We got a call in the other day from a woman who was quite angry that the long term care insurance carrier would not talk to her about her mother’s long term care insurance policy.
We know it is frustrating…but in this, the insurance company’s hands are tied because of HIPAA laws and other privacy issues about medical records and finances.
This is why we beat the drum around here until folks are nearly deaf that they should have a Durable Power of Attorney written and duly notarized. If you are over 18, you need to have SOMEONE designated as the person who can speak on your behalf and make decisions on your behalf if you are incapacitated.
Look at it this way, the minimum fine for a breach of privacy on the federal HIPAA law is $200,000….per offense. And it can go as high as 1.5 million if it appears egregious or purposeful. So if you were in the shoes of a doctor’s office or the long term care insurance carrier, what would your standard operating procedure be – knowing that you face such a stiff fine if you breach?
There are two ways around this:
1) Go see a local attorney and just make sure you have your ducks in a row on this. If you can fax in a copy of the Durable Power of Attorney (DPOA), the carrier and doctor will answer every question you have.
2) If the policy holder still has all their mental faculties you can have them sign a Third Party Authorization giving explicit, written permission for the insurance company to share information with designated persons. This is often a form that the insurance company will provide you (or is downloadable), but it can also be a simple typed statement with the policy holders name and policy ID clearly noted and a statement of instruction about permission (dutifully signed and dated, of course!).
Contact - Mrs. LTC
Long Term Care Claims & Insurance