Supreme Court finds doctor’s release of records to insurer was covered by patient authority

Doctors are often unsure whether they are permitted to release patient records or health information to third parties such as lawyers or insurers. While it is important to check the nature and scope of the authority, this case confirmed doctors are permitted to provide information where it is covered by a valid authority. 

By way of background, Mr G was working as a civil engineer when he began to experience symptoms of daytime somnolence, general tiredness, malaise and depression. His GP referred him to a tertiary hospital for review by a respiratory physician, Dr P. After conducting a series of sleep studies, Dr P diagnosed narcolepsy. 

Mr G resigned from his employment but only a few days later sought to withdraw his resignation. When his employer declined to accept the withdrawal, Mr G took the matter to the employment tribunal attempting to regain his employment. When that was unsuccessful, he tried to claim a disability support pension, also unsuccessfully.  

Then he made a claim for salary continuance insurance. The insurer initially rejected the claim as outside the terms of the policy but then agreed to pay out under the policy for 2 years as a good faith payment. At the end of the 2 years, Mr G made a further claim for Total and Permanent Disablement. It was at this point the insurer contacted Dr P requesting medical information. 

Health records – disclosure to third parties 

As part of its assessment, the insurer wrote to Dr P requesting clinical notes relevant to Mr G’s insurance claim and a report on Mr G’s treatment. The request included a broad authority signed by Mr G permitting the release of ‘all information with respect to any sickness or injury, medical history, consultations, prescriptions, or treatment and copies of all hospital or medical records.’ 

Dr P responded to the insurer, briefly outlining prior involvement with Mr G, but noting that they were unable to provide current information as they had not seen Mr G for 2 years.  

Mr G claimed Dr P had breached patient confidentiality. He claimed he had emailed Dr P requesting that he only provide clinical notes and not provide any report and that he had not consented to Dr P disclosing his confidential health information. 

Ending the doctor–patient relationship 

Mr G had made threats against Dr P and had been convicted of criminal offences.  

The court noted Dr P requested Mr G to stop sending threatening emails, then had blocked Mr G’s email address and had advised him of this fact.  

Mr G then attempted to communicate using another email address, which Dr P also blocked.  

The court determined that Dr P never received Mr G’s email requesting that he not provide a report. 

It also found that Dr P was entitled to block Mr G’s email address due to the threats Mr G had made. At that time Mr G was not a patient and Dr P was not required to specifically inform Mr G every time he blocked a different address. 

The court particularly commended Dr P on their professionalism and for providing fair and measured evidence despite the threats and complaints Mr G had made. 

The court concluded that Dr P owed Mr G a duty of confidentiality. 

It also found Mr G had authorised Dr P to release his health information to the insurer in the declaration he completed on the claim form.  

Dr P had responded appropriately to the insurer’s questions based upon their medical knowledge and treatment of Mr G. The information was released in accordance with a valid authority that had never been effectively withdrawn. There was no improper disclosure of confidential information.  

The court noted that it was not appropriate for Mr G to directly communicate with Dr P to explain or limit the scope of the authority. The appropriate way for Mr G to withdraw or vary the authority would have been to communicate that to the insurer. 

Mr G’s claim against Dr P was dismissed. 

You do owe a duty of confidentiality to patients even after a treating relationship has ended. 

However, that duty is not absolute.  

You can provide copies of records to a third party, if you have the patient’s consent – ideally this authority should be in writing. 

This case confirms that doctors are entitled to rely on an unambiguous signed authority. However, if you have any doubts about the authority, we recommend contacting the patient to clarify.  

Avant factsheet: Providing medical records to a third party 

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