GP Receptionist provided my Medical History to Insurance Company

Shinobi1

I made a medical insurance claim and the insurance company contacted my GP. However, the receptionist answered the phone and provided them information without my consent. Now my claim has been rejected due to pre-existing condition. 
My question is can i take any action against the practice for giving out my information without my consent? surely this is a massive data breach 

Brie

I would have thought there was something on the claim form saying that they may need to ask for information and by signing the form (or submitting on line) you have given consent for them to discuss your medical situation with the surgery.  

Old_Lifer

This was done by telephone and was dealt with not by a doctor but by the receptionist ?

Caz3121

I would suggest keeping the insurance rejection and the data breach separate (If you had declined to give consent the claim would likely be rejected, if you had given consent the outcome would have been as it has turned out to be)
Check the insurance claim form to ensure that there was no tick box that you agreed to GP disclosing and if not look at your GP practice complaints process as a starting point

Shinobi1

the doctor submitted a report with my consent but the insurance company called the GP practice to validate. a receptionist answered and provided information that i didn't give consent to. 
On that basis it was rejected, As this was not submitted by GP I have appealed with insurance company. sounds like a long battle is ahead with the GP practice now. 

Shinobi1

Brie said:

I would have thought there was something on the claim form saying that they may need to ask for information and by signing the form (or submitting on line) you have given consent for them to discuss your medical situation with the surgery.  

the surgery needs my consent prior giving any information i would have thought

Brie

Shinobi1 said:

Brie said:

I would have thought there was something on the claim form saying that they may need to ask for information and by signing the form (or submitting on line) you have given consent for them to discuss your medical situation with the surgery.  

the surgery needs my consent prior giving any information i would have thought

Yes of course it does!  And that's what you need to look for - had you in fact given consent.  Forms can be vague or misunderstood, by you, by the GP, by the receptionist or even the claim company.

But as someone else said - keep the 2 issues separate.  

Look to see if it was in fact a data breach.  If it was then you should complain to the practice manager.

If it wasn't a data breach then I would suggest you want to know what specifically the receptionist said.  They are not medical professionals and can (in my personal experience) get things wildly wrong.  They might not have even been looking at your file.  Can you get a recording of the call?? (this might be a question for the claim company)

Then why was the claim rejected?  If you had a broken arm from hang gliding but your history showed you have been a diabetic for 10 years does that invalidate your entire policy?  If so what's being diabetic got to do with having a broken arm?  Or is it that you didn't tell the claim company that you have been a diabetic for 10 years when you claimed for a diabetic related emergency? 

Of course the majority of claims seem to be initially rejected but then many are upheld on subsequent review.   

Tigsteroonie

I would check the small print of your claim carefully - did you consent to them contacting and obtaining information from your GP (i.e. a named person) or from the GP Practice? 

maisie_cat

When the insurance company requested medical information from the GP they should and probably did provide the patient consent.
When you made the claim you will have provided that consent and you can ask the GP what consent they acted upon.
What you cannot do as a rule is pick and choose what information they provide unless you want the claim rejected.

Sandtree

Shinobi1 said:

the doctor submitted a report with my consent but the insurance company called the GP practice to validate. a receptionist answered and provided information that i didn't give consent to. 

Your clutching at straws

You gave permission for your GP surgery to answer the questions of your insurer. It really should be of no surprise that when insurers ask for copy of records/notes etc that its an admin person that does the photocopying/printing etc and not the doctor.

Look it at the other way too... if you fail to give such consent your claim is also declined

dunstonh

I'm struggling to see any data protection breach here.   Permission was given for the surgery to provide details.  Details were requested and given.    GPs don't do most of the administration tasks.  The administrators/receptionists, clerical staff do.

Now my claim has been rejected due to pre-existing condition. 

That has nothing to do with the information supply though.