospitals or medical services corporations, and health maintenance organizations shall reimburse for emergency services that are due to a medical emergency. (2) Reimbursement for pre-hospital medical care and transport delivered pursuant to paragraph (…

(a) For the purposes of this section, the term. (1) “Health benefit plan,” “health insurer,” and “insured” shall have the same meanings as provided in § 31-3001. (2) “HIV screening test” shall mean the testing for the human immunodeficiency virus or any other identified causative…

For the purposes of this subchapter, the term: (1) “Baseline mammogram” means a screening mammogram that is used as a comparison for future examinations. (2) “Screening mammogram” means a low dose x-ray used to visualize the internal structure of the breast. (3) “Cytologic screen…

(a) Any individual or group health benefit plan, including Medicaid, shall provide health insurance benefits to cover: (1) A baseline mammogram for women, including a 3-D mammogram; (2) An annual screening mammogram for women, including a 3-D mammogram; and (3) Adjuvant breast ca…

The requirements of this subchapter shall apply: (1) To any health benefit plan delivered or issued for delivery in the District more than 120 days after March 7, 1991; and (2) To any health benefit plan renewed, amended, or reissued 120 days after March 7, 1991.

(a) Every individual and group health insurance policy or service, including Medicaid, shall provide coverage for colorectal cancer screening for policyholders residing in the District of Columbia. (b) The screening shall be in compliance with American Cancer Society colorectal c…

For the purposes of this subchapter, the term: (1) “Commissioner” means the Commissioner of the Department of Insurance and Securities Regulation. (2) “Health benefits plan” means any accident and health insurance policy or certificate, hospital and medical services corporation c…

(a) Each individual and group health benefits plan issued or renewed in the District of Columbia shall provide coverage for prostate cancer screening in accordance with the latest screening guidelines issued by the National Comprehensive Cancer Network, to include no less than on…

This subchapter shall apply to all individual and group health benefits plans issued or renewed on or after 120 days after March 25, 2003.

The Commissioner may issue rules and regulations necessary to implement the provisions of this subchapter.

(a) Within 180 days of march 14, 2007, the Mayor shall submit legislation to the Council for the establishment of a database of closed obstetrician/gynecologist malpractice claims reports to be submitted by providers of medical malpractice insurance. (b) The legislation shall inc…

For the purposes of this chapter, the term: (1) “Approved clinical trial” means: (A) A clinical research study or clinical investigation approved or funded in full or in part by one or more of the following: (i) The National Institutes of Health; (ii) The Centers for Disease Cont…

(a) A health insurer shall not limit or deny coverage, or impose additional conditions on the payment for the coverage, of routine patient care costs of items, drugs, and services furnished to a qualified individual in connection with participation in an approved clinical trial. …

This chapter shall not limit, prohibit, or modify a qualified individual’s right to: (1) File a grievance and use an independent review process, if available; or (2) Use the independent medical review system.

For the purposes of this chapter, the term: (1) “Group health plan” means an employee welfare plan (as defined in section 3(1) of the Employee Retirement Income Security Act of 1974, approved September 2, 1974 (88 Stat. 829; 29 U.S.C. § 1002(1)), to the extent that the plan provi…

(a) An individual health plan or group health plan, and a health insurer offering health insurance coverage that provides coverage for prescription drugs, shall provide health insurance coverage for prescribed, orally administered anticancer medication used to kill or slow the gr…

This chapter shall apply to group health plans for years beginning on or after December 17, 2009.

For the purposes of this chapter, the term: (1) “Dependent child” means an insured’s child by blood or by law who: (A) Is under 26 years of age; (B) Has no dependent of his own; (C) Is enrolled as a full-time student at an accredited public or private institution of higher educat…

(a) A group health plan or an individual health plan, and a health insurer offering health insurance coverage that provides coverage for dependent children, that delivers, issues for delivery, amends, or renews a health insurance policy in the District of Columbia shall make heal…

This chapter shall not limit or alter any right to dependent coverage or to the continuation of coverage that is otherwise provided for in the District of Columbia.

For the purposes of this chapter, the term: (1) “Health benefit plan” means an accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfar…

A health benefit plan shall provide coverage for the equipment, supplies, and other outpatient self-management training and education, including medical nutritional therapy, for the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes, and non-ins…

No health insurer shall: (1) Require an insured to pay a higher deductible, copayment, or coinsurance; require a longer waiting period; or impose any other condition for coverage of any of the benefits set forth in this chapter other than is required for other benefits covered by…

(a) The requirements of this chapter shall apply to all health benefit plans issued, delivered, renewed, or reissued on the 91st day after October 21, 2000. (b) All health benefit plans other than the health benefit plans specified in subsection (a) of this section shall comply w…

(a) If an insurer decides to discontinue a particular class of group, or blanket policy of, hospital, surgical, or medical expense insurance offered in the small or large group market, the policy of the class may be discontinued by the insurer only if: (1) The insurer requests in…