Terms Used In Montana Code > Title 33 > Chapter 19 > Part 1 - General Provisions

• Adverse underwriting decision: means any of the following actions with respect to insurance transactions involving insurance coverage that are individually underwritten:

  (i)a declination of insurance coverage;

  (ii)a termination of insurance coverage;

  (iii)failure of an insurance producer to apply for insurance coverage with a specific insurance institution that the insurance producer represents and that is requested by an applicant;

  (iv)in the case of a property or casualty insurance coverage:

  (A)placement by an insurance institution or insurance producer of a risk with a residual market mechanism, an unauthorized insurer, or an insurance institution that specializes in substandard risks; or

  (B)the charging of a higher rate on the basis of information that differs from that which the applicant or policyholder furnished;

  (v)in the case of a life, health, or disability insurance coverage, an offer to insure at higher than standard rates. See Montana Code 33-19-104

• Applicant: means a person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten. See Montana Code 33-19-104
• Consumer report: means any written, oral, or other communication of information bearing on a natural person's credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living that is used or expected to be used in connection with an insurance transaction. See Montana Code 33-19-104
• Contract: A legal written agreement that becomes binding when signed.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Declination of insurance coverage: means a denial, in whole or in part, by an insurance institution or insurance producer of requested insurance coverage. See Montana Code 33-19-104
• Fraud: Intentional deception resulting in injury to another.
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Individual: means a natural person who:

  (a)regarding property or casualty insurance, is a past, present, or proposed named insured or certificate holder;

  (b)regarding life, health, or disability insurance, is a past, present, or proposed principal insured or certificate holder;

  (c)is a past, present, or proposed policyowner;

  (d)is a past or present applicant;

  (e)is a past or present claimant; or

  (f)derived, derives, or is proposed to derive insurance coverage under an insurance policy or certificate subject to this chapter. See Montana Code 33-19-104

• Insurance institution: means a corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society, or other person engaged in the business of insurance, including health maintenance organizations, and health service corporations as defined in 33-30-101. See Montana Code 33-19-104
• Insurance producer: means an insurance producer as defined in 33-17-102 and 33-30-311. See Montana Code 33-19-104
• Insurance transaction: means a transaction involving insurance primarily for personal, family, or household needs, rather than for business or professional needs, that entails:

  (a)the determination of an individual's eligibility for an insurance coverage, benefit, or payment; or

  (b)the servicing of an insurance application, policy, contract, or certificate. See Montana Code 33-19-104

• Insurance-support organization: means a person who assembles or collects information about natural persons for the purpose of providing the information to an insurance institution or insurance producer for insurance transactions, including:

  (i)the furnishing of consumer reports or investigative consumer reports to an insurance institution or insurance producer for use in connection with an insurance transaction; or

  (ii)the collection of personal information from insurance institutions, insurance producers, or other insurance-support organizations for the purpose of detecting or preventing fraud, material misrepresentation, or material nondisclosure in connection with insurance underwriting or insurance claim activity. See Montana Code 33-19-104

• Licensee: means :

  (a)an insurance institution, insurance producer, or other person who is licensed or required to be licensed, authorized or required to be authorized, or registered or required to be registered pursuant to this title; or

  (b)a surplus lines insurer. See Montana Code 33-19-104

• Medical care institution: means a facility or institution that is licensed to provide health care services to natural persons, including but not limited to health maintenance organizations, home health agencies, hospitals, medical clinics, public health agencies, rehabilitation agencies, and skilled nursing facilities. See Montana Code 33-19-104
• Medical professional: means a person who is licensed or certified to provide health care services to natural persons, including but not limited to a chiropractor, clinical dietitian, clinical psychologist, dentist, nurse, occupational therapist, optometrist, pharmacist, physical therapist, physician, podiatrist, psychiatric social worker, or speech-language pathologist. See Montana Code 33-19-104
• Medical record information: means personal information that:

  (a)relates to an individual's physical or mental condition, medical history, medical claims history, or medical treatment; and

  (b)is obtained from a medical professional or medical care institution, from the individual, or from the individual's spouse, parent, or legal guardian. See Montana Code 33-19-104

• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: means a natural person, corporation, association, partnership, or other legal entity. See Montana Code 33-19-104
• Personal information: means any individually identifiable information gathered in connection with an insurance transaction from which judgments can be made about an individual's character, habits, avocations, finances, occupation, general reputation, credit, health, or any other personal characteristics. See Montana Code 33-19-104
• Policyholder: means a person who:

  (a)in the case of individual property or casualty insurance, is a present named insured;

  (b)in the case of individual life, health, or disability insurance, is a present policyowner; or

  (c)in the case of group insurance that is individually underwritten, is a present group certificate holder. See Montana Code 33-19-104

• Privileged information: means any individually identifiable information that:

  (a)relates to a civil or criminal proceeding involving an individual; and

  (b)is collected in connection with or in reasonable anticipation of a claim for insurance benefits or civil or criminal proceeding involving an individual. See Montana Code 33-19-104

• Property: means real and personal property. See Montana Code 1-1-205
• Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
• Residual market mechanism: means an association, organization, or other entity defined or described in 61-6-144. See Montana Code 33-19-104
• State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201
• Unauthorized insurer: means an insurance institution that has not been granted a certificate of authority by the commissioner to transact the business of insurance in this state. See Montana Code 33-19-104
• under common control with: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. See Montana Code 33-19-104