Life Insurance or Disability Insurance and Confidentiality – the MIB and Limits of HIPAA

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The Health Insurance Portability and Accountability Act (HIPAA) has a few limitations that should be considered when you are applying for life insurance or disability insurance.

Life insurance and disability or long term care insurance companies ask you for the names of all the doctors who have treated you and your consent to get records from the doctors. The consent authorizes the release of all records, and you don’t have a choice about signing the authorization if you want to get the insurance.

MIB Group and Information Sharing

However, if the doctors do in fact release all the records (and insurance companies are incredibly tenacious about requesting them, often placing many, many phone calls to the doctor’s office) you should know that this information is usually shared with an organization called MIB Group (or MIB).

If this sounds cloak in dagger (MIB used to have a name, the Medical Information Bureau but that was apparently too revealing and they changed their name to MIB… Men in Black?) it is, a bit.

MIB collects the data and then shares it, for up to seven years, with any other insurance company that requests it. Now, it is perhaps a bit reassuring to know that the information is shared as “codes” rather than the entire medical record. But what exactly is coded is very hush hush. And the information is pretty widely available to insurance companies.

As wikipedia puts it… “MIB’s Underwriting Services are used … by MIB’s member life and health insurance companies to assess an individual’s risk and eligibility during the underwriting of life, health, disability income, critical illness, and long-term care insurance policies.”

According to the Federal Trade Commission, MIB’s member companies account for 99 percent of the individual life insurance policies and 80 percent of all health and disability policies issued in the United States and Canada.

MIB and California’s Privacy Law

And MIB is also not covered by California’s privacy law. At least according to its privacy policy.

Gateway’s Policy

When Gateway receives a request for records from an insurance company we will contact you again to verify that you wish the release of all records.

We generally prefer to release a summary of your care that just lists your diagnoses and dates of treatment.

If you insist we will release the entire record but it may take a while to comply and it we will have to charge you for the work it takes us.

Gateway Fees for Release of Information

Since a complete record set can run to thousands of pages, if you wish for us to release your entire record there is a charge for the time we take to create this massive file and fax it to the insurance company.

Current fees (2020), in California, are…

Fees for providing records as part of a legal procedure…

Search Fee: $4.00 (or $6.00 depending on requestor)
Evidence Fee: $15.00
Pages 1+: $0.10 per page
Microfilm: $0.20 per page

Cal. Evid. Code § 1158 (2),  Cal. Evid. Code § 1563 (6)

Fees if you request a copy of your records…

Pursuant to Health & Safety Code section 123110, a doctor can charge 25 cents per page plus a reasonable clerical fee. For diagnostic films, such as an x-ray, MRI, CT and PET scans, you can be charged the actual cost of copying the films. This only applies if you have made a written request for a copy of your medical records to be provided to you.

Again, records can run to hundreds and hundred of pages due to the nature of printing electronic health records.

Gateway Psychiatric never exceeds these fees and usually charges less. Our fees are just the cost of collating and faxing the information. However sending information via fax when the files are this large can take many, many attempts….

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