What To Do When The Adjuster Asked for a Medical Authorization

Always be cautious when dealing with insurance companies, especially ones that represent an at-fault driver. Insurance companies exist for one reason: to make a profit.

When an adjuster asks for information from you, they are looking for information needed to complete your claim, but they are also digging for any information that can be used to reduce or deny that claim.

Get Guidance Handling Insurers

Car accident injury victims should be especially careful when an insurance adjuster asks for medical records. You are required to release some medical records to prove your diagnosis and your injury’s relationship to your accident.

However, never give an insurance company access to all of your medical records. They are usually fishing to find a pre-existing condition, which allows them to reduce the value of your injury claim. If you are being asked to release medical records, always ask yourself if it is a reasonable request and if the records are relevant to your claim.

You have a legal right to deny requests or ask for clarification. Contact an experienced West Palm Beach car accident attorney team to learn more about your legal rights and to receive guidance on how to handle insurer requests.

What Types of Records Should I Share with the Insurance Adjuster?

To understand why you may not want to release certain medical records to the insurance company, it helps to first understand what records you do want to release.

• Medical documentation written during your initial visit.
• Records of your diagnosis listing your symptoms, the pain you feel, and any debilitating effects.
• Descriptions of the treatments you received after your accident occurred.
• X-rays are incredibly important because they show irrefutable proof that an injury has occurred.

Keep a copy of your discharge papers, too, since these provide a summary of your visit, including your reasons for visiting, your diagnosis, generalized line items for treatments, and services you have received.

Save all hospital bills and records of treatments, services, and other medical care. Keep your receipts related to self-pay items, including prescriptions, parking fees, and transportation to your appointments.

If you paid for treatments using your insurance, write a record of any cost-sharing, co-pays, or deductibles, and request a copy of the billing statement sent to your health insurance carrier. When you attend visits for follow-up care, save all of the new copies of any paperwork and billing statements.

You want proof that you are receiving follow-up care as instructed, and you want to document the progression of your injuries as they heal.

What Types of Records Should You Avoid Sharing with Insurers?

Any document that’s not directly related to your car accident injuries and the treatment of them is very likely to be considered legally irrelevant to your case.

You have the right to maintain your medical privacy, and you also have a right to refuse requests that you consider unreasonable. Be especially careful of blanket permissions to access the entirety of your health records.

Insurers are looking for pre-existing conditions, which can be something as simple as a history of heart disease, smoking, or being overweight. Any possible pre-existing conditions will be scrutinized. Insurers will then use their assessment of what pre-existing conditions you had to begin denying coverage.

This can mean dollar amount deductions, but it can also mean a refusal to cover entire swathes of treatment on the basis of a pre-existing condition.

General Tips on Sharing Medical Information with Insurance Companies

Any time you receive a request for medical documentation, try to share the bare minimum. Keep the original copies for your records, and send duplicates to insurers. Make them request more information if they need it.

This may delay your settlement offer, but it’s better than sharing something that cannot be “unseen,” at least not without having a motion granted by a judge presiding over a related legal action. When you think a records request may be an overreach or irrelevant to your case, request clarification from the insurance company.

Make them explain why they need the documents. You can also say that their request is unreasonable because you want to maintain your privacy. Even with records that are relevant and necessary to your claim, have them sent to you rather than releasing them directly from the hospital.

That way, you can review the information and ensure that you aren’t sending off more information than you intended. Any costs for medical records requests should be included in the value of your claim.

In other words, you want to be reimbursed if the care provider wants to charge you for the copies or the releases.

Don’t Make a Recorded Statement

Be Assertive of Your Rights When Dealing with Insurers, Work with an Experienced Car Accident Attorney

Protect your rights when filing an insurance claim. Insurance adjusters may lull you into a false sense of security by acting friendly or claiming that some request is just standard procedure. Always ask questions.

Demand that they explain why they need certain records. Make them work for information that you feel isn’t relevant to your claim or records that you feel are “unreasonably burdensome” to provide.

Working with a car accident lawyer during your case can help you be aware of your rights as well as what legal strategies you can use to maximize your chances of obtaining full compensation for all of your accident losses.

Talk to an experienced car accident attorney near you when you call Steinger, Greene & Feiner today at (800) 560-5059 or contact us online to schedule your free appointment.