Legal Question in Insurance Law in Utah

Re: Medical Insurance - Request for Information scope

Your insurance policy is a contract which governs the terms of their obligation to provide payment. They have a right to require medical information on the party receiving medical treatment, but do not have a right for medical histories of other family members. The justification for medical histories on the recipient is to verify that the patient has disclosed previous history which may affect the liability of the insurance company. For example, if the patient suffered from arteriosclerosis and had not disclosed a history of diabetes the medical history would turn up the diabetes, which may limit the liability of the insurance company since diabetes often is a factor in arteriosclerosis. However, asking for medical backgrounds on other family members goes too far.

Offer to sign a release for the patient. If the insurance company balks at payment, file a complaint with the insurance commissioner and sue the company in small claims court. Your other option is to hire an attorney and sue in district court. There may be others in your same circumstances, which may justify a class action lawsuit. (A class action requires a class representative to sue on behalf of all persons, known and unknown who may have been victimized by the same practice.)