January 20, 2011 by Canadian Underwriter
Saskatchewan Government Insurance (SGI) has issued a public statement clarifying “misconceptions” that the insurer says have arisen based on the findings of a recent Privacy Commissioner report, as reported in Canadian Underwriter’s online news on Jan. 14.
In its report, the Office of the Information and Privacy Commissioner in Saskatchewan said it had reached an impasse with SGI over three complaints related to the collection of personal health information under the Automobile Accident Insurance Act (AAIA).
“I would like to emphasize that the privacy commissioner’s report does not suggest SGI has allowed inappropriate access, mistaken release or breach of any customer’s personal information,” SGI president and CEO Andrew Cartmell said in the statement. “The commissioner’s concerns are regarding the health information SGI collects from its customers to administer benefits for injuries sustained in auto collisions.”
Cartmell said SGI does not collect the complete medical records of all customers who file injury claims.
“For the large majority of the roughly 6,000 injury claims we assess in a year, we require only minimal information,” he said. “However, for complex injury claims, we do require a full medical history to accurately determine benefits.”
Cartmell said that the complexity of some cases requires someone familiar with the nature of the injuries to review the individual’s medical record to determine what information may be relevant to the claim.
“Under current practice, the initial review is performed by a trained injury representative at SGI,” he said. “The file is then referred to a medical specialist for further review.”
He said the alternative to this practice is to have the initial file review performed by the individual’s family doctor. “SGI has not pursued that alternative due to the additional burden it would place on Saskatchewan doctors and the delay it would cause to our customers in receiving their benefits,” he said.
Cartmell also emphasized that SGI always asks customers for consent to obtain their medical records, and customers have the right to refuse consent.
“If a customer chooses to refuse consent, we still try to work with them to provide benefits to the best of our ability with the information to which we have access,” he said. “When they do give consent, SGI carefully limits access to their health records to only those who need it in order to properly administer benefits.”