When Should You Send Your Medical Records to an Insurance Adjuster?

Client giving document needed to his lawyer.

With few exceptions, you should never give an insurance adjuster access to your medical records without first consulting with an attorney. If you have a minor injury, and your only medical bills are for maybe an urgent care visit or a doctor’s visit, you might be OK letting your own insurance company receive those records and pay the bill. But if you suffer any sort of significant injury, you should let an experienced injury lawyer handle this process for you.

At Truitt Law Offices, our car accident lawyers understand how the insurance companies operate in Indiana. We can take steps to limit the scope of what the insurance company sees from your medical records and help you to avoid unnecessary problems with your case. To learn more, call or contact us online today. We can provide a free consultation through our offices in Fort Wayne, Huntington and Indianapolis.

Why Does the Insurance Company Need My Medical Records?

In order to fully assess your injuries and determine compensation for your medical expenses, an insurance company may need to review some of your medical treatment records. However, there are limits to what the insurer can see and should see. For instance, say you are in a car accident, and you tear a rotator cuff in your right shoulder. It may take a few weeks before you really start noticing the pain. As the pain intensifies, you might decide that it is time to see a doctor. So, you go to a doctor and receive the diagnosis. The doctor then advises you to get surgery on your shoulder to repair the tear.

An insurance company may need to review those records and bills in order to know that (a) your injury is related to the accident, (b) the costs of the procedure and (c) what type of future medical issues you might experience. So, if the insurance company wants to see those records, it is a reasonable request. However, this isn’t the only reason the insurance company wants your records.

What an Insurance Company May Do with Your Medical Records

After you file a car accident claim, an insurance adjuster will call you frequently. The adjuster may tell you that, in order to pay your medical bills, the insurance company needs to be able to communicate with your doctors and get your bills and records. Once you sign an authorization form which gives that access to the insurance company, you can expect the company to seek all of your treatment records – possibly going as far back as 10 or more years. The company will essentially go on fishing expedition, seeking information about any type of care that it can try to use to downplay your injury or reject your claim.

Did you hurt your arm playing baseball in college? The insurance company will look for it. Did you have a work injury eight years ago? The company will find it.

Did you have a brief period of depression several years ago? The company wants to know. Did you complain to a doctor about a sore arm just a month earlier? The company will jump on that, too.

What are Pre-Existing Medical Conditions?

As you can see, the insurance company will want to know if you have any “pre-existing injuries.” Under federal law, health insurance companies are prohibited from denying coverage for pre-existing injuries. However, the law does not bar auto insurance companies from doing so. If an insurance adjuster thinks he or she can make a strained argument that you hurt your arm 10 years ago, the adjuster will try to use this to deny your claim and say you were already hurt. Even if it’s an unreasonable and far-fetched assertion, the adjuster will try to use it.

If you suffered depression a few years ago, it will give the insurance company all of the ammunition it needs to argue that your emotional distress claim is made-up and fake. In other words, the insurance company will argue that you were already suffering emotional difficulties. Think this sounds crazy and mean-spirited? Well, you’re right. It is. But it’s just another day at the office for many insurance company adjusters. It is how insurance companies keep their money.

What is an Independent Medical Examination (IME)?

Sometimes, insurance adjusters will see something in a person’s medical chart that looks helpful. Perhaps it’s a work injury from years earlier. It may have absolutely nothing to do with the car accident, but it may be enough for the insurance company to demand an independent medical examination.

The insurance company may ask you to undergo an independent medical examination (IME). Now, your insurance company will be armed with all of your medical records and a report from an allegedly neutral and independent physician to claim that your injuries are either unrelated to your accident or not as severe as you claim.

You Should Never Sign Anything Without an Attorney

An attorney from Truitt Law Offices can change the entire bargaining position for you. Instead of just giving the insurance company access to all your medical records, an attorney will first acquire the relevant records and review them. The lawyer can limit what the insurance company sees to only your accident-related medical treatment. Your attorney can require the insurance company to go through the attorney in order to see additional information from medical providers. Without your permission, your doctors should never be contacted by an insurance adjuster. In fact, your medical providers cannot speak to the adjuster. Doing so would violate HIPAA.

However, your attorney can freely communicate with your doctors and learn more about your injuries, treatment and prognosis, including whether you will need surgery.  Eventually, your attorneys will build the case and present it to the insurance company in a compelling way that helps the adjuster to see exactly what a jury would see if the case went to trial. In litigation, you may need to provide more records, but only if a court orders you to do so. At each step of the process, your attorney can actively work to protect your privacy and keep only relevant information flowing to the insurance company.

For help dealing with insurance companies after a car accident, trust Truitt Law Offices. We will fight for the compensation that you deserve. Contact us today for a free consultation.

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About the Author

Phil Truitt joined Truitt Law Offices in 2018 after he earned his J.D. from Ohio Northern University Ohio Northern Pettit College of Law. However, his association with the law firm dates all the way back to childhood. His father, Richard, established the firm over 40 years ago. Growing up, Phil…