Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7131 Volume 316 News Saturday 21 February 1998 Dutch face disclosure of medical records People who take out life insurance in the Netherlands from 1 March may have to authorise disclosure of their medical records if they die within a fixed period. The proposal, from the association of insurers, would end the position in which Dutch doctors are the only doctors in Europe who are not allowed to disclose information on patients relating to life insurance claims. The association wants to tighten up the current requirements because of what it claims is evidence of fraud, costing "tens of millions of guilders." The health ministry and the Royal Dutch Medical Association oppose the change, fearing that patients will be signing a blank cheque for the future. The Dutch want to retain unique position over records Photo: CHRIS PENNARTS/HOLLANDSE HOOGTE A medical examination is not obligatory for people who take out insurance for less than about £100,000 ($160,000). Furthermore, information on the causes of death is kept anonymous in accordance with the current agreement between insurers and the medical profession, which dates back to 1910. But insurers now quote figures showing a death rate of 16% among clients who take out life insurance during the previous two years, compared with an expected average for the population as a whole of 5%. They believe that this "clearly shows" that "relevant information" is being hidden from the insurance companies. The insurers' association proposes that clients should authorise that information about the course of an illness and cause of death can be disclosed if they die before an agreed number of years has passed. A Belgian insurer has recently offered Dutch citizens life insurance under these terms, and it was revealed during a debate in parliament that this did not contravene Dutch law. Dutch insurers say that they face unfair competition from insurance companies in other countries. The Royal Dutch Medical Association argues that if there is sufficient evidence a judge can order the disclosure of medical records, but patient confidentiality must outweigh suspected fraud. The association fears "considerable risks" to health if patients, such as those who may be HIV positive or who are suicidal, are made more reluctant to seek medical help. In addition the relationship between a doctor and surviving relatives, who may be treated by the same doctor, could be damaged - for example, if payment is refused because a doctor maintains patient confidentiality. Tony Sheldon, Utrecht Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline