Fees when providing insurance reports and certificates

This guidance is to assist GPs in charging insurance companies who have asked for patient information.

Location: UK
Audience: GPs
Updated: Thursday 12 August 2021
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Insurance companies requesting full medical records

These fees are for guidance only. It is up to the doctor and insurance company to negotiate an acceptable fee.

This guidance reflects the advice from the Information Commissioner’s Office that use of SARs (subject access requests) is not appropriate to provide medical information to the insurance industry.

Our guidance on SARs for insurance purposes

 

Allowance*
GP report for insurance applicants £104
GP supplementary reports £27

*Competition Act rules apply, the fees listed were last agreed in 2006

Completing insurance reports

Providing a life assurance report should run smoothly with minimum disruption to doctors and their patients.

We would expect doctors to abide by the following principles:

  • the information should be provided in the manner requested and be as complete as possible. This should prevent needless issuing of additional questionnaires or requests for clarification, which do not command a further fee
  • the report should be returned within 20 working days of receipt of the request, sometimes sooner in exceptional circumstances
  • when an insurance applicant is declined or postponed as a result of a medical disclosure on the application form, the insurance company will give the reason for declination to the applicant
  • 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 requests 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’s advisable to inform the insurance company if a request has been made. Once the patient has seen the report they may withdraw their consent for it to be sent.

 

Fees and private medical insurance companies

Fees are offered to GPs by some private medical insurance companies for medical reports on prospective subscribers for private medical insurance.

We do not recommend fees for this work and would advise doctors to charge at their private rate.

 

Targeted reports

A number of insurance companies have introduced targeted reports for life assurance and income protection.

These reports are shorter than full GP reports and require information on a single condition However, they often require as much work as a full report as their synthesis requires the doctor to read the entire record to adapt the 'targeted report' so that it gives a fair and true reflection.

We suggest charging your full and normal fee for private work.

The BMA has not supported the introduction of these targeted reports, and therefore there is no recommended fee.

 

Reports for patients taken ill abroad

Doctors are not bound by their terms of service to provide these reports, and are entitled to a charge at their own rate for providing the report.

Consent is needed before information is disclosed to insurance companies for the purpose of verifying claims, for example before a company organises repatriation of a policy holder (or their relative if their illness affects the policy holder’s holiday duration) taken ill abroad. In such cases, the company must approach the policy holder, and/or their relative, for permission and provide evidence to the doctor.

If the policy holder, and/or their relative, is not competent to give consent, doctors may release the information necessary in the person's best interests.

The insurance company will explain what information is required in each case.

The view of the BMA is that if the above conditions are met then GPs should aim to co-operate with any reasonable requests. GPs should not however be blackmailed with any threats that certain action will compromise the validity of the patient's insurance and the repatriation process.

Please be mindful of data protection issues when submitting information that may leave the EU or UK.

 

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