Patient records used to 'load' premiums

Insurance cover: Patients are not aware of the consequences of general practitioners health information to insurance companies…

Insurance cover: Patients are not aware of the consequences of general practitioners health information to insurance companies, the a.g.m. of the Irish Medical Organisation (IMO) has been told.

During a debate last weekend on a motion calling on the insurance industry to advise its clients of the potential disadvantage of current practices, Dr John Duignan, a GP in Stillorgan, Co Dublin, said the system "lacked transparency". He also criticised the arbitrary nature of the process which he said was damaging the relationship between family doctors and their patients.

He told The Irish Times there was an urgent need for a routine, face-to-face exchange of information between insurance companies and patients, especially where premia are loaded because of a person's previous medical history. "At present, there are too many obstacles to getting feedback from companies," he said.

Dr Ciaran Donovan, a GP in Cork city, described a recent experience in which an insurance company asked him to complete a private medical attendant's report (PMA) without including the patient's consent authorising him to do so - a PMA is the standard format used by the insurance industry to gather medical information on those seeking insurance cover for mortgages and life insurance.

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When Dr Donovan sought a completed consent form, the firm presented a consent dated December 1995, which had been signed by the patient eight years earlier in connection with a different insurance application.

Dr Philip Crowley, a GP practising in Dublin's inner city, said the present system put patients at serious disadvantage.

IMO president Dr James Reilly said: "There was a need for better standards for our patients where this issue was concerned."

The Information Guide for General Practitioners to the Data Protection Acts 1988 - 2003 is specific in its advice to family doctors. "Personal health information should only be used or disclosed for the purpose for which it was collected," it says, adding that the informed consent of the patient should be "the guiding principle" when obtaining personal health information.

"Patients should understand what information is being collected, why it is being collected and who it might be disclosed to," according to the guide, which was published earlier this year by the Irish College of General Practitioners (ICGP) and the GP Information Technology section of the Department of Health.

The Irish Times understands GPs are pressurising the IMO and the ICGP to end the present agreement with the insurance industry on the completion of PMAs.

The medical profession may seek to replace the PMA concept with independent medical examinations, which would include a full explanation to patients of the consequences of supplying a wide-range of personal health information to the insurance industry.

"With the rise in the average value of mortgages, information is now being sought on many more people's health, resulting in loaded premia or outright refusal of cover," one source noted.