Skip to main content
Find a Lawyer

Massachusetts General Laws Part I. Administration of the Government (Ch. 1-182) Ch. 175I, § 10

Current as of January 01, 2025 | Updated by Findlaw Staff

(a) In the event of an adverse underwriting decision, the insurance institution or insurance representative responsible for the decision shall:

(1) either provide the applicant, policyholder or individual proposed for coverage with the specific reason for the adverse underwriting decision in writing or advise such person that upon written request such person may receive the specific reason in writing; and

(2) provide the applicant, policyholder or individual proposed for coverage with a summary of the rights established under subsection (b) and sections eight and nine.

(b) Upon receipt of a written request within ninety business days from the date of the mailing of notice or other communication of an adverse underwriting decision to an applicant, policyholder or individual proposed for coverage, the insurance institution or insurance representative shall furnish to such person within twenty-one business days from the date of receipt of such written request:

(1) the specific reason for the adverse underwriting decision, in writing, if such information was not initially furnished in writing pursuant to paragraph (1) of subsection (a); and

(2) the specific items of personal and privileged information that support such reason; provided, however, that:

(i) the insurance institution or insurance representative shall not be required to furnish specific items of privileged information if it has a reasonable suspicion, based upon specific information available for review by the commissioner, that the applicant, policyholder or individual proposed for coverage has engaged in criminal activity, fraud, or material misrepresentation; and

(ii) specific items of medical record information supplied by a medical care institution or medical professional shall be disclosed either directly to the individual about whom the information relates or to a medical professional designated by such individual and licensed to provide medical care with respect to the condition to which the information relates, whichever such individual prefers. Mental health record information shall be supplied directly to such individual, pursuant to this subsection, only with the approval of the qualified professional person with treatment responsibility for the condition to which the information relates or of another equally qualified mental health professional. Upon release of any medical or mental health record information to a medical professional designated by such individual, the insurance institution, insurance representative or insurance-support organization shall notify such individual, at the time of the disclosure, that it has provided the information to the medical professional; and

(3) the name and address of the source that supplied the specific items of information pursuant to paragraph (2) of subsection (b); except that a source that is a natural person acting in a personal capacity need not be revealed if confidentiality was specifically promised; provided, however, that the identity of any medical professional or medical-care institution shall be disclosed either directly to the individual or to the designated medical professional other than the one who initially supplied the information, whichever such individual prefers.

(c) The obligations imposed by this section upon an insurance institution or insurance representative may be satisfied by another insurance institution or insurance representative authorized to act on its behalf.

(d) When an adverse underwriting decision results solely from an oral request or inquiry, the explanation of reasons and summary of rights required by subsection (a) may be given orally.

Previous Part of Code Next Part of Code
Back to Chapter List

Cite this article: FindLaw.com - Massachusetts General Laws Part I. Administration of the Government (Ch. 1-182) Ch. 175I, § 10 - last updated January 01, 2025 | https://codes.findlaw.com/ma/part-i-administration-of-the-government-ch-1-182/ma-gen-laws-ch-175i-sect-10/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

Was this helpful?

Welcome to FindLaw's Cases & Codes

A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.

Go to Learn About the Law

Latest Blog Posts

For Legal Professionals

Learn About The Law

Get help with your legal needs

FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.

Go to Learn About the Law

Need to Find an Attorney?

Search our directory by legal issue

Enter information in one or both fields (Required)

Copied to clipboard