What a medical confidentiality waiver form is in a long-term care insurance claim, why the insurance company asks for it, the difference between a focused waiver and a blanket one, and what to check before signing.
Why it is asked for at all
In order to assess a long-term care claim the insurance company needs access to medical information. Without the insured person's consent, medical bodies are not permitted to give it that information.
A confidentiality waiver form is that consent. It allows the company to approach the health fund, hospitals and other medical bodies directly and to obtain information about the insured person.
This is a legitimate and accepted part of the process, and in most cases you cannot make progress without it. That said, there is a significant difference between a focused waiver and a broad one, and it is worth knowing what you are signing.
What to check on the form
Before signing, it is worth going over the form and checking a few points. It takes only a few minutes.
- Which bodies the company may approach — a defined list or bodies without limit
- What period the waiver relates to — recent years or the entire medical history
- What purposes the information will serve — assessing the claim only, or other purposes too
- How long the waiver remains in force
- Whether it can be revoked and on what conditions
- Whether information about family members is also being requested — for which there is usually no justification
A blanket waiver versus a focused one
There is a difference between a form that allows the company to obtain the complete medical file, from any body, with no time limit, and a form that relates to the period and the bodies relevant to the claim.
From the insured person's point of view, a focused waiver is preferable. It gives the company what it needs to assess the claim, without opening up the entire medical history.
You can ask for the form to be adjusted, and you can ask why such a long period is needed. Such a request is legitimate, though it will not always be accepted. It is important to remember that refusing to sign may delay the claim, so this is a question of balance.
What to do when the insured person cannot sign
Where the insured person is not competent to sign — for example in an advanced cognitive condition — an appropriate authorising document is required.
The accepted options are an enduring power of attorney that has come into effect, or a guardianship appointment order. Each company sets out which documents it accepts.
What you must never do: sign in the insured person's place. Even where the intention is good and even where it is obvious that they would have agreed, signing without authority may damage the claim and give rise to further problems.
After signing
Keep a copy of the signed form. It sounds obvious, but many families sign and send it on without keeping a copy, and then cannot remember what they signed.
If it later emerges that the company obtained information not relevant to the claim, the copy is what makes it possible to check whether the scope of consent was exceeded.
The information here is general and does not constitute legal advice. On questions concerning privacy or the scope of consent, you should approach an appropriate professional.
Frequently asked questions
Do we have to sign a medical confidentiality waiver?
In practice, in most cases a claim cannot proceed without it, because the insurance company needs access to medical information in order to assess the claim. It is an accepted part of the process.
What should we check before signing?
Which bodies the company may approach, what period the waiver relates to, what purposes the information will serve, how long it remains in force, and whether information about family members is also being requested.
Can we ask for a more focused waiver?
You can ask, and it is a legitimate request. A waiver relating to the relevant period and bodies is preferable from the insured person's point of view. Bear in mind that refusing to sign may delay the claim.
Who signs when the insured person is not competent?
An appropriate authorising document is required — an enduring power of attorney that has come into effect, or a guardianship appointment order. Do not sign in the insured person's place without authority, even with good intentions.
Do we need to keep a copy?
Absolutely. The copy makes it possible to check later what the scope of consent was, if a concern arises that information not relevant to the claim was obtained.
Official sources for further checking
This is general information and does not replace personal medical, legal or insurance advice. Eligibility is determined by the documents and rules that apply to each case.
