Patients info highly private: Andhra Pradesh State Consumer Redressal Commission

HYDERABAD: Andhra Pradesh State Consumer Redressal Commission has warned doctors and hospitals to not share patient information, unless required by a court of law, and warned them that if they go against this, they would be running into a risk of legal consequences. The Commission was dealing with a home loan case against SBI. The Commission stated that maintaining confidentiality of a patient’s medical aspects is absolutely necessary and said that it is not only part of a doctor’s professional conduct but also a Constitutional obligation. 

A two-member Bench comprising Justice Noushad Ali (president) and P. Mutyala Naidu of the Commission were allowing the claim of one G. Vijaya Kumari of Vijayawada against SBI Life Insurance Company Ltd.  The Bench observed that “it is trite to note that of late, almost every doctor/hospital is observing a professional obligation and the mandate of Constitution with impunity. They are sharing medical records of patients routinely with insurance companies, without realising consequences.”

“While selling the policies, the insurance companies do not take care as to whether the intending purchaser is eligible for the policy. They in fact lure them through agents and sell policies only with a view to improve their financial top-line. But when it comes to settlement of claims, they engage in all sorts of exercises, suspecting bona fides of claim,” the Bench noted. The Bench pointed out that the insurance companies invariably engage their so-called investigators, who in-turn approach doctors/hospitals for records. 

“These doctors/hospitals are obliging to them as a matter of course. The present case is one such instance,” it said. The Commission said that Doctors/hospitals should treat medical records and patient information as highly private and sensitive, to maintain doctor-patient confidentiality, and should adhere to regulations of Indian Medical Council of India.  The case of the applicant was that her husband Seshagiri Rao had obtained Rs 22 lakh as housing loan from SBI Branch at Benz Circle in Vijayawada. 

The insured covered the loan with a policy under SBI RIN Raksha Home Loan Scheme, by paying a premium of Rs 64,057. The policy was valid for a period of 186 months, with insurance cover from September 14, 2012 and the Bank was the master policy holder. Seshagiri Rao died in 2014 due to Cancer and when his wife approached the Bank claiming waiver of the home loan covered by the insurance policy, the Bank denied the claim on the ground of suppressing facts, based on a report given by an investigator, engaged by the SBI Insurance Ltd.

The Commission noted that the insured on his part appeared before a panel, including doctor of the Bank, who had then issued certificate about his good health, and the claim of the Bank and Insurance Company on the ground of suppression of material facts by the insured of his pre-existing illness does not have any substantial legal proof. While holding that the applicant was liable for the claim, the Commission directed SBI to settle the claim and refund the property documents and also to pay Rs 1 lakh to the applicant as compensation towards mental agony and also directed the Bank to pay Rs 25,000 towards costs of litigation, within three months.