33-19-306. Disclosure limitations and conditions. (1) Except as provided in this section, an insurance institution, insurance producer, or insurance-support organization may not disclose any personal or privileged information about an individual collected or received in connection with an insurance transaction.
     (2) Disclosure may be made with the written authorization of the individual but:
     (a) if the authorization is submitted by another insurance institution, insurance producer, or insurance-support organization, the authorization must meet the requirements of 33-19-204; or
     (b) if the authorization is submitted by a person other than an insurance institution, insurance producer, or insurance-support organization, the authorization must be:
     (i) dated;
     (ii) signed by the individual; and
     (iii) obtained 1 year or less prior to the date a disclosure is sought pursuant to this subsection.
     (3) Disclosure may be made to a person other than an insurance institution, insurance producer, or insurance-support organization, provided such disclosure is reasonably necessary:
     (a) to enable such person to perform a business, professional, or insurance function for the disclosing insurance institution, insurance producer, or insurance-support organization and such person agrees not to disclose the information further without the individual's written authorization unless the further disclosure:
     (i) would otherwise be permitted by this section if made by an insurance institution, insurance producer, or insurance-support organization; or
     (ii) is reasonably necessary for such person to perform its function for the disclosing insurance institution, insurance producer, or insurance-support organization; or
     (b) to enable such person to provide information to the disclosing insurance institution, insurance producer, or insurance-support organization for the purpose of:
     (i) determining an individual's eligibility for an insurance benefit or payment; or
     (ii) detecting or preventing criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with an insurance transaction.
     (4) Disclosure may be made to an insurance institution, insurance producer, insurance-support organization, or self-insurer if the information disclosed is limited to that which is reasonably necessary:
     (a) to detect or prevent criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with insurance transactions; or
     (b) for either the disclosing or receiving insurance institution, insurance producer, or insurance-support organization to perform its function in connection with an insurance transaction involving the individual.
     (5) Disclosure may be made to a medical care institution or medical professional of that information reasonably necessary for the following purposes:
     (a) verifying insurance coverage or benefits;
     (b) informing an individual of a medical problem of which the individual may not be aware; or
     (c) conducting an operations or services audit.
     (6) Disclosure may be made to an insurance regulatory authority.
     (7) Disclosure may be made to a law enforcement or other government authority:
     (a) to protect the interests of the insurance institution, insurance producer, or insurance-support organization in preventing or prosecuting the perpetration of fraud upon it; or
     (b) if the insurance institution, insurance producer, or insurance-support organization reasonably believes that illegal activities have been conducted by the individual.
     (8) Disclosure may be made as otherwise permitted or required by law.
     (9) Disclosure may be made in response to a facially valid administrative or judicial order, including a search warrant or subpoena.
     (10) Disclosure may be made for the purpose of conducting actuarial or research studies, provided:
     (a) no individual may be identified in any actuarial or research report;
     (b) materials allowing the individual to be identified are returned or destroyed as soon as they are no longer needed; and
     (c) 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, insurance producer, or insurance-support organization.
     (11) Disclosure may be made 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, insurance producer, or insurance-support organization, if:
     (a) 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
     (b) the recipient agrees not to disclose the information unless the disclosure would otherwise be permitted by this section if made by an insurance institution, insurance producer, or insurance-support organization.
     (12) Disclosure may be made to a person whose only use of such information will be in connection with the marketing of a product or service, if:
     (a) 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;
     (b) the individual has been given an opportunity to indicate that he does not want personal information disclosed for marketing purposes and has given no indication that he does not want the information disclosed; and
     (c) the person receiving the information agrees not to use it except in connection with the marketing of a product or service.
     (13) Disclosure may be made to an affiliate whose only use of the information will be in connection with an audit of the insurance institution or insurance producer or the marketing of an insurance product or service if the affiliate agrees not to disclose the information for any other purpose or to unaffiliated persons.
     (14) Disclosure may be made by a consumer reporting agency to a person other than an insurance institution or insurance producer.
     (15) Disclosure may be made to a group policyholder for the purpose of reporting claims experience or conducting an audit of the insurance institution's or insurance producer's operations or services if the information disclosed is reasonably necessary for the group policyholder to conduct the review or audit.
     (16) Disclosure may be made to a professional peer review organization for the purpose of reviewing the service or conduct of a medical care institution or medical professional.
     (17) Disclosure may be made to a governmental authority for the purpose of determining the individual's eligibility for health benefits for which the governmental authority may be liable.
     (18) Disclosure may be made to a certificate holder or policyholder for the purpose of providing information regarding the status of an insurance transaction.

     History: En. Sec. 15, Ch. 580, L. 1981; amd. Sec. 1, Ch. 713, L. 1989.