(215 ILCS 5/1014) (from Ch. 73, par. 1065.714)
Sec. 1014.
Disclosure Limitations and Conditions.
An insurance institution,
agent or insurance-support organization shall not disclose any personal
or privileged information about an individual collected or received in connection
with an insurance transaction unless the disclosure is:
(A) with the written authorization of the individual, provided:
(1) if such authorization is submitted by another insurance institution,
agent or insurance-support organization, the
authorization meets the requirements of Section 1007 of this Article, or
(2) if such authorization is submitted by a person other
than an insurance
institution, agent or insurance-support organization, the authorization is:
(a) dated,
(b) signed by the individual, and
(c) obtained one year or less prior to the date a disclosure is sought
pursuant to this subsection; or
(B) to a person other than an insurance institution, agent or insurance-support
organization, provided such disclosure is reasonably necessary:
(1) to enable such person to perform a business, professional or insurance
function for the disclosing insurance institution, agent or insurance-support
organization and such person agrees not to disclose the information further
without the individual's written authorization unless the further disclosure:
(a) would otherwise be permitted by this Section if made by an insurance
institution, agent, or insurance-support organization, or
(b) is reasonably necessary for such person to perform its function for
the disclosing insurance institution, agent, or insurance-support organization, or
(2) to enable such person to provide information to the disclosing insurance
institution, agent, or insurance-support organization for the purpose of:
(a) determining an individual's eligibility for an insurance benefit or payment, or
(b) detecting or preventing criminal activity, fraud, material misrepresentation
or material nondisclosure in connection with an insurance transaction; or
(C) to an insurance institution, agent, insurance-support organization
or self-insurer, provided the information disclosed is limited to that which
is reasonably necessary:
(1) to detect or prevent criminal activity, fraud, material misrepresentation
or material nondisclosure in connection with insurance transactions, or
(2) for either the disclosing or receiving insurance institution, agent
or insurance-support organization to perform its function in connection
with an insurance transaction involving the individual; or
(D) to a medical care institution or medical professional for the purpose of:
(1) verifying insurance coverage or benefits,
(2) informing an individual of a medical problem of which the individual
may not be aware, or
(3) conducting an operations or services audit,
provided only such information
is disclosed as is reasonably necessary to accomplish the foregoing purposes; or
(E) to an insurance regulatory authority; or
(F) to a law enforcement or other governmental authority:
(1) to protect the interests of the insurance institution, agent or insurance-support
organization in preventing or prosecuting the perpetration of
fraud upon it, or
(2) if the insurance institution, agent or insurance-support organization
reasonably believes that illegal activities have been conducted by the individual; or
(G) otherwise permitted or required by law; or
(H) in response to a facially valid administrative or judicial order,
including a search warrant or subpoena; or
(I) made for the purpose of conducting actuarial or
research studies provided:
(1) no individual may be identified in any actuarial or research
report,
(2) materials allowing the individual to be identified are returned or
destroyed as soon as they are no longer needed, and
(3) the actuarial or research organization agrees not to disclose the
information unless the disclosure would otherwise be permitted by this Section
if made by an insurance institution, agent or insurance-support organization; or
(J) to a party or a representative of a party to a proposed or consummated
sale, transfer, merger or consolidation of all or part of the business of
the insurance institution, agent or insurance support organization, provided:
(1) prior to the consummation of the sale, transfer, merger or consolidation
only such information is disclosed as is reasonably necessary to enable the
recipient to make business decisions about the purchase, transfer, merger
or consolidation, and
(2) the recipient agrees not to disclose the information unless the disclosure
would otherwise be permitted by this Section if made by an insurance institution,
agent or insurance-support organization; or
(K) to a person whose only use of such information will be in
connection with the marketing of a product or service, provided:
(1) no medical-record information, privileged information,
or personal information relating to an individual's character, personal
habits, mode of living or general reputation is disclosed, and no classification
derived from such information is disclosed,
(2) the individual has been given an opportunity to indicate
that he or she does not want personal information disclosed for marketing purposes and
has given no indication that he or she does not want the information disclosed, and
(3) the person receiving such information agrees not to use
it except in connection with the marketing of a product or service; or
(L) to an affiliate whose only use of the information will be in connection
with an audit of the insurance institution or agent or the marketing
of an insurance product or service, provided the affiliate agrees not to
disclose the information for any other purpose or to unaffiliated
persons; or
(M) by a consumer reporting agency, provided:
the disclosure is to a person other than an insurance institution or agent; or
(N) to a group policyholder for the purpose of reporting claims experience
or conducting an audit of the insurance institution's or agent's operations
or services, provided the information disclosed is reasonably necessary
for the group policyholder to conduct the review or audit; or
(O) to a professional peer review organization for the purpose of reviewing
the service or conduct of a medical-care institution or medical professional; or
(P) to a governmental authority for the purpose of determining the individual's
eligibility for health benefits for which the governmental authority may be liable; or
(Q) to a certificateholder or policyholder for the purpose of providing
information regarding the status of an insurance transaction; or
(R) to a lienholder, mortgagee, assignee, lessee, or other person shown
on the records of an insurance institution or agent as having a legal or
beneficial interest in a policy of insurance; provided that information
disclosed is limited to that which is reasonably necessary to permit such
person to protect its interest in such policy.
(Source: P.A. 82-108.)
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