A row is brewing involving doctors and insurers that may result in advisers and their clients being stuck between the two factions.
The conflict was ignited by insurers using data protection legislation to reduce the fees paid to GPs for medical reports and is likely to see clients being sent their full medical records by doctors following requests from insurers.
It stems from the termination of an agreement between the ABI and British Medical Association (BMA) on fees insurers should pay for requesting medical evidence.
As a result, according to a report from Pulse, the GPs news service, insurance companies are using data protection law to request the whole patient record for as little as £10 each, instead of the previous £97.
At present GPs are being told to comply with requests from insurers and send the file to patients, but to emphasise that the insurance company is not allowed to see the whole report.
This deterioration in relations has also prompted the BMA to seek legal advice on ‘the ABI's decision to scrap the deal on fees as it argues that the agreement is in the public interest'.
The article reports the £10 fee is a 90% reduction in costs compared with the standard fee for a medical report and comes with ‘considerable extra burdens on the practice, which has to first redact sensitive medical information such as HIV or smoking status, that is unrelated to the insurance claim'.
The General Practitioners Committee of the BMA recommends that if insurers insist on their current approach:
• the practice will have to send the report (subject to the usual exclusions) to the patient, with a briefing as to what the patient may wish to take out before sending it onto the insurance company,
• the practice cannot guarantee that the notes will arrive in the company's possession in the same state that they left the surgery,
• and the practice needs to be paid the fee up front.
It also highlighted the point that the Data Protection Act only entitles the data subject (the patient or client) to have access, not anyone else.
‘Although a lawyer is the patient's representative when instructed by the patient this is certainly not the case with an insurance company', it added.
Pulse originally learned that two unnamed insurance companies were using the Data Protection Act to access their clients' full medical records from a practice in Gloucestershire.
It added: "there are fears that this loophole could now be used more widely by insurers to reduce the fees they are charged by GPs, following the collapse of the agreement with the ABI."
Many insurers are trying to significantly reduce the number of GP reports (GPRs) requested and complaints have been frequently made about the length of time it takes doctors to return the information.
