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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Changes Over Time for Health Insurance: Losses due to Intoxication (“UPPL”)
Jurisdiction Date Range Denial of Health
Insurance Benefits
Specifically PERMITTED
Denial of Health
Insurance Benefits
Specifically PROHIBITED
Citations
California (1793)
1/1/2009 - 1/1/2021 Yes3 Citations
California (1835)
1/1/1998 - 12/31/2008Yes 1 Citations
Colorado (1818)
1/1/2007 - 1/1/2021 Yes3 Citations
Colorado (1836)
1/1/1998 - 12/31/2006  
Connecticut (1817)
10/1/2006 - 1/1/2021 Yes4 Citations
Connecticut (1837)
1/1/1998 - 9/30/2006  
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.

3/8/2007 - 1/1/2021 Yes3 Citations
District of Columbia (1838)

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

1/1/1998 - 3/7/2007Yes 1 Citations
Illinois (1796)
1/1/2008 - 1/1/2021 Yes3 Citations
Illinois (1845)
1/1/1998 - 12/31/2007Yes 1 Citations
Indiana (1813)
1/1/2008 - 1/1/2021 Yes4 Citations
Indiana (1846)
1/1/1998 - 12/31/2007Yes 2 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.

7/1/2002 - 1/1/2021 Yes3 Citations
Iowa (1843)
1/1/1998 - 6/30/2002Yes 1 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.

9/20/2007 - 1/1/2021YesYes5 Citations
Maine (1852)
1/1/1998 - 9/19/2007Yes 3 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.

1/1/2002 - 1/1/2021 Yes5 Citations
Maryland (1827)

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.

10/30/2000 - 12/31/2001YesYes4 Citations
Maryland (1851)
1/1/1998 - 10/29/2000Yes 2 Citations
Montana (5120)
2/28/2019 - 1/1/2021  No Law
1 Citations
Montana (1782)
1/1/1998 - 2/27/2019Yes 
Nevada (1783)
7/1/2006 - 1/1/2021 Yes8 Citations
Nevada (1864)
1/1/1998 - 6/30/2006Yes 2 Citations
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.

5/6/2019 - 1/1/2021YesYes3 Citations
New Jersey (1790)
1/1/1998 - 5/5/2019Yes 3 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.

10/1/2001 - 1/1/2021 Yes3 Citations
North Carolina (1858)
1/1/1998 - 9/30/2001Yes 1 Citations
North Dakota (1802)
8/1/2009 - 1/1/2021 Yes4 Citations
North Dakota (1859)
1/1/1998 - 7/31/2009Yes 1 Citations
Ohio (1800)
4/7/2009 - 1/1/2021 Yes3 Citations
Ohio (1866)
1/1/1998 - 4/6/2009Yes 1 Citations
Oregon (1829)
1/1/2018 - 1/1/2021  No Law
1 Citations
Oregon (1801)
1/1/2008 - 12/31/2017 Yes2 Citations
Oregon (1868)

Section designations in the Oregon Code were renumbered by the Oregon Legislative Counsel for the 2007 printed edition of the statutes, which was delivered in December 2007. Or. Rev. Stat. § 743.480 was renumbered to Or. Rev. Stat. § 743A.164 as part of this effort.

1/1/1998 - 12/31/2007Yes 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.

6/16/2005 - 1/1/2021 Yes4 Citations
Rhode Island (1870)
1/1/1998 - 6/15/2005Yes 1 Citations
Tennessee (1815)
7/1/2015 - 1/1/2021  No Law
1 Citations
Tennessee (1873)
1/1/1998 - 6/30/2015Yes 2 Citations
Texas (1791)
1/1/2014 - 1/1/2021  No Law
1 Citations
Texas (1874)
1/1/1998 - 12/31/2013Yes 
Vermont (1807)
6/5/2002 - 1/1/2021  No Law
1 Citations
Vermont (1877)
1/1/1998 - 6/4/2002Yes 1 Citations
Washington (1780)
6/10/2004 - 1/1/2021 Yes6 Citations
Washington (1878)
1/1/1998 - 6/9/2004Yes 1 Citations