5 - Reports for insurance companies
Agreed fees: life assurance and income protection
The BMA has agreed fees with the Association of British Insurers (ABI) for reports and medical examinations undertaken for life assurance and income protection purposes.
The fees set out below are binding only on member companies of the ABI with whom the BMA negotiates nationally. In practice, the agreed fees are paid in almost every case as 99 per cent of life assurance business is undertaken by ABI member companies and members should insist on them wherever possible.
Life assurance is important for patients, especially at significant points in their lives and the BMA agrees that the process of applying for life assurance should run smoothly, with the minimum of disruption to doctors and their patients. The following principles have been agreed between the BMA and the ABI:
- that the information should be provided in the manner requested and should be as complete as possible. This would, thereby, prevent needless issuing of additional questionnaires or requests for clarification of or further information on the original report, which do not command a further fee
- that the report should be returned within 20 working days of receipt of the request. In return, insurance companies will not send reminders until 15 days have elapsed. The BMA acknowledges that insurance companies may ask for a more speedy response in exceptional circumstances, for example in connection with the completion of a loan. As this is outside the agreement the ABI acknowledges that a higher fee may be negotiated if GPs wish
- when an insurance applicant is declined or postponed as a result of a medical disclosure that they have made on the application form the insurance company will give the reason for declination to the applicant. However, if a new or poorly controlled medical condition is revealed on the GPR or following a medical examination, and not disclosed on the application form, the insurance company will inform the GP.
Medical reports for life assurance purposes are covered by the Access to Medical Reports Act 1988. Under this Act, if a patient indicates that they wish to see the report before it is despatched, the GP should refrain from sending it for 21 days from the receipt of the request for the report. It may be advisable to inform the insurance company if a request to see the report has been made. Once the patient has seen the report they may decide to withdraw their consent for it to be sent.
The BMA and the ABI have jointly developed guidance to make it easier for GPs to provide information to their patients’ insurance companies. The guidance includes a standard covering letter from insurers with an overview of the kind of information relevant to different types of insurance; a standard GP report (GPR) form; and a standard consent declaration for patients. The BMA and the ABI have also jointly published this information within the document Medical information and insurance .
The BMA/ABI agreement is not time limited but it may be reviewed at any time by the ABI or the BMA. When either party requests a review, the agreement will remain in force for up to six months following the request for a review unless the new agreement comes into force before then.
GPs are reminded that the provision of copies (whether paper or electronic) of the medical record is not appropriate and is not covered by the patient's consent to the report.
Effective date: 1 April 2008
Please note that reports should be provided in the manner requested and should be as complete as possible.
1. Agreed rates
a) GP report for insurance applicants £84.00
b) GP supplementary reports £21.50
Note: Patients have the right to see the report before it is sent to the insurance company. If a request is made, the insurance company should inform the GP and the patient has 21 days to arranage to see it.
c) Medical examinations undertaken on a GP's own patient £92.50
Note: When an applicant fails to keep a pre-arranged appointment 50 per cent of the fee should be paid by the insurance company.