Calling insurance on behalf of someone else is legal, but the company won’t discuss the account until you prove you’re allowed to hear the details. What counts as proof depends on the type of insurance, the insurer’s own rules, and whether the policyholder is still able to participate. Sometimes a quick joint phone call is enough. Other times you’ll need a power of attorney, a court order, or the insurer’s own authorization form on file.
The Easiest Path: A Joint Call
Before gathering legal documents, try the simplest option. If the policyholder is available and willing, most insurers will let them call in, verify their identity, and give verbal permission for you to speak on the line. Some companies then notate the account so you can call independently in the future. Others treat the consent as a one-time event and require the policyholder to call in again next time. Ask during the call which approach the insurer uses, so you know whether you’ll need to repeat the process.
This route works well for routine questions: checking a claim status, asking about a bill, or confirming coverage details. It saves everyone time and avoids the review period that comes with formal documents.
Claims Against the Other Driver’s Insurance
One situation catches people off guard. If you were in an accident and want to file a claim against the other driver’s insurance, you do not need that driver’s permission. You can contact their insurer directly, report the claim, and negotiate your settlement. The other company may dispute fault and offer only partial payment, but the right to file and pursue the claim on your own is yours.
The Insurer’s Own Authorization Form
Many insurance companies offer third-party authorization forms as a simpler alternative to legal documents. These let a policyholder name someone who can access account information and discuss policy details. The scope is usually narrower than a power of attorney. A typical authorization form allows the designated person to receive documents, ask questions about coverage, and get account updates, but does not authorize withdrawals or changes to the policy.
Requirements vary. Some insurers require notarized signatures or a Medallion Signature Guarantee from a bank. The authorization usually stays in effect until the policyholder revokes it in writing or passes away. If the person signing is doing so under a power of attorney or guardianship, expect the insurer to want a copy of that legal document as well.
Call the insurer’s customer service line to request the correct form. Many are downloadable, but the format and requirements differ enough that you should use the one built for that company and policy type.
Power of Attorney
A power of attorney is a legal document in which one person (the principal) appoints someone else (the agent) to act on their behalf. The principal must be mentally competent when they sign it. Once someone has lost the ability to understand what they’re agreeing to, it’s too late to create one. The scope can be broad, covering all financial and legal matters, or narrow, covering a single insurance policy.1Federal Long Term Care Insurance Program. Understanding Powers of Attorney
The most important distinction is between durable and non-durable versions. A non-durable power of attorney stops working if the principal becomes incapacitated, which is exactly when most families need it most. A durable power of attorney remains in effect even after the principal can no longer make decisions, making it far more useful for long-term caregiving.1Federal Long Term Care Insurance Program. Understanding Powers of Attorney
Handing a power of attorney to an insurer is not always straightforward. The company will review the document to confirm it grants authority relevant to the specific type of insurance involved. A healthcare power of attorney, for example, usually covers medical decisions but may say nothing about managing a policy’s financial details.1Federal Long Term Care Insurance Program. Understanding Powers of Attorney Expect a review period. Don’t be surprised if they ask for the original rather than a copy, or request proof that the power of attorney hasn’t been revoked and that the principal is still alive.
Guardianship or Conservatorship
When someone has already lost the ability to manage their own affairs and no power of attorney exists, a court-appointed guardianship or conservatorship is typically the only path forward. Unlike a power of attorney, which the principal creates voluntarily, guardianship requires filing a petition with a court, attending a hearing, and having a judge determine that the person truly cannot handle their own decisions. The process is more time-consuming and expensive. Court filing fees alone commonly range from around $40 to over $400 depending on the jurisdiction, and attorney fees add significantly to the cost.
Once appointed, a guardian generally has broad authority over the ward’s personal and financial matters, including dealings with insurance companies. The court order itself serves as your proof of authority. Keep certified copies on hand, because insurers will want to see the documentation before sharing any account information. Courts also impose ongoing reporting obligations; you may need to file periodic accountings showing how you’ve managed the ward’s affairs.
Health Insurance and HIPAA
Health insurance operates under stricter privacy rules than other types of insurance. The HIPAA Privacy Rule applies to health plans, including medical, dental, vision, and prescription drug insurers, and sets national standards for how these entities can use and share protected health information.2U.S. Department of Health & Human Services (HHS). Summary of the HIPAA Privacy Rule
If you hold a power of attorney or guardianship that gives you authority over someone’s healthcare decisions, HIPAA requires the insurer to treat you as if you were the patient. You get the same access rights the patient would have, including the ability to request records, discuss claims, and authorize disclosures. The rule applies to anyone with legal authority under state or other applicable law to make healthcare decisions on the individual’s behalf.3eCFR. 45 CFR 164.502 – Uses and Disclosures of Protected Health Information
HIPAA is also more flexible than most people assume when it comes to family members involved in a patient’s care. If the patient is present and able to make decisions, a health plan or provider can share relevant information with a family member as long as the patient agrees, is given a chance to object and doesn’t, or the circumstances reasonably suggest the patient wouldn’t mind. When the patient is incapacitated and can’t weigh in, a covered entity can use professional judgment to decide whether sharing information with an involved family member is in the patient’s best interest.4eCFR. 45 CFR 164.510 – Uses and Disclosures Requiring an Opportunity for the Individual to Agree or to Object
Context matters more than paperwork here. A spouse sitting in the hospital room when a nurse discusses billing is a different situation from an estranged relative calling the insurer from across the country. The rule gives healthcare entities discretion, and outcomes will vary.
HIPAA does not apply to auto, homeowners, renters, or life insurance. Those insurers still won’t share your details with someone claiming to be a relative. They rely on their own authorization procedures, driven largely by internal policies and state insurance regulation.5Federal Trade Commission. How To Comply with the Privacy of Consumer Financial Information Rule Gramm-Leach-Bliley Act
Medicare-Specific Forms
Calling 1-800-MEDICARE on behalf of a beneficiary requires a specific authorization form. Form CMS-10106, “Authorization to Disclose Personal Health Information,” lets the beneficiary designate who can receive their personal health information and how much can be shared. The beneficiary signs the form, specifying either limited or full access, and mails it to the Medicare Written Authorization Department or submits it through their Medicare.gov account.6Centers for Medicare & Medicaid Services. Authorization to Disclose Personal Health Information Release Form
For Medicare appeals and claims disputes, a separate form applies. Form CMS-1696, “Appointment of Representative,” lets the beneficiary appoint someone to handle a specific claim, appeal, grievance, or request. Both the beneficiary and the representative must sign it. The appointment lasts one year from the date both signatures are in place and can be used for multiple appeals during that period.7Centers for Medicare & Medicaid Services. Appointment of Representative – CMS Form 1696
If a personal representative is completing the CMS-10106 form on behalf of someone who can’t sign for themselves, they need to attach supporting documentation such as a power of attorney.6Centers for Medicare & Medicaid Services. Authorization to Disclose Personal Health Information Release Form
After the Policyholder Dies
When a policyholder dies, any existing power of attorney becomes void. It terminates at death. Authority to manage the deceased person’s insurance affairs shifts to the executor named in their will or, if there’s no will, to an administrator appointed by a probate court. The executor receives a letter of testamentary (or letter of administration when there’s no will) from the court, which serves as official proof of authority to act on behalf of the estate.
Insurers will typically require a certified copy of the death certificate along with the letter of testamentary or administration before they release information or process claims. For Medicare specifically, requesting information for a deceased beneficiary requires submitting documentation such as executor papers, next-of-kin verification with a court stamp and judge’s signature, or a letter of testamentary or administration.6Centers for Medicare & Medicaid Services. Authorization to Disclose Personal Health Information Release Form
Don’t wait to contact the insurer. Some policies have claim filing deadlines, and auto or homeowners coverage on the deceased person’s property may need to be maintained or transferred quickly to avoid a gap.
What Happens If You Call Without Authorization
The most likely outcome of calling without proper documentation is that the insurer refuses to talk to you. They’ll say they can’t share information and end the conversation. That’s not a legal consequence. It’s the system working as designed.
For the person calling, the actual legal risk is narrow. Impersonating a policyholder to extract information, using someone else’s insurance details to commit fraud, or accessing account information to cause financial harm can lead to civil lawsuits and, in extreme cases, criminal charges. Simply calling to ask about a family member’s policy and being turned away is not a violation. It’s an unsuccessful phone call. The line between innocent inquiry and actionable conduct is whether deception or harm is involved.
Practical Tips for a Smooth Call
Insurance companies deal with authorized representatives constantly, and they deal with fraud attempts constantly. Preparation makes the process easier on both sides.
- Have the policy number ready. The insurer will also ask for the policyholder’s full name, date of birth, and sometimes their address or last four digits of their Social Security number.
- Send documents before you call. If you have a power of attorney or guardianship order, fax or email it to the insurer in advance so it can be reviewed and logged.
- Keep certified copies. Insurers often want originals or certified copies of court documents, not regular photocopies. Order multiple certified copies of any guardianship order or letter of testamentary; banks and investment accounts will want them too.
- Ask what’s on file. If the policyholder previously submitted authorization paperwork, the insurer should have it in their system. Confirm it’s still active before launching into questions.
- Document everything. Write down the date, time, representative’s name, and reference number for every call. If a dispute arises later about what was discussed or authorized, those notes become valuable.