HIPAA Practices That Harm Consumers and Impede Underwriting

A woman nervously looking at a laptop

The Health Insurance Portability and Accountability Act of 1996 is a very complex piece of legislation. So are the various privacy laws in each state in the United States. Most consumers think of HIPAA as the form they sign when they go to a hospital or doctor’s office, or when they apply for life or health insurance. What they may not know is the way many health care organizations of all kinds use HIPAA to delay, mislead, or prevent consumers from either getting their own health care information, or granting others the right to do so.

The Problem with HIPAA 

As far as HIPAA authorizations (i.e., HIPAA forms) are concerned, the federal legislation passed almost 30 years ago did establish standards for what must be in a valid HIPAA form. Unfortunately, many health care providers and organizations, and particularly their lawyers, have chosen to interpret what the law did NOT prohibit from being in these documents, as an excuse to require things in addition to those in the Federal standard. The result is a dizzying array of forms, rules, requirements and behaviors on the part of health care providers that impose a burden on consumers seeking to gain access to information that, generally speaking, belongs to them.

Consumers who explore selling their unwanted or unneeded life insurance policy, are told up-front that they will need to release their health care information (e.g., medical records and other health care data) as part of the life settlement process. They sign HIPAA-compliant authorizations as part of that process. The executed forms are then used by life settlement companies to request health care data and medical records from the health care providers who have or are currently caring for the insured. The medical information gathered is used to qualify and evaluate the insured, and ultimately prepare life expectancy reports, which are a critical input for life settlement transactions.

However, when health care providers impose their own requirements and standards on consumers and life settlement companies that represent them, they delay or impede the entire process. In some cases, a health care provider’s refusal to accept a fully compliant and valid HIPAA form signed by the insured can prevent access to vital medical information. In turn, the absence of complete correct information can cause the life expectancy assessments to be inaccurate or overly conservative, and that can cost the consumer thousands, even hundreds of thousands of dollars.

Consumers Access to Accurate Life Underwriting

Consumers have a right to their health care information, and they have the right to grant access to that information to others. Health care providers who require their own forms, require items on forms that are non-standard and driven by preference not law, and who arbitrarily decide when forms are acceptable to them – outside the legal standards – are harming consumers without valid reasons. These behaviors also impede the life insurance and life underwriting processes, because these activities cannot be completed until all the right information is available. These exercises are best conducted when that information is as complete as possible, and health care providers who impose their preferential requirements to inhibit these processes are harming the very patients they claim to be protecting.

At ISC Services, we create life expectancy assessments based on meaningful health care records and data. We have decades of experience in developing accurate, individualized reports for insured people who are entering a life settlement transaction. If you have questions about the problems with accessing medical information for life expectancy assessments, contact ISC Services today.