Assurant Health Privacy Practices Individual Rights and Forms

Access Inspect Copy PDF Icon
Right to Access:You have the right to request to access and/or inspect your protected health information in a designated record set.

Amend or Correct PHI PDF Icon
Right to Amend:If you feel that the information we have about you is incorrect, you may ask to have protected health information in a designated
record set amended.

Accounting of Disclosure PDF Icon
Right to an Accounting of Disclosures:You have the right to receive an accounting of disclosures made by us of your protected health information after April 14, 2003.

Restriction on Disclosures PDF Icon
Right to Request Restrictions:You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations.

Life Endangerment PDF Icon
Right to Confidential Communications:If you feel that your life may be in danger if Assurant Health contacts you at the address or phone number maintained in our records, you may request that we contact you in a different way or at a different location.

To open the HIPAA rights forms you will need Adobe Acrobat Reader Diagonal Arrow which is a free download from Adobe Corporation.

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