Insurers - Privacy

Health Claims for Auto Insurance Processing (HCAIP) is responsible for the operation of the electronic processing system (HCAI) for automobile insurance claims. This system allows health care facilities and insurers to communicate with each other by facilitating the transmission of Ontario claim forms (OCFs). The aim is to facilitate the claims adjudication process. Data which has all personal identifiers removed (aggregated data) is also used to assess how insurance resources are accommodating the needs of claimants. In order to fulfill our mandate the HCAI system contains sensitive personal health information. Protecting this information is the job of HCAIP, healthcare providers, insurers and the claimants.

Below are the main actions HCAIP will take and the actions we depend on others to take, in order to protect the confidentiality of personally identifiable information (PII).

HCAIP commits to:

maintain appropriate technical and administrative safeguards to protect the data in the HCAI system
audit the privacy practices of any third parties that HCAI contracts to establish consistency with HCAIP standards
contact the appropriate organization (insurer or provider facility) in the event we are approached by a claimant for PII. If we are required by law to release information we will, in most cases, advise you of the fact
provide training material and update users on the HCAI system
take prompt action in the instance of a privacy breach

Healthcare facilities management and healthcare providers are asked to:

be aware of your responsibility to protect the Personal Information of your clients (patients) as detailed in your organization’s policies and applicable privacy law
ensure that the Authorizing Officer is familiar with the HCAI application and that access to users in your organization is provided on a role based model. In addition as staff moves within the facility or leaves, have access promptly changed or removed
comply with the requirements as set out in the Provider terms and conditions agreements signed with HCAI
obtain and store the claimants consent to treatment
record only the necessary information for treatment and payment
access only the files of the claimants/patients you are working with
protect PII from unauthorized disclosure in paper, electronic or verbal format
ensure claimant data is as accurate as possible

Insurers are asked to:

ensure your staff has privacy/security training on a regular basis and that changes in the HCAI system are communicated in a timely manner
provide access on a role based model and promptly remove or change access as staff moves or leaves
not download claimant data to a hard drive or mobile device unless known to your supervisor
assist in any investigation should there be a breach involving your organization’s data

Claimants are asked to:

ensure your healthcare provider has accurate information about your status, your place of residence and your insurer
be sure your healthcare provider explains whom they will be sharing your information with in order to both provide treatment and receive payment. You will be asked to sign a consent form to confirm that you understand the process.

If you have any concerns about your PII contact the Privacy Officer for the insurance company you deal with or the Privacy Officer at HCAI privacyofficer@hcaiprocessing.ca or
416-644-3120

Website Usage Data and Cookies

HCAI Processing automatically collects Internet Protocol (IP) addresses and website usage information on all visitors to the website. This information helps in analyzing the traffic and refining and optimizing the site design. Cookies are of the single session type which means users must login again on return to the site.

Lists

HCAI Processing does not give, sell or trade lists containing personal information for marketing or any other purpose not related to the handling of individual claims.

Linkages

Where links from hcai.ca or hcaiinfo.ca to other Web pages are provided, HCAI Processing is not responsible for the privacy practices or content of those sites.

HCAI Privacy Policy (PDF)

HCAI Privacy FAQs for Health Care Facilities/Providers

Request to Access Personal Information (DOC)

Information About Accessing your Personal Information (PDF)

The Privacy Officer is available to answer questions at privacyofficer@hcaiprocessing.ca or at the number above.