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Privacy Issues in Auto Claims Handling

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When defending claims, auto insurance carriers gather confidential medical and personal information about the claimants and insureds. Properly shielding confidential medical and personal information from disclosure is, therefore, a necessary loss prevention practice. The course, “Privacy Issues in Auto Claims Handling,” addresses these issues in connection with the application for insurance or the settlement of a claim. The module is presented by Meloney Cargil Perry, a founding partner of the Dallas office of the law firm of Meckler Bulger Tilson Marick & Pearson, LLP.

In the course, the instructor begins by outlining the Federal and State laws to consider when gathering confidential medical and personal information about the claimants and insureds. Next, she covers the steps necessary in general employee training to ensure compliance with these laws even before a claim has occurred, including the handling of electronic, confidential information and responding to requests for documents. Perry then addresses the claim handling concerns found in first- and third-party claim handling scenarios as well as the litigation concerns in responding to discovery requests and in electronic filings with the court. Finally, she speaks to certain exceptions and carve outs to confidentiality provisions.

After completing the course, the attendee will be able to outline the various Federal and State laws on confidentiality, describe the employees’ handling procedures for electronic, confidential information, learn how to respond to requests for documents, address claim handling concerns when dealing with third-party requests, explain how to best handle discovery requests and the electronic filing of court documents, and list the exceptions and/or carve outs that permit the dissemination of confidential information, whether it is to SIU investigators, in response to court orders/subpoenas, or as a result of a request by a governmental agency or by the Department of Insurance.

The course is designed for practitioners and insurance professionals working in the area of liability insurance coverage and litigation.

What CE Credit is available?

Note: To qualify for credit, you must submit completion (including a passed final exam if required) within five days of completing the last quiz. No partial credits will be awarded.

State:
Adjuster General CE Hours:
Adjuster Ethics CE Hours:
Attorney General CLE Hours:
State's Course ID:
NH 2.0 482652
TX (classroom equivalent) 2.0 101924
NC 2.0 C96427
FL * ( Provider Number: 364169 ) 2.0 1182369
IL 2.0 528128
WY 2.0 26112
OK 2.0 1024210

* This course has been approved by the Florida Department of Financial Services for insurance continuing education credit.

Course Content

Welcome and Session Overview
Expand
Lesson Content

1) Introduction
2) Course segments
a) General policy handling
b) Claim handling concerns
c) Litigation concerns
d) Exceptions
3) Federal and State laws to consider
a) Gramm-Leach-Bliley Act
i) Purpose
ii) Records and information covered
iii) Application to auto claims
b) Health Insurance Portability and Accountability Act
i) Purpose
ii) Application to auto claims
iii) Exceptions in auto claims
c) State-specific statutes and regulations
i) Statutes
ii) Insurance codes
iii) Administrative codes
4) General policy handling
a) Privacy policy instruction from transactions with the carrier
b) Privacy policy instruction from third parties
5) Recap

Steps in General Employee Training to Ensure Compliance Before a Claim has Occurred
Expand
Lesson Content

1) Handling procedures for electronic, confidential information
a) Electronic vs. paper
b) Metadata
c) Reply all and forwarding
2) Responding to requests for documents
3) General claim handling scenarios
4) Recap

Claim Handling Concerns
Expand
Lesson Content

1) Third party requests
2) First and third-party claim scenarios
a) Request by the claimant
b) Request by the insured
c) Sending documents to an adverse carrier/subrogation
d) Request by insured’s attorney/Letter of Representation (LOR)
3) Recap

Claim Handling Concerns (continued) / Litigation Concerns
Expand
Lesson Content

1) Audience questions
a) Emailing documents to the
attorney
b) Using encryption
2) Litigation concerns – Discovery requests
a) Objections
b) Production of documents

c) Protective order
3) Recap

Litigation Concerns (continued)
Expand
Lesson Content

1) Electronic filing
2) Litigation scenarios
a) Protective order
b) Protecting sensitive, medical information
c) Obtaining a release
3) Recap

Exceptions and/or Carve Outs
Expand
Lesson Content

1) Exceptions and/or carve outs
a) SIU Fraud Investigation
b) Court order and/or subpoena
c) Request by governmental agency or the Department of Insurance
2) Third party requests scenarios
a) Release of insured’s information
b) Confidentiality provisions
3) Fraud investigations scenario
4) Recap

Get CE Credit or Certificate of Completion.

Submit within 5 days to get CE Credit or Certificate of Completion.

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