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New York Domestic Violence Notice

New York Confidentiality Protocol for Victims of Domestic Violence and Endangered Individuals

New York Insurance Law 2612 requires that certain insurers establish procedures to protect and limit access to certain personal information related to a victim of domestic violence.

New York Insurance Law 2612 provides that, if any person covered by an insurance policy delivers to the insurer a valid court order of protection issued by a court of competent jurisdiction in New York State against the policyholder or other person covered by the policy, then the insurer is prohibited for the duration of the order from disclosing to the policyholder or other person the address and telephone number of the insured, or of any person or entity providing the covered services to the insured. If the child is a covered person, then the right may be asserted by the child’s parent or guardian.

New York Insurance Law 2612 also requires a health insurer, as defined in that section of the law to include an accident and health insurer, to accommodate a reasonable request made by a person covered by an insurance policy to receive communications of claim related information by alternative means or at alternative locations if the person clearly states that disclosure of the information could endanger the person. If the covered person is a child, then the right may be asserted by the child’s parent or guardian. The law further provides that, except with the express consent of the person making the request, a health insurer may not disclose to the policyholder: (1) the address, telephone number, or any other personally identifying information of the person who has made the request or child for whose for whose benefit a request was made; (2) the nature of the health care services provided; or (3) the name or address of the provider of covered services.

Procedure to Make a Request

To submit a valid court order of protection and / or a request to receive communications of claim related information by alternative means or at alternative locations to Central States Indemnity Co. of Omaha please use the following address:

Central States Indemnity Co. of Omaha
1212 North 96th Street
Omaha, NE 68114
Attention: Confidentiality Request

Please include:

  1. Policy information if available.

  2. Any Alternative address, telephone number or other method of contact; and

  3. A valid court order of protection issued by a New York State Court and / or a statement that the disclosure of claim related information could endanger the person seeking confidentiality

To revoke a request, please mail a notarized letter to the above address.

For further information on domestic violence services, please contact the New York State Domestic and Sexual Violence Hotline at 1-800-942-6906.
You may also access the following website: http:www.opdv.ny.gov/help/dvhotlines.html

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