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
AL (Alabama)
1/1/2017Yes 2 Citations
AK (Alaska)
1/1/2017Yes 2 Citations
AZ (Arizona)
1/1/2017Yes 2 Citations
AR (Arkansas)
1/1/2017Yes 2 Citations
CA (California)
1/1/2017 Yes3 Citations
CO (Colorado)
1/1/2017 Yes3 Citations
CT (Connecticut)
1/1/2017 Yes4 Citations
DE (Delaware)
1/1/2017Yes 2 Citations
DC (District of Columbia)

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

1/1/2017 YesNo Law
3 Citations
FL (Florida)
1/1/2017Yes 2 Citations
GA (Georgia)
1/1/2017Yes 2 Citations
HI (Hawaii)
1/1/2017Yes 2 Citations
ID (Idaho)
1/1/2017Yes 2 Citations
IL (Illinois)
1/1/2017 Yes3 Citations
IN (Indiana)
1/1/2017 Yes4 Citations
IA (Iowa)

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.

1/1/2017 Yes3 Citations
KS (Kansas)
1/1/2017Yes 4 Citations
KY (Kentucky)
1/1/2017Yes 3 Citations
LA (Louisiana)
1/1/2017Yes 3 Citations
ME (Maine)

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.

1/1/2017YesYes5 Citations
MD (Maryland)

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 Effective January 1, 2002, the statute permitting intoxication exclusions in individual health insurance policies was repealed and a regulation was promulgated prohibiting such exclusions.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.

1/1/2017 Yes5 Citations
MA (Massachusetts)
1/1/2017  
MI (Michigan)
1/1/2017  
MN (Minnesota)
1/1/2017  
MS (Mississippi)
1/1/2017Yes 2 Citations
MO (Missouri)
1/1/2017Yes 2 Citations
MT (Montana)
1/1/2017Yes 2 Citations
NE (Nebraska)
1/1/2017Yes 2 Citations
NV (Nevada)
1/1/2017 Yes8 Citations
NH (New Hampshire)
1/1/2017  
NJ (New Jersey)
1/1/2017Yes 4 Citations
NM (New Mexico)
1/1/2017  
NY (New York)
1/1/2017Yes 2 Citations
NC (North Carolina)

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.

1/1/2017 Yes3 Citations
ND (North Dakota)
1/1/2017 Yes4 Citations
OH (Ohio)
1/1/2017 Yes3 Citations
OK (Oklahoma)
1/1/2017  
OR (Oregon)
1/1/2017 Yes3 Citations
PA (Pennsylvania)
1/1/2017Yes 1 Citations
RI (Rhode Island)

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.

1/1/2017 Yes4 Citations
SC (South Carolina)
1/1/2017Yes 2 Citations
SD (South Dakota)
1/1/2017 Yes5 Citations
TN (Tennessee)
1/1/2017  No Law
1 Citations
TX (Texas)
1/1/2017  No Law
1 Citations
UT (Utah)
1/1/2017  
VT (Vermont)
1/1/2017  No Law
1 Citations
VA (Virginia)
1/1/2017Yes 2 Citations
WA (Washington)
1/1/2017 Yes6 Citations
WV (West Virginia)
1/1/2017Yes 2 Citations
WI (Wisconsin)
1/1/2017  
WY (Wyoming)
1/1/2017Yes 2 Citations
US ( United States)
1/1/2017