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The Role of Power of Attorney in Accessing Medical Records for Insurance Claims

Assigning a person in your life to act as a power of attorney is a responsible step to ensure you get the best possible care during a claim.

Published on:
May 9, 2024

As a patient, you alone have the legal right to access your health data. Health data is collected from medical records such as documents, test results, notes from ER or doctor visits, and forms. Medical records can range from a few hundred pages to a few thousand, depending on age and the complexity of your medical situation. These medical records are an essential component of an insurance claim

The patient automatically has the right to access their own health data. However, when it comes to transferring this data to anyone else, patients will need to be mindful of power of attorney. Power of attorney (or POA) is a legal document signed by the patient, while they are competent and mentally capable enough to decide what happens to them or their loved ones if they become unable to decide for themselves. The document is essentially a ‘living will’, although POA is only in effect while you are alive. If you are ever incapacitated, the POA document appoints a person of your choice, and gives them the power to make decisions on your behalf. This appointee is called an attorney – although they don’t need to be a lawyer to fulfill the role. 

POA and Medical Records in Insurance Claims

Why is having or giving POA so important in a claim? POA is necessary in order to hand over a patient’s medical records to the lawyer or insurance adjuster handling their claim. This can save claimants a great deal of time, and potentially be the key to getting them access to benefits and care. If a patient is injured or unable to process the claim and they do not have POA assigned, the person administering their insurance claims will need to work around the access requirements as they process the claim, leading to lengthy delays. 

Since medical records are such a critical aspect of an insurance claim, it's no surprise that insurance claims (or changes) go smoother when POA is arranged. For example, if you did not have POA in place, your dependent child or spouse could not make any changes to an insurance policy held in your name alone - even if it pertains to the house they live in or even co-own. If they did have POA, they could amend or cancel the policy.  A substitute decision maker can be appointed, but only in a process which can be costly or cause even more delay.  

Scope of POA

When POA is given to someone you trust, they can then provide authorization and access to your medical documents when needed — and avoid providing them when it’s not wanted or required. Your POA has permission to make financial decisions for you, should you find yourself in a position where you are not able to do so. This includes managing your investments, bank accounts, or bills, collecting money owed to you, or providing for your clothing and care. 

What the POA cannot do is transfer their authority to another person (such as a spouse or sibling). The POA is also not allowed to lay claim to your money or property, act as a POA beyond your death or return to wellness, or change the beneficiary on a life insurance policy that you own. They also do not have access or ownership over your money – just the ability to access it and manage your affairs.  All of these criteria help to ensure that the role of POA is not abused, by either the person administering your finances or the person facilitating your care. 

How To Appoint a POA

If you’re looking to protect your assets and loved ones, as well as ensure that you receive a high standard of care, appointing a POA is a good idea. While medical records are able to be accessed by you and you alone, it’s almost always a good idea to share these responsibilities. The additional insight from medical records and your health history to your insurance company can make or break the case, and without the medical records, the company might not be able to get started on the claim. 

Ready to appoint a POA? In many parts of Canada, you’ll need to have your POA request notarized with a relevant professional (in general, this person must be impartial, above 18, and able to assess your mental faculty as you sign). Notarizing these documents can sometimes be challenging in the hospital or other medical situations, since you might not have access to critical pieces of identification, like ID. Make sure everything is in place as soon as you can; while your POA document is effective as soon as it is signed (with proper witnesses) some institutions (like banks) won’t accept documents that have not been notarized. 

Not many people want to think about who they’ll assign their responsibilities in the event of a traumatic accident or major injury. However, assigning a person in your life to act as a POA is a responsible step to ensure you get the best possible care during a claim. 

Kristen Campbell
Content Writer

Kristen is the co-founder and Director of Content at Skeleton Krew, a B2B marketing agency focused on growth in tech, software, and statups. She has written for a wide variety of companies in the fields of healthcare, banking, and technology. In her spare time, she enjoys writing stories, reading stories, and going on long walks (to think about her stories).

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