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What Are Insurance Medical Authorization Forms Used For?

Published on Sep 12, 2019 at 8:31 am in Personal Injury.
What Are Insurance Medical Authorization Forms Used For?

When you’ve been in an accident and you decide to file a claim with your insurance company, you’ll need to provide strong evidence that connects your injuries and losses to the incident. At some point in time, the insurance adjuster may ask for documentation about your injuries and medical treatment. One of the documents you could be requested to sign is called a medical authorization form. In general, a medical authorization form will give the adjuster access to your medical records.

It’s important to understand what a medical authorization for is, what your insurance company will do with it, what they will see, and how they will use that information in regard to your claim before you sign anything. Speaking with a lawyer is always a good idea before signing any official documentation from your insurance company, so you don’t run into trouble later. Let’s go over the ins and outs of medical authorization forms and how they could affect your chances of receiving the compensation you need to recover from your accident.

What Is a Medical Authorization Form?

A typical medical authorization form grants authorization from you, the patient, to a third party, like your insurance company, for access to your medical records. Depending on the agreement, the scope may be limited or broad. With authorization, the adjuster may have blanket access to your medical records or the ability to speak with your physicians without you present.

In order to prove you were hurt in a personal injury accident and suffered damages because of the negligent actions of another, you’ll need evidence. Even if you submit the proper records related to your accident, the insurance adjuster can request a medical authorization form. They may claim they need additional information to fully assess the extent of the damage you suffered.

In addition to a medical authorization form, you may be asked to consent to an independent medical examination as part of the claims process. This type of examination is conducted by a physician hired by the insurance company. It’s typically not in your best interest to submit to this because the physician may return an opinion that’s in favor of the insurance company because they work for them, even if that’s not the case.

What Information Is Contained in Medical Records?

Once your adjuster has access to your medical records, they will be able to evaluate your medical history and make determinations as to whether or not they believe your accident-related injuries deserve the compensation you’re seeking. It’s important to understand what they’ll have access to, so you are prepared to dispute any issues they come across.

  • Past Medical History. Your past medical history does not only include appointments and treatments related to the accident. This will include all appointments, procedures, and medications from your past. If, for example, you were in a car accident and sustained a head injury, but there was an incident in the past where you hit your head while playing football, the insurance company could dispute your injury.
  • Doctors’ Notes. When the insurance company looks at your doctor’s notes, it’s likely they’re looking for contradictions between what you said and what your doctor has said about your accident-related injuries. If you neglected to mention specific symptoms that are typically associated with the injury your doctor diagnosed you with after the accident, they may want to speak with your doctor to determine how they came to their conclusion.
  • How Often You’ve Seen the Doctor. If you frequently visited the doctor prior to your accident for unrelated conditions and illnesses, the insurance company could try to draw connections between the injuries you claimed to have sustained in the accident to your medical issues in the past.

Can What My Insurance Company Sees Be Restricted?

Medical authorization forms don’t have to include all of the information discussed above. You have the right to restrict what your adjuster sees. When you review the initial form, you’ll want to make sure the information they’re requesting is relevant to your injury from the accident. If, for example, you broke a bone during the accident, there’s no need for the insurance company to have information about the surgery that removed your appendix years ago.

There’s no need to provide access to medical records back to your birth. They only need access to records that involve the accident. This typically includes your initial medical examination with emergency medical personnel or a physician and any follow-up appointments or therapy session for the accident injuries.

Medical records can contain a lot of information about your identity. You’ll want to ensure this information is not released. Information like your social security number can be redacted, so that type of information is kept confidential and protected.

You’ll also want to consider limiting the access they have to information. With a full release, they can speak with your doctor without you being present. It’s best to protect your information and make them work to get it, if it’s needed at all. When you work with a personal injury attorney, they can communicate on your behalf to ensure your information and records are properly restricted.

Should I Sign a Medical Release for the Insurance Adjuster?

Knowing whether to sign a medical release can be confusing, especially when you’re dealing with injuries and monetary setbacks while waiting for your claim to settle. Even if you’ve already sent copies of your relevant medical records and your personal injury demand letter, your adjuster may ask for additional records you did not provide. If, for example, there is an indication of a preexisting condition, the adjuster may ask to see records concerning that issue.

It will be up to you and your lawyer to decide if the adjuster’s request is reasonable. If it seems the adjuster is trying to determine if the insurance company will pay for additional medical costs, supplying them with the information they request could result in greater compensation. If, however, the information they’re requesting seems unreasonable or completely irrelevant, they could be asking for it to build a stronger case against giving you compensation. Determining the adjuster’s intent can be confusing, but our lawyers have been helping clients make the right decisions for their situations for years.

To determine if you should sign an authorization form, you’ll want to ask the adjuster to explain why additional records are necessary. If their answer is not convincing, you have the right to inform them that you do not believe the documents are relevant or that providing them would intrude on your privacy.

If you do allow the adjuster permission, it’s a good idea to refrain from signing an agreement that allows them to directly obtain the records. Always obtain the records yourself, review them, and then provide the adjuster with the information they requested.

What Are the Disadvantages of Signing a Medical Authorization Form?

As you can see, signing a medical authorization form is not always in your best interest. Understanding just what the disadvantages boil down to is important in deciding if signing is right for your circumstances.

  • Incomplete Records. If you sign a medical release too soon after your accident, your records could be incomplete. If the doctor does not know the full extent of your injuries, the treatments you’ll need, or how long recovery will take, the adjuster won’t be able to accurately assess how much compensation you’re owed.
  • Invasion of Privacy. If you sign a blanket authorization that allows the adjuster full, independent access to your medical records, they could access sensitive information that has nothing to do with the accident. Depending on the information, they could try to use this against your claim.
  • Reduction in Settlement. If you provide your adjuster with medical authorization, it can make it more difficult for your lawyer to negotiate the right settlement for you outside of court. You could have to compromise and take a lower final offer or take the case to trial.

Should I Speak with a Lawyer Before Signing a Medical Authorization Form?

If you were injured in an accident that wasn’t your fault, you’ll want to take all the steps you can to maximize your settlement. Unfortunately, insurance companies and their adjusters can say and do things to make you unintentionally reduce your settlement. To avoid this, it’s important to work with an experienced attorney.

When you schedule a free consultation with our lawyers, we’ll review your claim and medical records. If you decide working with our law firm is the right decision for you and your family, we’ll handle the phone calls with the insurance company for you. This will ensure nothing is said to jeopardize your future compensation. If the company requests a medical authorization form, we’ll explain what that means for your unique situation and provide a recommendation based on our experience.

To learn more about insurance and medical authorization forms, contact us today. We’ll make sure you understand your rights and legal options through every step of your claim, so you can focus on recovery and restoring order in your life.

The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice. Viewing does not constitute an attorney-client relationship. Prior case results do not guarantee a similar outcome.

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