Why Insurance Companies Request Medical Records in Injury Claims

Posted on behalf of Jeff Pitman on November 12, 2021 in Personal Injury
Updated on May 2, 2024

why insurance companies request medical recordsWhen seeking compensation for injuries caused by a negligent person, you may be asked by the insurance company to grant access to your medical records. If so, you may be wondering if you have to agree to this release. Is it common for insurance companies to request medical records in an injury claim? Do they even have a right to this private information? Could it hurt your chances of getting compensated if you refuse?

At PKSD, our Milwaukee personal injury lawyers are ready to help protect your best interests, as well as your right to privacy, during the claims process. While the insurance company may need to see some of your medical records, an attorney can control how they are disclosed.

FREE Case Review. Call 414-333-3333 today.

Why the Insurance Company Requests Medical Records in an Injury Claim

Insurance companies are for-profit businesses, and as such, their end goal is to pay as little on a claim as possible. This approach does not align with a plaintiff’s goal of being fairly compensated for injuries caused by the defendant’s negligence. That said, the way an adjuster frames this request may not seem unreasonable to injury victims. They may think it is the only way they will receive compensation for their damages. However, it is not the whole story.

When viewing your medical records, the insurance company will be looking for:

  • Evidence that verifies your claim and their policyholder’s negligence
  • The type, severity and long-term prognosis of your injuries
  • Inconsistencies they can use against you – such as if you delayed getting medical care
  • Medical history that reveals preexisting injuries or health conditions

Insurance companies will look for any information that can help them reduce what they have to pay. Depending on what they are able to dig up, they may even try to deny your claim altogether.

Do You Have to Release Your Medical Records?

While the insurance company may have the right to validate your claim, they do not have the specific right to view all of your medical records. Signing a release would give them full access to look at any and all of your medical records.

For this reason, we strongly recommend that you:

  • Ask the insurance company why they want to see your medical records – you have the right to an explanation for any request that invades your privacy
  • Do not give a verbal agreement to release your medical records – conversations with the insurance company are typically recorded
  • Do not sign any release of your medical records – you and your attorney need the opportunity to see them first and decide what gets released
  • Tell them you will discuss this request with your attorney before agreeing to anything

Could Refusing This Request Hurt My Claim?

The insurance adjuster handling the call may try to pressure you into agreeing to release your medical records over the phone. He or she may even tell you that you could hurt your chances of getting compensated if you refuse. However, these are scare tactics insurance adjusters are trained to use.

How Hiring an Attorney Benefits You

If you do not already have an attorney handling your case, you may want to consider the benefits of hiring one. A qualified attorney is prepared to help you throughout the entire legal process. This means that whatever the insurance company does or requests next, your attorney is prepared to deal with them on your behalf.

Injury victims who have legal representation often recover more compensation than those who do not. The reason for this is that personal injury lawyers have extensive knowledge of the law and the benefit of experience.

An attorney can be a huge benefit when you get requests from the insurance company because he or she:

  • Knows the law and how to ensure that your privacy and rights remain protected
  • Understands the real purpose of the insurance company’s requests, such as asking to see your medical records
  • Is prepared to review your medical records with you to determine which records are relevant to your claim
  • Can limit the scope of the records that are released to the insurance company

Need Help With Your Injury Claim? Our Law Firm is Prepared to Help

At PKSD, we have proven results and a long history of helping injured victims in Wisconsin. Our team of legal professionals is deeply committed to fighting for full compensation on your behalf. If we represent you, we are ready to protect your rights throughout the legal process.

You may be unsure if you can afford an attorney or if you even have a valid claim. This is just one of the reasons we offer a free initial consultation. You can discuss your situation in a confidential meeting, with no obligation to hire our firm. If we do represent you, there are no upfront costs for you to pay. We also do not collect our attorney fees unless we are successful in winning your case.

PKSD. Trusted Legal Help. Proven Results.  414-333-3333

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