What to Do When the Insurance Company Requests Your Medical Records

A few weeks after your car accident, you receive a packet in the mail from the at-fault driver’s insurance company. Inside is a friendly letter and a seemingly standard form: the “Authorization for Release of Medical Records.” The insurance adjuster explains that in order to evaluate your injury claim, they need you to sign this form so they can get your medical records directly from your doctors. It sounds like a reasonable step in the process.

Stop. Do not sign that form.

This request is one of the most critical moments in your personal injury claim, and the authorization form the insurance company sends you is a trap. It is an intentionally broad, all-encompassing document that gives the insurer permission to dig through your entire, lifelong medical history.

While an insurance company has a right to review the medical records that are relevant to your accident injuries, they do not have the right to go on a fishing expedition through your private medical past to find anything they can use to deny your claim. How you handle this request is crucial to protecting both your privacy and the value of your case.

Useful Information for You: In a Nutshell

• Do NOT Sign the Insurer’s Blank Authorization: The release form provided by the at-fault driver’s insurer is almost always overly broad and gives them access to your entire medical history.
• They are Searching for Pre-Existing Conditions: The adjuster’s goal is to find any evidence of a prior injury or condition that they can use to argue your current pain is not from the car accident.
• You Control the Flow of Information: You and your attorney should be the ones to collect and provide only the relevant medical records to the insurance company.
• Your Own Insurer is Different: You do have a contractual duty to cooperate with your own insurance company for a PIP claim, which includes providing them with access to your records, but this should still be handled carefully.
• An Attorney Can Protect Your Privacy: A lawyer will never sign a blank authorization. They will obtain your records themselves and only release the specific documents that are pertinent to your accident claim.

The Danger of the “Blank Check” Authorization

The medical authorization form the at-fault insurer sends you is the equivalent of a blank check. It often gives them the power to:

• Access your entire medical file from every doctor you have ever seen, from birth until the present day.
• Speak directly with your doctors and other healthcare providers without you or your attorney being present.

They are not using this access to be thorough. They are using it to find ammunition against you. Did you see a chiropractor for a sore back five years ago? They will argue your current back pain is from that, not the crash. Did you ever mention feeling anxious to your doctor? They will argue your emotional distress is a pre-existing condition.

The Right Way to Share Medical Records

You do have to provide medical evidence to prove your injury claim. The key is that you control the process.

1. You and Your Attorney Obtain the Records: You, or your attorney on your behalf, will request the records directly from your medical providers (the ER, your primary care doctor, your physical therapist, etc.).
2. You Review the Records: Your attorney will carefully review the records to ensure they are complete and accurate.
3. You Provide Only the RELEVANT Records: Your lawyer will then send the insurance company only the specific records that are relevant to the injuries and treatment related to your car accident. This protects your privacy and prevents the adjuster from going on a fishing expedition.

What About My Own Insurance Company?

When you open a Personal Injury Protection (PIP) claim with your own insurer, you do have a contractual duty to cooperate with their investigation. They will also ask you to sign a medical authorization. While you must cooperate, it is still wise to have an attorney review their authorization to ensure it is reasonably limited in scope and time.

Protecting your private medical history is your right. You are not required to give an adversarial insurance company unfettered access to your entire life to get a fair settlement. If you have been injured in an accident in the Tacoma area and the insurance company is demanding you sign a medical authorization, search the Car Accident Lawyer Directory Tacoma. Compare profiles and find a trusted local attorney who can step in, protect your private information, and handle the claims process the right way.

References

• U.S. Department of Health & Human Services – HIPAA – “Your Rights”:Official information on the Health Insurance Portability and Accountability Act (HIPAA), which gives you the right to control who has access to your protected health information.

  https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

• Washington State Office of the Insurance Commissioner (OIC) – What to do if you have an accident:Official guidance on the claims process, which involves providing proof of your injuries to the insurer.

  https://www.insurance.wa.gov/what-do-if-you-have-accident-and-need-file-claim

• Washington State Bar Association (WSBA) – Public Resources:Provides guides on the legal system, including the “discovery” process where medical records are exchanged.

  https://www.wsba.org/for-the-public