If you were injured in a car accident in Virginia, the at-fault driver’s insurance policy will likely cover your medical expenses. However, before the insurance company pays your medical expenses and other losses you suffered in the crash, they will likely contact you directly and request copies of your medical records. While this may seem like a reasonable request, handing over your entire medical history can have a negative impact on your claim. In some cases, it can prevent you from being about to recover any damages if the insurance company finds information they can use to argue that you were partially at fault for causing the car accident. If you were contacted by an insurance company after being injured in a car accident, it is in your best interest to contact an experienced car accident lawyer who will protect your legal rights and ensure that you recover the damages to which you are entitled.
What Do Insurance Companies Look for When Reviewing Medical Records?
When dealing with an insurance company, it is important to understand that they are businesses, and their main goal is to make money and keep payouts as low as possible. When an insurance adjuster contacts you asking for your medical records, it is not because they are concerned about your well-being. Their goal is to find evidence that will allow them to either lower the value of your claim or deny it completely. Insurance adjusters generally look for the following details:
- Pre-existing conditions. If you injured your back in the car accident, and your medical records indicate that you saw a chiropractor three years ago for back pain, the insurance company may argue that your current back pain is due to a previous medical issue, and not the car accident.
- Gaps in treatment. If you delayed seeking medical treatment for your injury, or missed a physical therapy appointment, the insurance adjuster may use your medical records to claim that you were not actually hurt very badly.
- Alternative causes. The insurance adjuster may also look for notes in your medical history that address exercise-related injuries, work stress, or past accidents so they can shift the blame away from their driver.
Why Should Virginia Drivers Use Caution When Providing Medical Records?
Virginia is one of the few states in the country that still uses the legal doctrine known as “pure contributory negligence.” Under this strict rule, you may be prohibited from recovering any damages if you are found to be even 1% at fault for causing a car accident. Unfortunately, this rule heavily favors insurance companies. Insurance adjusters will examine your medical records with a fine-tooth comb, looking for anything they can use to avoid paying a sizable settlement. For example, if you did not follow your doctor’s advice, delayed getting prompt medical care, or had a pre-existing medical condition that may have contributed to the accident, the insurance adjuster may deny your claim entirely.
It is also important to remember that an insurance adjuster’s job is to investigate your claim and determine whether they have a legal obligation to pay. While this does not mean that the adjuster is behaving improperly, it does mean that you should be careful about what you say and the information you provide.
Why Should You Never Sign a Blanket Authorization Form?
When an insurance company requests medical records, they often do so by sending you a medical release form, which is almost always a “blanket authorization form.” This is a broad legal document that allows the insurance company to request your complete medical history from any doctors, hospitals, clinics, or pharmacies you have ever visited. This includes mental health records, gynecological or reproductive health records, or treatment for unrelated illnesses. There are several reasons why you should never sign a blanket release, including the following:
- It oversteps your privacy. The other driver’s insurance company has no legal right to look through your entire medical history. They are only entitled to information that is directly related to your injuries that were caused by the car accident.
- It gives them too much access to private information. Once you have signed the authorization form, the insurance adjuster can contact your primary care doctor, past specialists, and local hospital to obtain years of personal health information they can use against you to deny your claim.
- It cannot be easily undone. Once the insurance company gets your medical records using a blanket authorization form, it is unlikely that you will be able to get them back and prevent the documents from becoming a part of their official file.
What Should I Do if an Insurance Company Requests My Medical Records?
If an insurance adjuster contacts you directly, or sends you a release form to sign, you must take the following steps to ensure that your legal rights are protected and that you recover the financial compensation you deserve:
- Do not sign immediately. You are not legally required to sign an insurance company’s medical authorization form on the spot. Even if the insurance adjuster tries to pressure you by telling you that your claim will not proceed without it, tell them that you need time to review the request before making a decision.
- Clarify which insurance company is requesting the information. Your obligation depends on whether the person contacting you is from your insurance company or the at-fault driver’s.
– The other driver’s insurance company. You are under no obligation to provide access to your medical history or sign their forms. The only information you need to provide is proof of your injuries and financial losses caused by the other driver.
– Your insurance company. If circumstances require you to use your own coverage, including Uninsured Motorist coverage or Medical Payments (MedPay) coverage, your insurance policy will likely contain a “cooperation clause” that requires you to reasonably cooperate with your own insurance company. Keep in mind, however, that even your own insurer is not automatically entitled to unlimited access to your records. - Ask what records the insurance company is requesting. It is well within your right to ask the insurance adjuster to explain the type of medical records they are asking for, as well as the dates the records should cover, why they are necessary, and which medical providers they wish to contact.
- Decline the blanket release politely. You may decline the request to sign a broad authorization form while still being cooperative. For example, you can say that you are uncomfortable signing something that releases all of your medical history, but you will gladly provide the medical records related to the car accident once your treatment is complete.
- Collect the specific records yourself. Take control of the process by requesting copies of your medical records from your healthcare providers, including itemized billing statements for treatment you receive after the car accident.
- Limit the scope of what you provide. Make sure that you only send documents that are directly related to the accident, including:
– Emergency room visit summaries from the day of the car accident
– Diagnostic test results ordered for your injuries, including X-rays, MRIs, and CT scans
– Treatment notes from physical therapy or specialists treating your crash-related pain
– Itemized medical bills corresponding to those visits - Keep copies of everything you send to the insurance company, including:
– Medical records
– Medical bills
– Signed authorizations
– Letters from the insurer
– Emails
– Claim forms
– Receipts
– Appointment records
– Other documents related to your claim
What if the Insurance Company Refuses to Pay My Claim?
If you believe that the insurer responsible for compensating you for your injuries and other losses is mishandling your claim, it is highly recommended that you take the following steps to ensure that your legal rights are protected and that you recover the damages to which you are entitled:
- File a complaint with the Virginia State Corporation Commission’s Bureau of Insurance. They accept complaints involving Virginia-issued insurance policies and will determine whether your insurance company followed applicable insurance laws and policy provisions.
- Contact an experienced car accident lawyer. While the Bureau can review your complaint and determine whether any laws or policies have been violated, a car accident lawyer will determine who is at fault, assist you with a personal injury claim, and ensure that you recover the damages you are entitled to, including medical expenses, property damage, and pain and suffering.
An Experienced Virginia Beach Car Accident Lawyer at Anchor Legal ® Protects the Rights of Car Accident Victims
If you were injured in a car accident and an insurance company has contacted you requesting your medical records, it is highly recommended that you contact a Virginia Beach car accident lawyer at Anchor Legal ® as soon as possible. We will evaluate the details of your case, determine whether the insurance adjuster violated your legal rights, and pursue the maximum financial compensation you deserve for your injuries. For a free consultation, call today at 757-LAW-0000 or contact us online. Located in Virginia Beach, we proudly serve clients in the surrounding areas.