Understanding the Privacy of Your Therapy Notes: Key Insights Before Signing Insurance Forms

Real Stories

Marcus's Story: Short-Term Disability

Marcus* had been with his company for eight years when he hit a wall. The panic attacks started suddenly: heart racing, couldn't breathe, feeling like he was dying. His doctor diagnosed severe anxiety and recommended he take short-term disability leave to focus on treatment.

Two weeks into his leave, his employer's insurance provider sent him a consent form requesting his complete therapy records. The letter was clear: "To continue receiving benefits, we require documentation of your treatment and progress."

Marcus was already anxious about money, short-term disability only covered 60% of his salary. He had a mortgage, two kids, and his wife had just been laid off. He was terrified that if he didn't sign immediately, his benefits would be cut off.

So he signed. He didn't realize he was giving them access to everything- including the sessions where he'd talked about his sexuality (something he wasn't out about at work), his father's suicide, his struggles with alcohol years ago, and his fears about his manager's discriminatory comments (the actual trigger for his breakdown).

When his claim came up for review, the insurance company questioned whether his anxiety was "pre-existing" based on mentions of past trauma. They suggested his alcohol use from five years ago might be a factor. They extended their review period, delaying his benefits.

Marcus felt violated. He'd shared those things in confidence with his therapist to heal, not to have them used against him by his employer's insurance company.

Marcus didn't give informed consent. He signed away his privacy because he was desperate to keep his benefits.

Sarah's Story: Motor Vehicle Accident

Sarah* had been in a car accident. She was dealing with chronic pain, PTSD from the collision, and couldn't work. Her insurance company sent her a form requesting access to her therapy records to process her motor vehicle accident claim.

She was barely sleeping. Her bills were piling up. She was terrified of losing her home. When that form arrived with a note saying her claim couldn't proceed without it, she signed it immediately. She didn't read it carefully. She didn't ask questions. She just needed her claim approved so she could survive.

Three weeks later, her insurance adjuster called to discuss "concerning details" from her therapy notes. Things she'd shared about childhood trauma, her marriage struggles, a past depressive episode. None of it was related to the accident. But now it was all in her file, being used to question the legitimacy of her current symptoms.

Sarah didn't give informed consent. She signed away her privacy out of desperation.

*(Names changed for privacy)

A cozy therapy space with a notepad ready for notes

An Addendum to Insurance Companies

Let's be clear about what's happening here.

When you request full clinical notes from clients who are:

• Unable to work due to injury or illness

• In chronic pain or psychological distress

• Facing financial crisis

• Desperate for their claims to be approved

• Worried about losing their income, their home, their stability

You are not obtaining informed consent. You are exploiting vulnerability.

Whether it's a motor vehicle accident claim, a short-term disability claim, or a long-term disability claim, clients in compromised health are signing forms they don't fully understand because they're in survival mode. They're not thinking about privacy- they're thinking about keeping the lights on, feeding their families, and getting the treatment they need.

This is coercion dressed up as consent.

True informed consent requires:

• Mental and emotional capacity to understand what's being agreed to

• Time to review and ask questions

• Freedom from duress or desperation

• Clear explanation of alternatives

• Understanding of what information is actually relevant to the claim

A person in crisis, facing financial ruin, cannot freely consent to giving away their most private therapeutic conversations.

Insurance companies: You have a responsibility to request only what is necessary and relevant to the claim: not everything a person has ever shared in therapy. A functional assessment or treatment summary can verify care without violating the therapeutic relationship.

Do better.

A notepad and pen resting on a therapy couch, ready for notes

The Reality Check

Let's talk about something that doesn't get discussed enough in therapy spaces: what happens to your confidentiality when insurance companies come knocking.

You've been doing the work. Showing up to therapy, being vulnerable, unpacking trauma, sharing things you've never told anyone else. Your therapist has created a safe space where you can finally be authentic without judgment.

Then you're in an accident, or you go on short-term disability, or you file a long-term disability claim, and suddenly your insurance company wants to see your clinical notes.

Here's what most people don't realize: When you sign that consent form for your insurance company, you might be giving them access to everything you've shared in your most vulnerable moments- including things that have nothing to do with your current claim.

Why This Matters

Therapy works because of trust. You need to know that what you say in that room (or on that screen) stays between you and your therapist. When clients know their words might end up in an insurance file, reviewed by strangers who are looking for reasons to approve or deny claims, something shifts.

You might:

• Hold back on sharing certain struggles

• Downplay your symptoms

• Avoid discussing topics that feel "too much"

• Second-guess your honesty

• Worry that past mental health issues will be used against your current claim

• Fear that personal details (sexuality, family trauma, relationship issues) will be exposed to your employer's insurance provider

And that defeats the entire purpose of therapy.

What Insurance Companies Are Really Asking For

When an insurance company requests your clinical notes for a motor vehicle accident, short-term disability, or long-term disability claim, they're often asking for:

• Session-by-session documentation

• Your diagnosis and treatment plan

• Detailed notes about what you discussed (including things unrelated to your claim)

• Your therapist's clinical observations and assessments

• Information about your progress (or lack thereof)

• Your entire mental health history

• Personal disclosures about trauma, relationships, identity, and past struggles

They frame it as necessary to process your claim. And while they do need some information to verify you're receiving treatment, they don't necessarily need access to everything.

The problem? When you're unable to work, in pain, and bills are mounting, you're not in a position to question what they're asking for. You just sign and hope your claim gets approved.

Here's What You Need to Know

1. You Have Rights

Even in a crisis, you don't have to sign away complete access to your therapy notes. You can:

• Request that only a summary be provided instead of full session notes

• Ask your therapist to provide a functional assessment rather than detailed clinical content

• Limit what information is shared to only what's relevant to your current claim

• Specify exactly what the insurance company can access

• Ask for time to review the form with your therapist before signing

• Request clarification on what "complete therapy records" actually means

• Refuse consent entirely (though this may affect your claim—and insurance companies know this)

  
  

2. Your Therapist Should Protect Your Privacy

At ReiDefine Wellness, we believe in protecting the sanctity of the therapeutic space. That means:

• We will never release your full clinical notes without discussing it with you first

• We can provide insurance companies with functional summaries that verify treatment without exposing your private conversations

• We'll help you understand exactly what you're consenting to before you sign anything

• We'll advocate for your right to privacy while supporting your motor vehicle, short-term disability, or long-term disability claim

• We'll push back on overly broad requests that aren't relevant to your claim

• We'll help you understand what's actually necessary versus what's invasive

  
  

3. There Are Alternatives

You don't have to choose between getting the support you need and protecting your privacy. Options include:

• Functional assessments: Your therapist can provide a letter confirming treatment, diagnosis, and how your condition affects your ability to work or function—without detailing what you discuss in sessions

• Limited consent forms: Specify exactly what can be shared (dates of service, diagnosis related to the claim, treatment goals) and what cannot (session content, personal disclosures, unrelated mental health history)

• Separate documentation: Some therapists keep two sets of notes—clinical notes for therapeutic purposes and administrative notes for third parties

• Time-limited consent: Consent that covers only the period relevant to your claim, not your entire therapeutic history

• Condition-specific consent: Consent that covers only information related to the condition for which you're claiming benefits

  
  

What We're Doing Differently

At ReiDefine Wellness, we're committed to:

• Educating clients upfront about confidentiality limits and insurance requests

• Creating consent forms that clearly explain what you're agreeing to

• Offering alternatives to full note disclosure whenever possible

• Protecting your therapeutic space so you can continue to be vulnerable and authentic

• Advocating on your behalf when insurance requests are overly broad or invasive

• Never taking advantage of your vulnerable state to push through consent you don't fully understand

• Helping you understand what's actually required versus what's being requested

  
  

Before You Sign Anything

STOP. Take a breath. Then ask these questions:

1. What exactly is the insurance company requesting?

2. Do they need full clinical notes, or will a summary suffice?

3. Can my therapist provide a functional assessment instead?

4. What information is actually relevant to my current claim?

5. What are my options if I don't want to release detailed notes?

6. How will this affect my claim?

7. Can I have time to review this with my therapist before signing?

8. Am I signing away access to my entire therapy history, or just information related to this claim?

9. Will my employer have access to this information?

10. What happens if I limit what I consent to share?

Remember: Your insurance company works for you. You have the right to understand what you're signing and to ask for alternatives that protect your privacy, even when you're desperate for your claim to be approved.

You are allowed to protect yourself, even in crisis.

The Bottom Line

Therapy is sacred. It's one of the few places where you should be able to show up exactly as you are, without fear of judgment or consequences. When insurance companies request access to your clinical notes (especially when you're already in a vulnerable, desperate state) that safety can feel compromised.

You deserve to know:

• What you're signing

• What your options are

• That your therapist will protect your confidentiality as much as possible

• That signing away your privacy out of desperation is not true informed consent

• That you have the right to question what's being requested

  
  

At ReiDefine Wellness, we're not just here to provide therapy, we're here to protect the space that makes healing possible. Even when insurance companies come knocking. Even when you're in crisis. Even when it feels like you have no choice.

You have a choice. We'll help you understand it.

Have questions about confidentiality, insurance requests, or your rights as a client? Reach out to us at admin@reidefinewellness.com or call 780-851-4676. We're here to support you, advocate for you, and ensure your therapy remains a safe space, no matter what your insurance company is asking for.

Your healing matters. Your privacy matters. Both can coexist.

ReiDefine Wellness is a multi-provincial holistic wellness center, providing trauma-informed, culturally responsive therapy across Alberta, Saskatchewan, and Ontario. We believe in decolonizing mental health care and protecting the therapeutic relationship above all else.