Any Lawyers Out There?

[nicash4 4]

I have a question regarding HIPAA laws; is it possible to sue an insurance company for sending confidential information regarding myself to another party (my father, also policy holder of my insurance...whom I've had no contact with in 10 years) after its been alerted on the insurance companies system to only send information to my home address?

Long story short last year around this time my sister had the VSG and her approval letter was sent to my dad. Yesterday I found out the same thing happened to me and the only thing the insurance company says, is sorry. I have fought for 2 years to terminate my dad as my representative and I successfully did that...or I thought I did. But is it possible to go after a big multi-million dollar insurance company for screwing up this big? I'm so frustrated because my dad willingly chose to walk out of my life and he doesn't get the right to know what's going on with me medically.

Any advice would be greatly appreciated!

[Bufflehead 6,358]

@@nicash4 just wanted to let you know that even though there are lawyers here, it would be a violation of our ethical rules to give out legal advice to someone who isn't a client, and we have to do all sorts of background/conflict checks and formal arrangements to make you a client. Also, we are only allowed to practice law in the jurisdictions where we are licensed, and it's too hard to determine where an internet message board is considered to be for jurisdictional purposes. I would say, it is in your best interest to have an in-person consultation with a local attorney or at least visit your local law library to do some guided research with legal reference attorneys showing you how to use the materials you might need.

Your local bar association may be able to provide free or low cost consultation services. I know mine does free in-person consultations on Saturday mornings with volunteer attorneys, or they provide references to specialist attorneys who will meet with someone for 30 minutes, I think for $25. It isn't that we don't want to be helpful here, we just can't. Good luck!

[OKCPirate 5,323]

While I agree with @@Bufflehead on the legal ethics, I will tell you that HIPPA isn't the approach to this problem. When searching for legal remedies, you might want to start with your state's insurance regulatory board/agency. HIPPA isn't worth the paper it's printed on since ObamaCare went into effect. Privacy is non-existent when you are dealing with third party payers. Sorry, your data will be sold to providers of Vitamins etc. by the insurance companies. It's a gaping loophole. That's why I self paid and never told my primary care doctor about the WLS because I didn't want the info on my computerized medical record because that data isn't covered by HIPPA either because the taxpayers "have paid for it."

[BLERDgirl 6,417]

Not a lawyer, but this sound more like the insurance company's error than the hospital. Are you saying your father is the main policy holder and you & your sister are listed on the policy as dependents?

[CanyonBaby 1,852]

Not a lawyer here, either, but a visit to you Attorney General's office might be due. Also, check out your hospital's policy, and ask, ask, ask....anyone who will listen. There might be a specific office/person who deals with this type of stuff professionally. It's definitely worth asking about....good luck and let us know what you find out!

[nicash4 4]

I more or less wanted to know if it was possible to sue an insurance company. Yes, my dad is the policy holder of the account but we are listed on the insurance. But as of 2 years ago we terminated him as our personal representative meaning he no longer has access to EOB, online access, bills, authorization letters etc. To me this is so personal because as I near my surgery date for VSG, I don't want it to be clouded by a man who isn't involved in my life. Last year when my sister had the surgery too and they sent him the approval, my dad sent her surgeon and the insurance company letters requesting that the surgery be denied due to the fact that my sister didn't ask for permission. Honestly who does that.

I just don't like the fact that I've gone through all the trouble of filing the right paperwork and he still has access...and that the insurance company is ignoring what is on record. But I thank you guys for your input, I truly do.

[AngelaWilliamsMD 290]

I'll try to tackle this from a health professional's point of view. If he's the policy holder then I believe he legally has the right to know (to a degree) what's going on with his insurance claims and of those that are his dependents.

[Tssiemer1 549]

Yeah confidentiality doesn't matter if he's the policy holder. My husband is my policy holder and he has access to everything. Even stuff I don't want him to know. :-/

[nicash4 4]

I'll try to tackle this from a health professional's point of view. If he's the policy holder then I believe he legally has the right to know (to a degree) what's going on with his insurance claims and of those that are his dependents.

But his right was terminated legally, thus meaning he no longer has a right. The only thing he can know is how much money we have spent within the allowed expenses. The insurance company is sensing him information regarding the VSG surgery (which gives the full explanation including what all my medically diagnoses are) when they weren't supposed to. I don't know. I'm just frustrated because he hasn't tried to talk to me or my siblings in 10 years and my health problems are mine and mine alone. But thank you for your input! I appreciate it

[BLERDgirl 6,417]

Make sure you have the termination in writing from the insurance company. In fact going forward I would call and speak to an insurance representative before any big procedure such as this. I understand your anger. However, this definitely sound like the insurance company's error and not the hospital.

[OKCPirate 5,323]

@@nicash4 - Oh, that is a hospital/billing office problem. I had the same thing happen where my ex-wife gets stuff from doctors I saw when we were both on the same insurance. Since it has been over five years and I was paying for the procedure I didn't even think to make sure their record was up to date, but they mindlessly filed with insurance anyway. She got notice that insurance wasn't going to pay for it because I wasn't on the policy (duh) and a complete run down of my colonoscopy (oh, the horrible night of a 1000 showers). Embarrassing, but I thing that might be where the problem lies.

[CanyonBaby 1,852]

I understand your point is in pursuing a lawsuit. So, get all you can IN WRITTEN FORM, before you begin. Documentation is everything, and you will need it. Without it, there's not much hope, so search everywhere you can to get all that has transpired IN WRITING. You may need witness statements, get them in writing. Especially focus on dates of when things occurred/transpired. Without this ammunition, you won't get far.

However, you MAY wake up the insurance company enough so they don't continue making these "mistakes", if that will satisfy you. Also, google this, to see if there are other complaints similar in nature, for possible class-action lawsuits against this company. Ask your local BBB (Better Business Bureau) if there are any current actions against this company. These are all starting points, but at least a place to begin. Good luck to you, and I hope you receive satisfaction on this.