Health Care Services and Financing

Health Insurance: Losses due to Intoxication (“UPPL”)

Laws that prohibit exclusion of insurance claims arising from intoxication of the insured.

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Jurisdiction Policies as of Denial of Health
Insurance Benefits
Specifically PERMITTED
Denial of Health
Insurance Benefits
Specifically PROHIBITED
Citations
Alabama (1777)
1/1/2020Yes 2 Citations
Alaska (1778)
1/1/2020Yes 2 Citations
Arizona (1788)
1/1/2020Yes 2 Citations
Arkansas (1811)
1/1/2020Yes 2 Citations
California (1793)
1/1/2020 Yes3 Citations
Colorado (1818)
1/1/2020 Yes3 Citations
Connecticut (1817)
1/1/2020 Yes4 Citations
Delaware (1787)
1/1/2020Yes 2 Citations
District of Columbia (1828)

Section designations in the District of Columbia Code were renumbered in connection with the publication of the D.C. Official Code, 2001 Edition.

1/1/2020 Yes3 Citations
Florida (1795)
1/1/2020Yes 2 Citations
Georgia (1789)
1/1/2020Yes 2 Citations
Hawaii (1794)
1/1/2020Yes 2 Citations
Idaho (1779)
1/1/2020Yes 2 Citations
Illinois (1796)
1/1/2020 Yes3 Citations
Indiana (1813)
1/1/2020 Yes4 Citations
Iowa (1814)

The prohibition in Section 514A.3 prohibits intoxication exclusions in a "medical expense policy," which is defined as an "accident and sickness insurance policy that provides hospital, medical, and surgical expense coverage." Intoxication exclusions are not expressly prohibited in other types of "accident and sickness insurance policies," such as an accident insurance policy that provides for fixed sum payments or wage replacement.

1/1/2020 Yes3 Citations
Kansas (1797)
1/1/2020Yes 4 Citations
Kentucky (1786)
1/1/2020Yes 3 Citations
Louisiana (1781)
1/1/2020Yes 3 Citations
Maine (1784)

Pursuant to Me. Rev. Stat. Ann. tit. 24-A, §§ 2701, 2728, intoxication exclusions are prohibited in “health insurance contracts” with the exception that they are permitted in “group or blanket” policies.

1/1/2020YesYes5 Citations
Maryland (1826)

Between October 30, 2000, and December 31, 2001, intoxication exclusions were permitted by statute in individual health insurance policies but were prohibited by regulation in group health insurance policies, individual and group health maintenance contracts, and individual nonprofit health service plans. Effective January 1, 2002, the statute permitting intoxication exclusions in individual health insurance policies was repealed and a regulation was promulgated prohibiting such exclusions. The regulations prohibiting exclusions in group health insurance policies, individual and group health maintenance contracts, and individual nonprofit health service plans remained in effect.

1/1/2020 Yes5 Citations
Massachusetts (1816)
1/1/2020  
Michigan (1819)
1/1/2020  
Minnesota (1820)
1/1/2020  
Mississippi (1799)
1/1/2020Yes 2 Citations
Missouri (1798)
1/1/2020Yes 2 Citations
Montana (5120)
1/1/2020  No Law
1 Citations
Nebraska (1810)
1/1/2020Yes 2 Citations
Nevada (1783)
1/1/2020 Yes8 Citations
New Hampshire (1821)
1/1/2020  
New Jersey (5135)

A blanket insurance policy or certificate or other group policy or certificate providing health insurance may include an exclusion for losses resulting from the covered person's use of alcohol; however, as of May 6, 2019, this does not apply to a "group health benefits plan." 2019, N.J. Admin. Code tit. 11, § 4-42.11.

1/1/2020YesYes3 Citations
New Mexico (1822)
1/1/2020  
New York (1785)
1/1/2020Yes 2 Citations
North Carolina (1803)

The prohibition in N.C. Gen. Stat. s. 58-51-16 prohibits intoxication exclusions in a "medical expense policy," which means an "accident and health insurance policy that provides hospital, medical, and surgical expense coverage." Intoxication exclusions are not expressly prohibited in other types of "accident and health insurance policies," such as an accident insurance policy that provides for fixed sum payments or wage replacement.

1/1/2020 Yes3 Citations
North Dakota (1802)
1/1/2020 Yes4 Citations
Ohio (1800)
1/1/2020 Yes3 Citations
Oklahoma (1823)
1/1/2020  
Oregon (1829)
1/1/2020  No Law
1 Citations
Pennsylvania (1792)
1/1/2020Yes 1 Citations
Rhode Island (1805)

In 2005, Rhode Island amended its UPPL law through two enacted bills, each having a different effective date. 2005 R.I. Pub. Laws 48 became effective on June 16, 2005, and 2005 R.I. Pub. Laws 58 became effective on June 23, 2005.

1/1/2020 Yes4 Citations
South Carolina (1806)
1/1/2020Yes 2 Citations
South Dakota (1804)
1/1/2020 Yes5 Citations
Tennessee (1815)
1/1/2020  No Law
1 Citations
Texas (1791)
1/1/2020  No Law
1 Citations
Utah (1812)
1/1/2020  
Vermont (1807)
1/1/2020  No Law
1 Citations
Virginia (1808)
1/1/2020Yes 2 Citations
Washington (1780)
1/1/2020 Yes6 Citations
West Virginia (1809)
1/1/2020Yes 2 Citations
Wisconsin (1824)
1/1/2020  
Wyoming (1881)
1/1/2020Yes 2 Citations
United States (1825)
1/1/2020