Disability Income Protection

Disability Income Protection

American Labor Life Insurance Company

Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Notice of Privacy Practices for Personal Health Information



The purpose of this notice is to explain how you can obtain, use and disclose your health information. Please read through it carefully.

Note: The HIPAA regulations, in regards to Personal Health Information, apply only to the information we collect relating to our disability insurance.

By law, we are required to protect the confidentiality of Personal Health Information and furnish you notices of our legal responsibilities and Privacy Practices regarding Personal Health Information. We are required to abide by the terms of this notice for as long as it is in effect. If necessary, we reserve the right to change our Privacy practices, procedures, and terms of this HIPAA Notice of Privacy Practices for Personal Health Information as needed, and put a new Notice in effect immediately for all Personal Health Information maintained by us. If any materials change is made that effects the terms of this notice, a revised notice will be provide to all primary policy holders.

Use And Disclosure of Your Personal Health Information



We will not use or disclose your Personal Health Information for any other purpose except as stated below unless we have permission from you in writing. You have the right to withdraw your permission in writing. We will honor your request of withdrawal as of the date of receipt and to the point that we have not already used or disclosed your Personal Health Information in good faith with your prior authorization. With the exception of the following, we reserve the right to use and disclose your Personal Health Information:
  • As necessary for payment purposes such as the payment of claims.
  • As permitted by law for regular business operations including but not limited to customer service, claims, underwriting, premium rating, detection or prevention of fraud or abuse, and any other issues regarding your disability insurance.
  • We may use and disclose your Personal Health Information to provide you with information regarding other benefits and services that may be of interest to you.
With your permission, your Personal Health Information may be disclosed to individual family members, friends or others to assist them in your care or to pay for your care. In the event that you are incapacitated, unavailable, or in an emergency medical situation and we have determined that limited disclosure of some of your Personal Health Information is in your best interest, we may disclose said information to those individuals without your approval.

There may also be times when it becomes necessary for us to release some Personal Health Information to an outside organization or person to support us in our regular business activities. However, these business partners are also required to honor and protect the privacy of your Personal Health Information as well.

There are other uses and disclosures that we may furnish to third parties without your approval as required and/or permitted by law, they are:
  • Any purposes as required by law
  • Reporting of certain required diseases to public health facilities
  • If there is any suspicion of child abuse or neglect
  • If we suspect that you are a victim of abuse, neglect, or domestic violence
  • Government oversight agencies that conduct audits, investigations, civil and/or criminal investigations
  • If order to do so by a court or administrative subpoena, qualified protective order or discovery request
  • To law enforcement officials as required by law
  • Funeral directors and/or coroners consistent within the law
  • For some research projects that have been approved by an institutional review board with established regulations to protect the privacy of people involved.
  • As required by the military if you are a member or veteran of the armed forces services
  • If required for national security or intelligence services
  • When needed to prevent a threat to your health and/or safety or health and/or safety of any other individual or the public at large
  • If required by worker compensation agencies or similar programs to substantiate your qualifications to receive workers’ compensation benefit

Individual HIPAA Privacy Rights


As long as we have your Personal Health Information on file, you have the right to receive and inspect a copy of specific items contained therein such as claim or policy information. Conversely, we may also deny your request to receive or inspect certain Personal Health Information as is required or allowable by law. This includes, but is not limited to, psychotherapy information or notes collected by us relating to the reasonable expectation of a criminal, civil, or administrative proceeding or action. We also have the right to require any such requests be in writing and should include as much detail as possible regarding the information you would like to inspect or copy. Furthermore, we may also impose a reasonable charge for access to your Personal Health Information.

You have the right to request an amendment to the Personal Health Information we have on file if you believe it to be incorrect. We will give each request appropriate review and due consideration, but are not legally required to accept all requested amendments. Said request for the amendment(s) must be in writing and clearly state the reason(s) for such a request.

You have the right to request an accounting or list of certain disclosures by us of your Personal Health Information. However, we are not required by law to provide an accounting of all disclosures, but will give due consideration to every request. As stated previously, all said requests must be written and will not include any accounting prior to July 1, 2008.

You have the right to request certain use and disclosure of your Personal Health Information for payment, treatment, and/or health care operations to be restricted by notifying us in writing. We are not legally required to agree to all said requests, but will make every attempt to review and accommodate each request.

You have the right to request that any communications relating to your Personal Health Information are made available to you by alternative means or location. We will agree to any reasonable request if our regular procedure of disclosure would endanger you. All said requests must be made in writing and addressed to the Privacy Officer at American Labor Life Insurance Company, 8 Marticville Rd., Lancaster, PA 17603 and include the reason you would be endangered by not using an alternative form of communication.

If you believe your privacy rights have been violated, you have the option of filing a complaint with us in writing, or with the Secretary of the U.S. Department of Health and Human Services at the address indicated below. There will be no retaliatory actions against you for filing a complaint.

U.S. Department of Health and Human Services
200 Independence Ave. SW
Washington DC 20201


If you have any questions or need additional assistance in regards to this notice or wish to exercise any of your rights outlined above, please contact the HIPAA/Privacy Officer at the address indicated below:

Attention: Privacy Officer
American Labor Life Insurance Company
8 Marticville Road
Lancaster, PA 17603
(800) 437-1670



Note: Individual state laws may provide you with additional privacy rights. Contact your own state for additional information regarding those rights.

This HIPAA Notice of Privacy Practices for Personal Health Information is effective July 1, 2008.



American Labor Life Insurance Company  8 Marticville Road, Lancaster PA 17603  Phone (800) 437-1670
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