Confidentiality of insurer's claim files and records; access by director; definition

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20-157.01. Confidentiality of insurer's claim files and records; access by director; definition

A. Pursuant to the director's authority under sections 20-156, 20-157, 20-160, 20-466 and 20-3502, an insurer shall comply with a request to produce any documents, reports or other materials, whether maintained in written or electronic format, from an insurer's claim file or an insurer's record that is required to comply with chapter 28, article 1 of this title.

B. Any documents, reports or other materials that are provided to the director pursuant to this section are confidential and are not subject to disclosure, including discovery or subpoena, unless the subpoena is issued by the attorney general or a county attorney or by a court at the request of the attorney general, a county attorney or any other law enforcement agency. The director may disclose the information only to a state or federal agency or officer pursuant to a lawful request, subpoena or formal discovery procedure. If the requesting party cannot warrant confidentiality pursuant to section 20-158, subsection I, the information that is provided pursuant to discovery, subpoena or lawful request as provided for in this subsection remains confidential. The director shall make reasonable efforts to notify an insurer of any request for a subpoena for documents, reports or other materials in an insurer's claim file or other record that are produced by the insurer pursuant to this section so that the insurer may assert, in a court of competent jurisdiction, any applicable privileges.

C. The director may use the documents, reports or other materials in the furtherance of any regulatory action brought by the director or in actions brought against the director.

D. Subject to the restrictions prescribed in section 20-299, the director shall provide an insurer with a copy of any document the director receives pursuant to this section that the director believes supports a violation of this title or that justifies any regulatory or other action against the insurer. A disclosure pursuant to this subsection is not a waiver of any applicable privilege or claim of confidentiality in the disclosed document.

E. For the purposes of this section, " insurer claim file" includes medical records, repair estimates, adjuster notes, insurance policy provisions, recordings or transcripts of witness interviews and any other records regarding coverage, settlement, payment or denial or adjustment of a claim asserted under an insurance policy.


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