When to Provide Medical Records to an Insurance Company
Posted on behalf of Gordon & Partners on Jan 06, 2021 in Personal Injury
If you decide to pursue a claim after being injured in an accident, the insurance company may request to see all medical records concerning your injuries and medical treatments. They will need to corroborate your records with medical bills you submitted for compensation. However, an insurer does not have the right to view your medical records unless you sign a release form granting them access.
Below, we discuss how to proceed in these situations to protect your claim. A West Palm Beach-based personal injury lawyer from our firm is ready to help you pursue the maximum compensation possible for your damages. An initial consultation is free of charge. There is no obligation to move forward even after learning about your rights and available legal options.
Why an Insurer Wants Your Medical Records
An insurer will want to find out as much information as possible about the accident. They may say they need copies of your medical records to verify your injuries prior to compensating you. However, that is not the only reason the insurance company wants your records.
An insurer will also be looking for any information that can potentially be used to lower the value of your claim or deny it altogether. For instance, they may discover evidence of a preexisting injury you sustained in another accident years beforehand. The insurance company may argue that your injuries are not related to the most recent accident.
They may also be searching for inconsistencies in your statements throughout your medical care. An insurer may question your doctor’s prognosis concerning maximum medical improvement and will likely come up with their own prognosis while accessing your records.
Necessary Versus Unnecessary Medical Records
In signing a medical release form, you may assume that you are only allowing the insurance company to obtain copies of your most recent medical records. However, if this release form is not carefully worded, you may be granting an insurer access to your entire medical history. This is why it is important to know the right medical information to provide insurance companies.
Charts, notes, X-rays and other diagnostic tests related to the accident are considered necessary medical records. Daily treatment provided during a hospital stay or medications prescribed to help relieve your symptoms and provide pain relief could help show the extent and severity of your injuries.
On the other hand, any type of medical documentation not directly related to your claim is considered unnecessary and may actually hinder your ability to recover compensation.
Handling a Medical Records Request
If an insurer has requested access to your medical records, it is in your best interest to wait until you consult with a lawyer. He or she can help review any requests you receive, advise you of your legal rights, and even communicate with the insurance company on your behalf.
Sometimes, an insurer may attempt to trick an injury victim into providing unnecessary access to records in an effort to pay less for a claim that may be worth more. You can protect yourself by having a lawyer request your medical records to review them before having them sent to the insurance company.
Limit the Scope
Do not sign a blank release form as this will also give an insurer access to all your medical records. Limit the scope by only listing the specific doctors and hospitals that have treated your injuries since the accident and the date ranges of this care. Providing too much information that the insurance company does not really need only gives them more fuel to find reasons to devalue or deny your claim.
Right to Maintain Privacy
Unfortunately, an insurer may request additional medical records just to gather anything else that could be used against you. If the request seems like an unfair settlement tactic, do not agree to it. Ask the insurance company to explain why the additional records are needed.
If a reasonable explanation is not given, inform them that you do not believe these records are relevant to your claim and that providing these medical records would intrude on your privacy.
An injury victim has the right to maintain privacy when it comes to his or her medical history. If a settlement is not reached and your claim goes to court, a lawyer can also help argue this issue.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that helps protect against the unauthorized release or disclosure of your medical information. However, if you sign a medical release form, you will be waiving your medical privacy. This is why it is important to limit the information provided only to the injuries related to your claim.
Let Our Firm Represent Your Best Interests
At Gordon & Partners, we know how insurance companies think and the tactics they may use to hurt the value of your claim. One of our lawyers is prepared to help you negotiate a claim or file a lawsuit if your injuries are severe enough in order to obtain the compensation you need.
Our initial consultations are 100 percent free and confidential. We charge nothing up front for our services and only receive payment if we help you win.