Notwithstanding any other provision of law of this Commonwealth, no insurance institution, agent, or insurance-support organization shall utilize as its disclosure authorization form in connection with insurance transactions involving insurance policies or contracts issued after January 1, 1982, a form or statement that authorizes the disclosure of personal or privileged information about an individual to the insurance institution, agent, or insurance-support organization unless the form or statement:
3. Specifies the types of persons authorized to disclose information about the individual;
4. Specifies the nature of the information authorized to be disclosed;
5. Names the insurance institution or agent and identifies by generic reference representatives of the insurance institution to whom the individual is authorizing information to be disclosed;
6. Specifies the purposes for which the information is collected;
7. Specifies the length of time such authorization shall remain valid, which shall be no longer than: a. In the case of authorizations signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement, or a request for change in policy benefits:
1. Thirty months from the date the authorization is signed if the application or request involves life, accident and sickness, or disability insurance; or
2. Two years from the date the authorization is signed if the application or request involves property or casualty insurance; b. In the case of authorizations signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy:
1. The term of coverage of the policy if the claim is for an accident and sickness insurance benefit; or
2. The duration of the claim if the claim is not for an accident and sickness insurance benefit; and
8. Advises the individual or a person authorized to act on behalf of the individual that the individual or the individual’s authorized representative is entitled to receive a copy of the authorization form.