After a car accident in Florida, an insurance adjuster for the other driver’s insurer may ask you for your medical records. You need to understand that insurers have no inherent right to your medical files, and you should never voluntarily release your medical records to another driver’s insurance company.
An insurance adjuster who asks for access to your medical records hopes to find an excuse to deny your insurance claim. If they get access to your medical history, there’s likely something they’ll claim is a pre-existing condition and the true source of the injuries you have suffered.
You must be careful after sustaining a significant injury in a car accident. Insurance adjusters have a fiduciary duty to minimize the amount of compensation their employers pay for accident claims. Only an experienced car accident lawyer working for you will truly have your best interests at heart.
Why Would an Insurance Adjuster Want to See My Car Accident Medical Records?
Medical expenses make up the greatest part of most car accident claims. An insurance adjuster’s job is to limit your payout, regardless of your injuries and what you actually deserve.
When an insurance adjuster seeks your medical records, the formal request they ultimately submit to your provider(s) will usually ask for your entire medical history. This gives them access to details about:
- Your overall health, diagnosis, and treatment for your car accident injuries
- Diagnoses and treatment for previous injuries and illness
- Your personal facts
- Your answers to diagnostic questions as compiled by your doctors.
Information in your medical records that might be used against you could include the following:
- Details of past injuries to the same body part(s) injured in the car accident
- Details of pre-existing medical conditions with symptoms similar to those you complain of now
- Gaps in treatment for your current injuries or your failure to seek prompt medical care, suggesting that your injuries are not serious
- Instances of you downplaying your car accident injuries or pain during a medical examination, potentially suggesting exaggeration of your current condition.
Information you provide to doctors should always be as honest and accurate as possible. Never exaggerate or downplay pain or other problems. It is also crucial to follow doctors’ orders for medical care, including keeping all appointments for follow-up exams and/or treatment.
What Should I Do if the Other Driver’s Insurance Company Wants to See My Medical Records?
If you are contacted with a request to release your medical records to an insurance company that is not yours, you can decline to do so.
Medical providers will typically follow the Health Insurance Portability and Accountability Act (HIPAA) guidelines, which govern who can and cannot view individuals’ personal information without permission. The insurer will need your signature to access your records and may present the request as a mandatory form. However, you do not have to sign.
If you decline to sign the initial request, the insurer may then provide a “limited” record release form, which authorizes the release of specific records only. You might agree to this, but it is crucial that it accurately describes appropriate records and is limited to them. You should have a lawyer review it before you sign.
An alternative approach is to ask your primary medical provider for copies of records that specifically pertain to treatment for your car accident injuries. You can give these to the insurance company, and they will have what they need to develop a proper payout for your claim.
At some point in the process of obtaining an insurance settlement, you may have to allow your insurance company access to your medical records. Your insurer will require this before they pay your medical bills. However, this should be a limited release with a date restriction that ensures they obtain records of medical care received after your car accident.
What Should I Do If the Other Driver’s Insurance Adjuster Wants to Speak with My Doctor?
You should reject an insurance adjuster’s request to speak to your doctors. Any reputable doctor will cite HIPAA as a reason they cannot discuss a patient’s condition with an insurance company without the patient’s consent.
If an insurance adjuster insists that speaking to or getting a recorded statement from your doctor is necessary to process your claim, you should speak to a car accident lawyer. Your attorney can contact the insurer to find out what they need from your doctors and submit the request on your behalf. An experienced personal injury attorney will know what’s proper for an insurer to request and receive — and screen out what is not.
Will I Be Required to Submit to a Medical Exam by the At-Fault Driver’s Insurance Company?
In some cases of complex injuries and/or lasting disability, the other driver’s insurance company may assert that your medical records do not provide a picture that matches your claim. They will insist upon an independent medical evaluation (IME) before a final settlement.
You will likely have to agree to an IME to move forward, but in fact, you’ll be seeing a doctor the insurer regularly works with and whom they expect to provide issues to raise in further settlement negotiations.
Unless a court order has been issued (which would require extreme circumstances), you would have no legal obligation to undergo an IME. However, an experienced personal injury lawyer can advise you about the status of current negotiations, the pros and cons of an IME, and the potential for settling afterward or proceeding to court.
Contact a Florida Car Accident Lawyer
Don’t let the insurance adjuster fool or bully you after a car accident; they are not on your side. An experienced car accident attorney from Zervos & Calta, PLLC, can protect your rights and guide you through the claim process after you’ve suffered car accident injuries in the Tampa Bay area. Our Florida car accident lawyers have a reputation for tough-as-nails settlement negotiations with insurers and know how to get results for auto accident victims.
Our attorneys have more than 50 years of combined legal experience and the dedication required to help you recover all of the compensation you deserve. Contact us today for a free, no-obligation consultation. You will pay nothing unless we secure compensation for you.
About the Author
Lauren Calta
Attorney Lauren Calta is a partner in the Tampa Bay law firm Zervos & Calta, PLLC. For 33 years, Lauren Calta has focused her legal practice on representing people who have been harmed in personal injury, car accidents or lost loved ones due to the negligence of others. A distinguished personal injury trial attorney, she has secured millions of dollars for her clients and is a lifetime member of the Million Dollar and Multi-Million Dollar Advocates Forum in recognition of having obtained a settlement or verdict in excess of $2 million. She also is an official member of Lawyers of Distinction, Tampa Bay Trial Lawyers, Clearwater Bar Association and Florida Justice Association.
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