Title 33, Chapter 39, Section 14
( 33-39-14)
An insurance institution, agent, or insurance-support organization
shall not disclose any personal or privileged information about an
individual collected or received in connection with an insurance
transaction unless the disclosure is: (1) With the written authorization of the individual, provided: (A) If such authorization is submitted by another insurance institution, agent, or insurance-support organization, the authorization meets the requirement of Code Section 33-39-7; or (B) If such authorization is submitted by a person other than an
insurance institution, agent, or insurance-support organization,
the authorization is: (i) Dated; (ii) Signed by the individual; and (iii) Obtained one year or less prior to the date a disclosure
is sought pursuant to this subsection; or (2) To a person other than an insurance institution, agent, or
insurance-support organization, provided such disclosure is
reasonably necessary: (A) To enable such person to perform a business, professional,
or insurance function for the disclosing insurance institution,
agent, or insurance-support organization and such person agrees
not to disclose the information further without the individual's
written authorization unless the further disclosure: (i) Would otherwise be permitted by this Code section if made
by an insurance institution, agent, or insurance-support
organization; or (ii) Is reasonably necessary for such person to perform its
function for the disclosing insurance institution, agent, or
insurance-support organization; or (B) To enable such person to provide information to the
disclosing insurance institution, agent, or insurance-support
organization for the purpose of: (i) Determining an individual's eligibility for an insurance
benefit or payment; or (ii) Detecting or preventing criminal activity, fraud,
material misrepresentation, or material nondisclosure in
connection with an insurance transaction; or (3) To an insurance institution, agent, insurance-support
organization, or self-insurer, provided the information disclosed
is limited to that which is reasonably necessary: (A) To detect or prevent criminal activity, fraud, material
misrepresentation, or material nondisclosure in connection with
insurance transactions; or
(B) For either the disclosing or receiving insurance
institution, agent, or insurance-support organization to perform
its function in connection with an insurance transaction
involving the individual; (4) To a medical-care institution or medical professional for the
purpose of: (A) Verifying insurance coverage or benefits; (B) Informing an individual of a medical problem of which the
individual may not be aware; or (C) Conducting an operations or services audit; provided only such information is disclosed as is reasonably
necessary to accomplish the foregoing purposes; (5) To an insurance regulatory authority; (6) To a law enforcement or other governmental authority: (A) To protect the interests of the insurance institution,
agent, or insurance-support organization in preventing or
prosecuting the perpetration of fraud upon it; or (B) If the insurance institution, agent, or insurance-support
organization reasonably believes that illegal activities have
been conducted by the individual; (7) Otherwise permitted or required by law; (8) In response to a facially valid administrative or judicial
order, including a search warrant or subpoena; (9) Made for the purpose of conducting actuarial or research
studies, provided: (A) No individual may be identified in any actuarial or research
report; (B) Materials allowing the individual to be identified are
returned or destroyed as soon as they are no longer needed; and (C) The actuarial or research organization agrees not to
disclose the information unless the disclosure would otherwise
be permitted by this Code section if made by an insurance
institution, agent, or insurance-support organization; (10) To a party or a representative of a party to a proposed or
consummated sale, transfer, merger, or consolidation of all or
part of the business of the insurance institution, agent, or
insurance-support organization, provided: (A) Prior to the consummation of the sale, transfer, merger, or
consolidation only such information is disclosed as is
reasonably necessary to enable the recipient to make business
decisions about the purchase, transfer, merger, or
consolidation; and
(B) The recipient agrees not to disclose the information unless
the disclosure would otherwise be permitted by this Code section
if made by an insurance institution, agent, or insurance-support
organization; (11) To a person whose only use of such information will be in
connection with the marketing of a product or service, provided: (A) No medical-record information, privileged information, or
personal information relating to an individual's character,
personal habits, mode of living, or general reputation is
disclosed, and no classification derived from such information
is disclosed; (B) The individual has been given an opportunity to indicate
that he or she does not want personal information disclosed for
marketing purposes and has given no indication that he or she
does not want the information disclosed; and (C) The person receiving such information agrees not to use it
except in connection with the marketing of a product or service; (12) To an affiliate whose only use of the information will be in
connection with an audit of the insurance institution or agent or
the marketing of an insurance product or service, provided the
affiliate agrees not to disclose the information for any other
purpose or to unaffiliated persons; (13) By a consumer reporting agency, provided the disclosure is to
a person other than an insurance institution or agent; (14) To a group policyholder for the purpose of reporting claims
experience or conducting an audit of the insurance institution's
or agent's operations or services, provided the information
disclosed is reasonably necessary for the group policyholder to
conduct the review or audit; (15) To a professional peer review organization for the purpose of
reviewing the service or conduct of a medical-care institution or
medical professional; (16) To a governmental authority for the purpose of determining
the individual's eligibility for health benefits for which the
governmental authority may be liable; (17) To a certificate holder or policyholder for the purpose of
providing information regarding the status of an insurance
transaction; or (18) To a lienholder, mortgagee, assignee, lessor, or other person
shown on the records of an insurance institution or agent as
having legal or beneficial interest in a policy of insurance,
provided that: (A) No medical-record information is disclosed unless the
disclosure would otherwise be permitted by this Code section;
and (B) The information disclosed is limited to that which is
reasonably necessary to permit such person to protect its
interest in such policy. |