Insurers Misquote Law to Get Private Claimant Information

I have been asked repeatedly by other attorneys why liability carriers are asking for client’s Social Security Numbers, Dates of Birth, etc. when letters of representation are received. Typically, this information is disclosed through the voluntary delivery of medical records and bills to liability carriers, but it is done when the claimant has carefully considered what to provide. These early requests (or demands by some carriers) can open access to sensitive client information to parties which may not have a right to it. That notwithstanding, liability carriers are insisting that Medicare requires them to verify this information for every claimant as soon as they make a claim.

The carriers are wrong.

Medicare Section 111 Reporting has communicated to liability carriers that when Medicare eligible claimants are paid benefits by the carriers, it must be reported to Medicare. That’s it. Nothing more.

Carriers, under the pressure of a per claimant/per day $1000 fine for failure to report, have put draconian measures in place to requiring the early collection of clients’ vital information, in an effort to avoid the penalty. It is likely that carriers will take advantage of this information to obtain your client’s insurance and medical history through national databases.

There is a fairly simple response to the demands from these insurers. Medicare has created a model form that lists the minimum reporting information that Medicare beneficiaries can use to report to liability carriers. The form is available on the Centers for Medicare/Medicaid Services website www.cms.gov. This form has a threshold question: Are you eligible for Medicare? If not, you simply skip all of the vital information questions, sign the form, and you’re done.

Use that form regardless of what carriers are asking you for, and make sure the carriers know that you are familiar with what is and is not required.

One comment on “Insurers Misquote Law to Get Private Claimant Information

  1. Here is the address for the form mentioned above:

    http://www.cms.gov/MandatoryInsRep/Downloads/NGHHICNSSNNGHPForm.pdf

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