Does an Insured Have a Right to Obtain Copies of the Documents in Their File?

A client of mine recently asked a really good question to which I cannot give a very good answer.  His question was what right does an insured have to get copies of the documents in his agency’s file for the insured.  I am not aware of any law or regulation that specifically addresses this question, except with respect to any documents that may contain information covered by the Health Insurance Portability and Accountability Act, commonly known as HIPAA.  That Act imposes obligations on those who have such information in their files that are beyond the scope of this post.  Those of my readers who are members of IIAG and thus, members of IIABA, can go to the IIABA’s members only section and find more information on those obligations under Legal Advocacy, Memoranda and FAQs.   My other readers can find such information on a blog found here.

For all other documents found in an agency’s files for their insureds, we are left with the general principle that an agent is considered to be the agent of the insurance company first.  As such, he or she owes no duties to an insured, other than to obtain the policy requested by the insured and by extension, any documents created by the agent during the course of obtaining such policy would belong to the agent and/or insurance company that issued the policy.  This same rule would apply to any documents acquired by the agent during the course of obtaining the insurance policy requested, except for those documents that were supplied by the insured.

As noted in an earlier blog post, under Georgia law, by his or her words or conduct an agent can create duties to an insured that do not exist otherwise.  That same principle would apply to the documents in an insured’s file.  If the agent by words or conduct leads an insured to believe that the documents in the agent’s file for the insured belong to the insured or that the insured will be able to get a copy of any such documents upon their request, the agent would have created a duty to the insured to provide copies of all such documents upon the insured’s request.

This principle can also work the other way.  If the agent informs the insured at the beginning of the relationship that any documents created or obtained by the agent during the course of providing services for the insured will belong to the agent and that the insured has no right to obtain copies of them, that rule will govern the relationship.  In any event, there is nothing to prevent an agent from charging a reasonable fee for making copies of any documents requested by the insured that the insured either has a right to obtain or that an agent agrees to provide.

So the answer to the above question is that it depends on the type of document being requested and on whether the agent has established a policy about the provision of copies of the documents in their file for an insured, either one way or the other.  If not and the document requested was not one that had been provided by the insured initially, then the default rule would be that an agent has no obligation to provide an insured with copies of documents in their file for the insured.

 

 

1 thought on “Does an Insured Have a Right to Obtain Copies of the Documents in Their File?”

  1. Mark,
    Again thank you for the timely post. Just a short while ago an Ex-Agency personal lines customer of mine made such a request. He had an active policy with me from 2009 – 2013. He contacted our office by telephone and requested that we make available to him all of the documents that might appear in his agency policy file.
    He was detailed in his requests, asking for copies of applications, declarations pages, change request documents, etc. At the time of his request our agency did not know our obligation or duty for this request as defined under Georgia law and Insurance Regulations.

    So, we contacted the carriers that that the customer was insured with and none of their policy services team could provide us with a clear answer on whether we should provide the documents or not.

    Finally, one of the sharper Marketing Representatives that serves our agency took my call and advised me that unless the request for documents comes from the carrier or by court order, I had no obligation to provide the documents to the ex-customer.

    However, this was a week long ordeal of making calls to carriers while simultaneously receiving calls from the ex-customer asking for the documents.

    It turns out that the ex-customer, who was of Hispanic descent, was applying for some form of citizenship and needed the documents to prove that he had been in the country for a certain period of time. Upon understanding what his intent was with the documents I ended up providing them to him at no charge.

    However, in the future, I intend to create an agency policy regarding such requests that clearly states the insured has no right to documents that the Agency creates or obtains during the placement or servicing process. And, if documents are released, that a reasonable charge may be applied.
    Thank you for your blog!

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