Everyone expects to see the death certificate on the insurer's list of documents. What surprises many people are the next few lines on the list: “medical document certifying the cause of death”, “copy of the hospital discharge summary”, “GP's certificate on the onset of the illness”. This is when the grieving relative faces two questions: are they even entitled to request their mother's or husband's medical records from the hospital – and why does the insurer need them at all, if the fact of death is not in question? As a broker, I see that some funeral insurance cases get stuck here rather than at the insurer. This article looks at the legal basis, the practical steps and the role of the waiver of medical confidentiality signed when the policy was taken out; the full list of documents is set out in the document checklist, and the official documents in the article on the death certificate.
- Under Section 24(11) of the Health Act (Eütv.), after a patient's death, their legal representative, close relatives and heirs may, on written request, access the data relating to the cause of death and to the treatment preceding death, inspect the medical records and obtain a copy of them.
- The insurer does not ask for medical records out of curiosity: for a death from illness within the waiting period, when checking the duty of disclosure, and for an additional accident benefit, the cause of death decides what the insured event is – which is why Hungarian policy conditions ask for copies of the medical certificate of death and the hospital discharge summaries.
- The waiver of medical confidentiality signed when the policy is taken out allows the insurer to request the data from the treating doctor and the hospital itself; under the Insurance Act (Bit.), it may process health data only with the written consent of the person concerned – this declaration reduces the family's burden even after death.
Why does the insurer ask for medical records if the death is not in dispute?
Because in funeral insurance, what is payable is decided not by the fact of death but by its nature. Hungarian policy conditions typically ask for medical documentation in three situations. The first is the waiting period: if death occurred in the first period of the contract, the insurer examines whether it was caused by illness or by an accident, because in such cases a reduced benefit or a refund of premiums may be payable for death from illness, whereas for accidental death the full sum is typically payable. The second is the duty of disclosure: under Section 6:452 of the Hungarian Civil Code (Ptk.), material circumstances must be disclosed when the policy is taken out, and if the death is connected with an undisclosed illness that already existed before the policy was taken out, the insurer's obligation to pay does not arise – unless the five years under Section 6:482 of the Ptk. have already passed. For this, the insurer needs to see when the illness began, which is why it asks for a GP's certificate or earlier test results. The third is the accident element: if the contract includes an additional accident benefit, the accidental cause is proved by the medical certificate of death, the hospital discharge summary or the autopsy report. For a natural death after the waiting period has ended, insurers are typically satisfied with the death certificate and a copy of the medical certificate of death – in the document list of one Hungarian set of conditions, too, these two items come first, and the hospital discharge summary is required only if it is needed because of the cause or time of death. Details can be found in the article on when funeral insurance does not pay.
Who is entitled to request the deceased's records? What the Health Act (Eütv.) says
Under Section 24(11) of Act CLIV of 1997 on Health (the Health Act, Eütv.), in the event of a patient's death, their legal representative, close relatives and heirs are entitled – on the basis of a written request – to access the health data relating, or potentially relating, to the cause of death and the data relating to the medical treatment preceding death, to inspect the medical records and to obtain a copy of them. Three things follow from this that matter in an insurance claim. First: the circle of those entitled is wide. The Health Act itself defines close relative (Section 3(r)): spouse, relative in the direct line, adopted child, stepchild and foster child, adoptive parent, step-parent and foster parent, sibling and cohabiting partner – so here, unlike under the general definition of close relative in the Civil Code (Ptk.), the cohabiting partner is included. Heirs are also entitled, but heir status is proved by the probate order, which is issued months later – so in practice the close-relative route is faster. Second: the right covers not the entire medical history but the data relating to the cause of death and to the treatment preceding death – precisely what the insurer asks for. Third: a written request is required, for which institutions ask for a copy of the death certificate and proof of the family relationship – a birth or marriage certificate, or a declaration in the case of a cohabiting partner. It is worth knowing that the data protection act (Infotv.) offers a separate route: if a person, during their lifetime, authorises someone in a public document or in a private document with full probative value, the authorised person may also exercise the right of access within five years of their death; without such an authorisation, a relative cannot request access on data protection grounds – so in an insurance claim, the rule of the Health Act described above is the route to take.
What to request, from whom – and what to expect?
The documents on the insurer's list originate in different places. The hospital discharge summary is issued by the hospital that provided the last treatment; many institutions have a form for requesting patient records and a separate procedure for the records of deceased patients, which is worth looking for on the institution's website or at its legal or data protection department. The medical certificate of death is issued by the doctor who examined the body under Government Decree 351/2013 on the examination of the deceased, and the family's copy often turns up via the funeral service provider; if it is missing, a copy can be requested from the issuing doctor or the hospital. The GP's certificate – on the insurers' own form, about the onset of the illness and the treatments – is completed by the GP; this is the most common sticking point, because the GP does not always know to whom it may be released, so take with you a written request referring to Section 24(11) of the Health Act and the document proving the family relationship. The institution's information sheet explains the cost of making copies; the time needed to release the records varies between institutions, so report the claim to the insurer even if the medical records are still being processed – submitting missing documents later is a routine step.
The waiver of confidentiality: what did you sign it for when taking out the policy?
At the end of the health declaration in a funeral insurance application there is almost always a separate paragraph: the insured person releases their treating doctors and healthcare institutions from medical confidentiality towards the insurer. Under Section 25 of the Health Act, the patient is protected by medical confidentiality and may decide who can receive information about their state of health; and Section 135 of Act LXXXVIII of 2014 on the Business of Insurance (the Insurance Act, Bit.) states that the insurer may process data relating to a client's state of health only with the written consent of the person concerned. The waiver is therefore not a formality: it is the declaration on the basis of which the insurer can itself approach the hospital and the GP in the claim, so that the family does not have to collect every document. Practice differs from insurer to insurer – some insurers make use of this option and their medical expert requests data directly, while others primarily expect the documents from the relatives – but in both cases the declaration opens the way; in practice, insurers rely on it to request data even after the insured person's death, because the insured person gave it during their lifetime. If this declaration was not given when the policy was taken out, the insurer typically cannot approach the institutions directly for data protection reasons, and obtaining the documents is left to the family. The honest health declaration is on the same sheet – this is discussed in the article on the duty of disclosure.
If the institution will not release the records, or the insurer asks for more
The institutions' caution is understandable, but the law is clear: on a written request, with proof of entitlement, the documentation relating to the cause of death must be released. If the request is refused, ask for a written explanation and refer to Section 24(11) of the Health Act; the patients' rights representative – a member of staff of the Integrated Legal Protection Service (IJSZ) – can help, and on data protection matters you can turn to the Hungarian National Authority for Data Protection and Freedom of Information (NAIH). On the insurer's side the situation is different: if it asks for further medical documentation after the documents have been submitted, ask exactly what it needs and why – this shows which document is decisive. Under Section 6:453 of the Civil Code, a delay in reporting has legal consequences only if, as a result, a material circumstance can no longer be established, so submitting documents later does not in itself jeopardise the claim. If a case gets stuck or is disputed, I help where I can, acting on your behalf – for example, in clarifying which clause of the conditions the insurer's request is based on, and which document is worth requesting from which institution; I do not provide legal representation, and I cannot take over requesting the records on the family's behalf. An overview of typical sticking points is given in the article on common sticking points.
What to do in advance – and what to do when it happens?
In advance, when taking out the policy: complete the health declaration honestly, sign the waiver of medical confidentiality, and in the “papers in one place” folder write down the name and surgery of your GP and the institutions where you receive long-term treatment – so the family knows where to turn. When it has happened: ask the hospital for the discharge summary as early as when you collect the documents, keep the copy of the medical certificate of death, and do not wait for the medical records before reporting the claim to the insurer. The insurer pays only for what is an insured event under your contract – the medical record is precisely what proves that this event has occurred.
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Sources
- Eütv. – Act CLIV of 1997 on Health (the Health Act): Section 24(11) – access to the deceased's medical records (legal representative, close relative, heir, written request); Section 25 – medical confidentiality
- Eüak. – Act XLVII of 1997 on the Processing and Protection of Health and Related Personal Data: Section 3(j) – definition of close relative; Section 7(7)
- Hungarian Civil Code (Ptk.) Section 6:452 (duty of disclosure), Section 6:482 (life insurance – five-year rule), Section 6:453 (consequences of late notification)
- Bit. – Act LXXXVIII of 2014 on the Business of Insurance (the Insurance Act): Section 135 – insurance secrecy, processing of health-related data with written consent
- Infotv. – Act CXII of 2011 (the Information Act): Section 25 – exercising the deceased's rights within five years of death (authorised person, close relative)
- DRKR Legal – Access to a deceased person's medical records (who is entitled, proof, scope of the data, Infotv. Section 25)
- MVM Biztosítás – funeral insurance general terms and conditions (17.4.8: copy of the medical certificate of death; 17.4.18.3: copies of hospital discharge summaries)
