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Parliamentary inquiry: CBA vague on patient medical records

The Australian 12:00am September 9, 2017

Michael Roddan

Commonwealth Bank has admitted it has no idea how many copies of patients’ full medical records it keeps for insurance purposes, and has warned an audit to find out would be an “impost” on its business and may not even establish an answer.

Senior executives from the bank’s life insurance division, CommInsure, were also unable to tell members of a parliamentary inquiry into the industry yesterday how much it paid doctors who complied with the company’s request for patient information. The inquiry into the $44 billion sector was established in the wake of revelations CommInsure was using outdated medical definitions to deny insurance claims. Allegations of poor claims handling procedures and of pressuring doctors to knock back legitimate claims also plagued the group. Comm­Insure was cleared of any “systemic” wrongdoing by an Ernst & Young review earlier this year.

During the parliamentary inquiry, life insurance providers revealed many doctors were volun­tarily sharing their patients’ entire medical histories, even though insurers had only asked for information relevant to a claim. Many customers were unaware they had consented to sharing their entire medical history when applying for a claim.

CommInsure managing director Helen Troup yesterday told members of parliament the company did not keep an account of when it received a customer’s entire record and did not destroy the information. Under current regulations, life insurers are required to keep information that forms part of the claims assessment.

“We are quite open to a principle requiring us to destroy (files),” Ms Troup said. When asked by Labor senator Deborah O’Neill how many entire medical records were kept by Comm­Insure, Ms Troup said the company was unable to “record that level of data”.

“I can’t give you an exact figure. It’s definitely not in the majority of cases because we don’t ask for that kind of information,” she said. CommInsure’s principle is to ask for information only relevant to the claim, but doctors often sent full medical records. “Would you be in a position to audit what you’ve got to see if you’ve got people’s full files?” Senator O’Neill asked.

“You can never say never that we couldn’t do that,” Ms Troup said. “But we pay over 20,000 claims a year and that would be an impost on our business to go and audit what we have on file,” she said.

CBA head of wealth management Annabel Spring said the company was unable to tell if it had received a full or partial medical file.

“I’m not sure that even if we did audit everything we would actually be able to tell,” Ms Spring said. “We do have an obligation that once the document has been given to us to keep it complete.”

Edwin Kruys, the vice-president and chairman of the Royal Australian College of General Practitioners, told the inquiry that doctors had “significant concerns” with insurance companies accessing whole patient records. It has led to some doctors underreporting issues their patients raised out of fear the information could be used against them.

“Patients may be reluctant if they know that their information may be stored on the desk of an insurance company,” Dr Kruys said.

He said about half of all requests from insurance companies were for the entire patient record, and many patients withdrew their previously provided consent to share information when they were notified of the insurer’s request for their records.

“It is all sorts of information patients have shared with their doctors over the years that they may not even remember,” Mr Kruys said.

“Companies should only be allowed to request specific reports that are relevant to the insurer’s issue at hand. All the other information that is contained in the records …. should not be included in the report,” he said.

Stephen Bradshaw, practitioner member of the Royal Australian College of General Practitioners, said he had never had a request for “targeted” information from an insurer. Companies always sought the full record.

Ms Troup said CommInsure would be open to an industry-wide policy of destroying medical records after use.