Insurance Policy Exclusions of Normal Pregnancy and Childbirth
Bankers Life & Cas. Co. v. Peterson (1993) 263 Mont. 156 [866 P.2d 241] held that an individual medical insurance policy that excluded coverage for normal pregnancy and childbirth violated Montana statute section 49-2-309, Montana Code Annotated (MCA).
MCA section 49-2-309, provides in pertinent part:
"(1) It is an unlawful discriminatory practice for a financial institution or person to discriminate solely on the basis of sex or marital status in the issuance or operation of any type of insurance policy, plan, or coverage or in any pension or retirement plan, program, or coverage, including discrimination in regard to rates or premiums and payments or benefits."
As the opinion points out, the Montana statute "has no federal or sister-state counterpart." (866 P.2d at p. 243.)
Bankers Life differs factually from this appeal insofar as the insurance policy at issue in Bankers Life completely excluded normal pregnancy and child birth from coverage, and did not involve a copayment or deductible. (Id. at p. 242.)
It is legally distinguishable because unlike the Knox-Keene Act, which specifically regulates health care service plans and allows copayments for maternity benefits, the Montana insurance statute on which Bankers Life relied had no accompanying statutory scheme allowing such copayments.
In the Knox-Keene Act, the Legislature enacted a statutory scheme that specifically governs health care service plans, and placed regulatory authority over this subject matter with the Commissioner of Corporations. by these steps, the Legislature intended the Knox-Keene Act, and not some other statutory scheme, to govern health care service plans.