Domestic Violence Notice

Privacy request procedure

We respect and take seriously the protection of an individual’s personal information. If you are a victim of domestic violence or other abuse, you may request that we send communications of claim related or policy related information to you by alternative means or at alternative locations. To provide us with an alternative address, telephone number, or other method of contact, write to us at the address below:

QBE North America
Attn: Privacy Official Corporate Legal Department
One General Drive
Sun Prairie, WI  53596

Please be advised that we have up to three business days to implement your request.

Procedure to revoke a request

If you previously submitted a request for privacy and would now like to revoke that request, write to us at the address above.

Additional Information for Residents of New York State

Section 2612 of the New York Insurance Law states that no insurer, solely because an individual is or has been the victim of domestic violence, may:

  1. refuse to issue or renew, deny or cancel any insurance policy;
  2. demand or require a greater premium or payment from any person; or
  3. designate domestic violence as a preexisting condition, for which coverage will be denied or reduced;

The fact that a person is or has been a victim of domestic violence is not a permitted underwriting criterion.

Under Section 2612 an insurer must keep confidential and shall not disclose the address and telephone number of an insured that is the victim of domestic violence, or any child residing with the victim, and the name, address, and telephone number of a person providing covered services to the victim, to a policyholder or another insured covered under the policy against whom the victim has a valid order of protection, if the victim, the victim’s legal representative, or if the victim is a child, the child’s parent or guardian, delivers to the insurer at its home office a valid order of protection.

Insurance Law Section 2612 also requires a health insurer, as defined in that section, to accommodate a reasonable request made by a person covered by an insurance policy or contract 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 a child is the covered person, then this right may be asserted by the child’s parent or guardian. 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 made the request or child 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 the covered services.

For additional assistance, please contact the New York State Domestic and Sexual Violence Hotline.

NYS Domestic and Sexual Violence Hotline: 800.942.6906
In NYC: 800.621.HOPE (4673) or dial 311
TTY: 866.604.5350

NYS Office for the Prevention of Domestic Violence: http://www.opdv.ny.gov/help/dvhotlines.html

Additional Information for Residents of Illinois

For Illinois Insurance Law 215 ILCS 5/355b, with respect to any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance shall accommodate a reasonable request by a person covered by a policy issued by the company to receive communications of claim-related information from the company by alternative means or at alternative locations if the person clearly states that disclosure of all or part of the information could endanger the person.  If a child is a covered person, then the right established by this section may be asserted by the child’s parent or guardian.

Except with the express consent of the person making the request, a company may not disclose to the policyholder: (1) the address, telephone number, or any other personally identifying information of the person who made the request or child 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 health care services.

The Illinois Department of Insurance ("Department") has promulgated 50 Ill. Admin Code 2928.30, which requires companies to develop and implement confidentiality protocols. The protocols must include written procedures by which a person may make a reasonable request, provided that the procedure does not require a justification as part of the reasonable request; the procedure by which the requestor may provide an alternative address, telephone number or other method of contact; and the procedures for revoking such a request.

For further information on domestic violence services, you can contact the Illinois Domestic Violence Helpline by dialing 1-877-863-6338 or by accessing the website for the Illinois Department of Human Services Domestic Violence Victim Services at the following link: https://www.dhs.state.il.us/page.aspx?item=30275