Medical confidential?

If ICBC asks your doctor for your information you may wonder: Can ICBC ask my doctor for my medical information? Can ICBC request a medical report from my doctor without my consent? What is ICBC entitled to know? If you are like most people, you consider your medical information to be private and confidential. So it is not surprising that when ICBC asks you, your lawyer or your doctor for this personal information that it raises some concern. However, despite the personal nature of the information being sought, it is also not difficult to appreciate that if you are asking an insurance company to cover expenses caused by an accident, then you are going to need to prove the existence, cause and effect of those injuries.

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First, you need to know that if you sign any of the authorization forms provided to you by ICBC for release of medical information, this may provide ICBC with more information than they generally are entitled to. ICBC should only get information relevant to your claim. If you sign their forms, you will have consented to your doctor giving ICBC any information listed in the form, which in my view is typically too broad. As a result, I do not recommend signing these forms without first speaking to a lawyer (for more information see my past article called “What’s in your medical records?”). If you retain a lawyer, your lawyer should review your medical records first and decide what records ICBC is entitled to.

Second, you need to know that even if you choose not to sign ICBC’s authorization forms, the Insurance (Vehicle) Act and Regulation provides a mechanism for ICBC to obtain medical information to evaluate your accident benefit claim without your consent and without advising your lawyer. The form is called a CL19 Medical Report and it is sent to your doctor to fill out with a cover page explaining each section of the two page report. Your doctor is legally required to fill out the CL19 Medical Report, at least in part. Specifically, the legislation (s.28 of the Act) requires your doctor to provide ICBC, as soon as reasonably practicable, with a report of your injuries, diagnosis, treatment and prognosis related to the accident in the form prescribed by ICBC. Your doctor is offered a financial incentive, if the form is properly completed and returned to the adjuster within a set period of time.

There are four sections to the CL19 form. Section A - asks your doctor to provide details of your relevant past medical history and other relevant medical concerns. Section B - asks your doctor to conduct a physical examination and report his or her findings. Section C - asks your doctor to provide your diagnosis related to the accident. Section D - asks your doctor to comment on your treatment and your employability. All of the information input on the form should be directly related to your accident claim. Caution should be exercised by your medical practitioners in filling out the form, particularly where there is uncertainty. Any answers that appear definitive or final can create challenging hurdles if the information on the form is inaccurate or misleading. For example, under the return to work planning section, if the “disability end date” is unknown, it is preferable to simply input “unknown” or “unknown at this time". ICBC adjusters and defence counsel will often refer back to these forms, and once written (such as a disability end date), even with new evidence it seems almost impossible to get ICBC to change its position.

In addition to the CL19 Medical Report (which ICBC can also request from a nurse, chiropractor, dentist, physiotherapist or hospital employee who treated you as a result of your accident), ICBC can demand that you promptly furnish a certificate or report from your doctor or any of the people just listed as to the nature and extent of your injury, and the treatment, current condition and prognosis of the injury (s.98 of the Regulation). ICBC can also demand that you attend an independent medical examination with a medical practitioner of its choice and as often as ICBC requires, within reason (s.99 of the Regulation). If you have commenced a lawsuit, the Rules of Court also entitle legal counsel for ICBC to request your relevant medical records and one or more independent medical examinations.

In short, ICBC is generally going to be entitled to some medical information that is relevant to payment of accident benefits. Also, where a personal injury claim is pursued, ICBC will be entitled to additional relevant information to assess the validity and value of your claim. What medical information is relevant will vary depending on the injuries and disability you allege were caused by the accident. If you have concerns about the medical information being requested by ICBC, you should seek legal advice.

*Important Note: The information contained in this column should not be treated by readers as legal advice and should not be relied on without detailed legal counsel being sought.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.