You’ve been in an auto accident. You’re hurt and you’ve been to the emergency room for treatment. You may even require further treatment for your injuries. Someone has to pay for this and you naturally assume that the at-fault person’s insurance will cover your injuries. You’ve sent them the medical records from your car accident and emergency room visit detailing the injuries you suffered in the crash.
You hesitate. You’re not sure if you should provide these records. You’re not alone.
What About Privacy Laws?
It’s reasonable to wonder why the insurance company is asking for these records. First, you should know that because of HIPAA laws, the insurance company cannot access any of your medical records without your prior consent. Your hospital should know this, which is why other healthcare firms would even have a centralized medical record retrieval solution in place to protect all patient data and records. In short, this law protects your privacy when it comes to your medical records.
Insurance companies have healthcare experts who work for them and provide timetables for how long it takes to heal from an injury. It is likely that these timetables will differ from what your doctor says. Actuaries, who work to determine insurance policy payment rates, also work to determine how much your injury is worth, along with how much your premiums will be. They’re all about assessing risk.
Know that the insurance company is probably looking for any reason to blame your injuries on another cause or even doubt that the accident caused your injuries. They will be looking for inconsistencies in statements that you, and anyone who accompanied you for treatment, may have made to a health care provider.
If an insurance company is requesting medical records, it is in your best interest not to sign a blanket release. Be polite about it but decline the request until you have spoken with the attorney handling your case.
What Happens If I Refuse to Release?
In many cases, the argument over whether medical records are relevant can be determined in court. Your attorney should be able to prevent unrelated medical records that could possibly be used against you in court.
If the adjuster or claims handler tries to push you into giving a verbal or written release, be polite, but firm. Often, they may try bad faith tactics such as trying to tell you that they will close your case if you refuse to release medical records or see a doctor that they have chosen for you.
Some of the time, the adjuster may just be looking for clarification on the injuries that you suffered. Before deciding whether or not to allow access to your medical records, be sure that you speak with an attorney and have them review the request. If you and your attorney do believe that the request is reasonable, do not allow the insurance adjuster or claims handler to get the medical records on your behalf. Always obtain the records yourself.