New life insurance information GPs need to know

The process for seeking patient consent and releasing medical information to life insurers is being updated following the introduction of a new standard.
 
The updated standard stems from a 2018 inquiry into the life insurance industry, in which the RACGP raised concerns regarding insurance company requests for patient medical information, particularly requests for full patient records.
 
The Parliamentary Joint Committee on Corporations and Financial Services (the Committee) supported the RACGP position that access to a patient’s full medical history and notes is often inappropriate, and that a targeted medical report should be the default way to share information.
 
It also recommended that the RACGP work with the Financial Services Council (FSC) to develop a standard process for requesting and providing patient medical information, which protects patient privacy and helps ensure companies providing life insurance receive only relevant information.
 
Under the new Standard No. 26: Consent for accessing health information, insurers will be required to ask for patient consent to access their health information in two standard ways (called an authority). Both authorities will be sought at the same time, but information can only be provided under the second authority under certain, limited conditions.
 
The first, and preferred, authority, involves GPs (with patient consent) providing a medical report which contains relevant information, including both statements of fact and medical opinion, only.
 
The second authority involves the provision of a patient’s full medical record, including consultation notes. This can only be released if the patient’s GP/practice is unable to, or did not, provide the report within four weeks; or if the report provided is incomplete, or contains inconsistencies or inaccuracies.
 
The authorities are only valid while a claim or application is being assessed, or while disclosures an individual is required to make under an insurance policy are verified.
 
According to an FAQ document posted on the college website, the RACGP recommends that GPs provide medical reports as opposed to complete medical records, where possible.
 
‘[The] default approach for releasing your patients’ health information should be a targeted medical report. We recommend this to prevent sharing of patient information which is not relevant to a third-party request,’ it states.
 
‘As always, you must not release medical information to a third party without your patient’s consent, unless you are legally required in response to a subpoena, court order or summons. It is essential that this consent is documented.
 
‘Similarly, you must have consent or authority to prepare a medical report prior to commencing the reporting process.’
 
The college has also produced other related resources to assist GPs, including A guide to writing medical reports and Managing external requests for patient information.
 
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