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Adjuster of No Fault MAY NOT Share Non Public Medical With 3rd Party Adjuster of Affiliate

by John Darer CLU ChFC MSSC CeFT RSP CLTC

The New York Insurance Department Office of General Counsel has issued OGC Opinion No. 09-06-09 which may impact structured settlement practice, particular those intermediaries who work with affilated auto insurers on two sides of a claim, where one handles the 1st party and another handles the 3rd party claim.

In an opinion of the Department’s Office of General Counsel (“OGC”) dated January 28, 2002, OGC concluded that an employee of an insurer that is adjusting a claimant’s no fault claim may share the claimant’s non-public health information with another employee in the same company who is adjusting the claimant’s third-party BI claim, without first obtaining consent from the claimant. That opinion relied on §  420.17(b) of New York Comp. Codes R. & Regs.(“NYCRR”), tit. 11, Part 420 (“Regulation 169”). See  OGC Opinion No. 09-06-09

The Office of General Counsel issued the following opinion on June 23, 2009 representing the position of the New York State Insurance Department.

RE: Non-public personal health information sharing among affiliates

Another inquiry asked the OGC whether the analysis set forth in the January 28, 2002 opinion applies with equal force to insurers that are affiliates.  In other words, she asks whether the employee of an insurer that is adjusting a claimant’s first-party claim may share non-public personal health information about that claimant with an employee of an affiliate that is adjusting the claimant’s third-party bodily injury (BI) claim.

The conclusion of the OGC is "The plain language of 11 NYCRR § 420.17(b) permits a licensee to share non-public personal health information for the performance of certain insurance functions “by or on behalf of the licensee” (emphasis supplied). Thus, the scope of that exception is limited to the same insurer—not to affiliate insurers. Therefore, an employee of an insurer that is adjusting a claimant’s first-party claim may not share non-public personal health information about that claimant with an employee of an affiliate that is adjusting the claimant’s third-party BI claim".

Medical information is needed to obtain a rated age , which in turn has impact structured settlement pricing of certain and life, life only and temp life contingent annuity payments.

Last updated May 24, 2024

How Making A Potentially True Statement Ruined A Competitor's Credibility

by Structured Settlement Watchdog

The following is a true story:

A plaintiff was considering a United States Treasury Bond Structured Settlement Trust and one of our industry brethren said he "also did T Bonds". When pressed by his competitor and the claims adjuster (his own client) to provide details, the structured settlement consultant was heard to say:

" Annuity carriers have T Bonds in Their Portfolios"

Should we say thank you to our competitor for becoming the punchline to a bad joke, the resulting ROFLMAO, and making the rest of our jobs a whole lot easier? Or do we pity the flights of financial illiteracy of those upon whom we are supposed to depend for advice?
 
Seriously, It is times like these when people should be seeing the best of what you have to offer. If you don't know what you are talking about keep your trap shut and seek help.

Financial Literacy....GET IT!?!