Privacy Policy

Additional Consent Applicable to Insurance Plan Members Only

The information collected about you, and if applicable, your spouse and/or dependents, is utilized by the insurer and/or plan administrator along with their service providers for several critical purposes. These include assessing your claims, underwriting, conducting investigations, performing audits, and administering the group benefits plan. This process may also involve the investigation of potential fraud and/or abuse of the plan. The use of this information is essential for the efficient and secure management of your benefits, ensuring that your claims are processed accurately and responsibly.

Authorization and Consent

I hereby grant permission for my healthcare provider to gather, utilize, and share personal information related to any claims made on my behalf with the insurer and/or plan administrator, as well as their service providers, for the purposes outlined previously.

Furthermore, I authorize the insurer and/or plan administrator along with their service providers to:

• Employ my personal data for the stated purposes.
  
• Share personal information with any relevant party, including healthcare professionals, investigative bodies, insurers and reinsurers, and administrators of government or other benefit programs, as necessary for these purposes.
  
• Exchange information regarding any claims with the plan member or an authorized representative.
  
• Transfer personal information for these purposes through electronic means or other methods as required.

I am aware that my personal information might be disclosed to authorized individuals as per the relevant laws.

I consent to the validity of a photocopy or electronic copy of this authorization, equivalent to the original, to facilitate the ongoing administration of the group benefits plan.

I hereby direct the payment of eligible claim benefits to the healthcare provider submitting my claims electronically to the group benefits plan and instruct the insurer/plan administrator to pay the provider directly. Should my claims be denied, I acknowledge my obligation to compensate the provider for their services and/or supplies.

I recognize that the insurer/plan administrator is not obliged to agree to this Assignment. I understand that any benefit payment made under this Assignment fulfills the insurer/plan administrator’s obligations regarding that payment. If the payment is made directly to me, the insurer/plan administrator’s duty for that payment is also considered fulfilled.

I understand that this Assignment applies to all eligible claims submitted electronically by the Provider, and I retain the right to revoke it at any time through written notice to the insurer/plan administrator.

If acting as a spouse or dependent, I confirm my authorization by the plan member to assign benefit payments to the Provider.