In TPD insurance claims it is common for an insurer to request reports from treating doctors or independent medical examiners. A claimant is entitled to access those reports as a matter of right pursuant to the Australian Privacy Principles.
Insurers will often say that they will not provide the medical reports until provision of procedural fairness just prior to a decision being made. This is again not a valid reason to delay provision of the medical reports. The reports must be provided when they are requested and TPD claimants should be requesting the reports as soon as they become available. Medical reports about TPD claimants will commonly contain factual statements which may be incorrect or inconsistent with the true state of affairs. As a TPD claimant it is important to correct these factual errors as soon as possible before they are relied upon by other doctors or the insurer in forming their decision.
Requests for the reports should be made initially to the claims manager handling the claim. If they refuse to provide access then the request should be directed to the privacy officer of the organisation. If the reports are still not provided, you can then make a complaint to the Office of the Australian Information Commissioner who will investigate the complaint and correspond with the organisation about their obligations. They will force the organisation to release the reports.
This is a useful means of obtaining important documents and information about your claim in a timely way to ensure the accuracy of information being used by an insurer in assessing the claim.