OGC Op. No. 04-03-23

The Office of General Counsel issued the following opinion on March 25, 2004, representing the position of the New York State Insurance Dept

Re: Record Retention

Question Presented:

How long does a health insurance company have to keep records of the insured?

Conclusion:

Generally, for six calendar years from its creation or until after the filing of a Report on Examination, in which the record was subject to review, with the Insurance Department or until the conclusion of an examination or investigation, whichever is longer. However, there is no obligation to provide an insured with the detailed claims history, including prescription coverages, of such individual.

Facts:

The Veterans’ Administration requested that an individual obtain his medical records from all of his doctors from 1973 to the present. The individual learned that doctors are not required to keep records for some thirty years. The individual hopes that the health insurers would retain prescription records for the past 30 years.

Analysis:

N.Y. Comp. Codes R. & Regs. tit. 11, § 243.2 (1996) (Regulation 152) refers to those records required to be retained by insurers for examination purposes and the necessary retention period. Such necessary records include claims, underwriting, complaints, and other records that the Superintendent requires for periodic examination. Once a policy is no longer in force, policy records generally need not be retained for the longer of six years or until after a Report on Examination in which the record was subject to review has been filed. It would be unlikely for this type of information to be retained for a significant time frame.

For further information you may contact Associate Attorney Jeffrey A. Stonehill at the New York City Office.