Privacy IL Protocols CPLIC - colonialpenn.com
Illinois Confidentiality Protocols
For Victims of Domestic Violence and Endangered Individuals
Illinois Insurance Law 215 ILCS 5/355b requires accident and health insurers to accommodate a reasonable request made by a person covered by an insurance policy to receive communications of claims-related information by alternate means or at alternate locations if the person clearly states that disclosure of the information could endanger the person. The parent or guardian of a covered child may request to receive alternate means of communication for the child.
Without the express consent of the person making the request, an insurer may not disclose: (1) the name, address, telephone number or other personal information of the person requesting the accommodation or child residing with such person; (2) the nature of the services provided to the impacted individual; or (3) the name or address of the person or entity providing services to the impacted individual.
You may submit a written request for confidential handling of health information to the company. The request must supply the following information:
- The manner in which you wish to receive confidential communications and specification of an alternative address or other information necessary to deliver information in the requested manner;
- The information, or type of information, to be communicated in the confidential manner requested (this may be limited to a particular illness or treatment or to all exchanges of protected health information);
- If applicable, the time period for which the request applies;
- If confidential handling of billing matters is also requested, the manner in which payment of premium will be made.
To download a Confidential Communication Request Form click here.
Requests should be addressed to:
Colonial Penn Life Insurance Company
399 Market Street
Philadelphia, PA 19181
A confidentiality request may be revoked at any time by mailing a letter of instruction to the address above.
For further information on domestic violence services, contact the Illinois Domestic Violence Hotline. Hotline: 1-877-863-6338
We recommend that participating health service providers print and post this information in their offices.