How Far Back Can a Car Insurer Request Medical Records for a Fort Worth Auto Accident Case?

The insurance company needs to review your medical records to confirm your car crash injury and the treatment you are receiving, but how much access should you give them? Should you sign a blanket authorization allowing the insurance company to see records from years before the accident?

You may question how far back an insurance company can request medical records and why they want to see records from the past five years.

Although you need to provide proof of your injuries and the value of your damages, you should be careful to limit the insurance company’s access. They are looking for information they can use against you.

The licensed Fort Worth car accident lawyers at our firm know how to protect your privacy while providing the records the insurance company needs to process your claim.

Am I Legally Required to Share My Medical Records with Insurance Companies?

Generally, you are not required to share your medical records with anyone, including insurance companies.

Your medical records are protected by the Health Insurance Portability and Accountability Act (HIPAA). For the most part, you control access to these records. HIPAA does not allow you to request records for anyone besides:

• Yourself
• Your children
• Another adult, including a deceased adult, for whom you are the legal representative

Texas has strict laws on the confidentiality of medical records. For example, according to the Occupations Code, Section 159.002, communication between a doctor and patient connected to professional services provided by the doctor is confidential. These conversations cannot be disclosed except as provided under state law.

Insurance companies and other parties cannot gain access to your medical information unless you provide written authorization, which means:

• You can decide what stays confidential and what the insurance company can see.
• You are in control of how far back the insurance company can look into your medical history.

If health care professionals or other parties share your health information with someone you did not authorize, they can be held liable for a breach of confidentiality.

You should never simply go along with an insurance company’s records request without consulting an experienced lawyer. Insurance companies do not care about protecting your rights. Their focus is on obtaining information to use against you, whether they can use the information to deny the existence of your injuries or undervalue your damages.

Anderson & Cummings has been protecting the rights of injured victims for decades, and there are no upfront costs with our services. If you have questions about what medical records an insurance company has access to, or how far back an insurance company can request medical records, contact our experienced law firm today.

Accessing Your Electronic Medical Records in Texas

Most of your health records are now electronic. Under Texas Health and Safety Code Title 2 Section 181.102, health care providers have 15 days to provide electronic records after receiving a written request from the patient. They can also provide the record in another format, if the patient agreed to receive the records that way.

Under Texas state law (Occupations Code Section 159.005), written consent for medical records must specify:

• The information that is to be released, whether it is medical records, billing records or something else
• The reason why the records should be released
• The person the records should be given to

What Happens if I File a Fort Worth Car Accident Lawsuit?

Insurance companies often have greater access to your medical records during a lawsuit compared to an insurance claim.

Discovery Process

Once you file a lawsuit, the insurance company can do discovery, allowing them to request medical records relevant to your case.

Subpoenas and Court Orders

Going to court also allows for interested parties to seek subpoenas or court orders, which allows them to bypass the need for written authorization to your medical history. Court orders are usually only made in complex or contentious cases. For instance, the court may order an independent medical exam.

How Much Access Do Insurers Have During a Lawsuit?

You may be concerned that discovery, court orders and subpoenas give broad access to your medical history, which might include medical records from before the crash. However, these options do not give insurance companies blanket authorization to your medical records. For example, a court order only gives access to the information listed in the order.

One reason Fort Worth crash victims should hire an experienced lawyer is that he or she will know how to protect your privacy while releasing the relevant information. These are complex issues that you do not want to be trying to sort through on your own. At Anderson & Cummings, we have 50 years of combined experienced and have obtained millions for crash victims.

How an Insurance Company May Use Your Medical History Against You

Insurance companies are for-profit businesses that are always looking for ways to pay out as little for claims as possible. That is why they scrutinize crash victims’ medical histories.

These are some of the ways an insurance company might use your medical history against you to challenge or undermine your claim:

Disputing the Extent of Your Injury

The insurance company may:

• Say your records prove your injuries are not as severe as you claim
• Compare current symptoms to those reported right after the accident
• Say your records reveal a preexisting medical condition that was aggravated by the crash; for example, the insurance company could point to a decade-old report of minor back pain, arguing this is the main source of your back pain.

These could all be reasons to deny your claim or reduce its value. In the case of a preexisting condition, aggravation of an existing condition may be worth less than a new injury.

Questioning the Credibility of Your Claim

• Insurance companies are always looking for inconsistencies that could cast doubt on the validity of your claim. They meticulously compare your current claim with past medical records.
• They may argue your records show your injuries are not as severe as they are described in your demand letter.
• Information about preexisting conditions could also cast doubt on your credibility. For instance, if you claimed you never had back problems before, but your records show you once met with a doctor to discuss back pain.
• Insurers may also point out differences between the symptoms you reported to different healthcare providers at different times.

Reducing the Compensation Amount

Insurers may use your medical history to argue for a reduction in compensation by highlighting prior health problems that could have contributed to your current condition.

The insurance company may pay special attention to delayed symptoms that you have included in your claim, such as symptoms of whiplash or a head injury like a concussion. They may dispute whether these symptoms are related to your crash injury, as they did not show up right away.

In some cases, insurance companies question whether you need all the treatment you are getting. They could argue this treatment does not provide much benefit, or it is not supported by enough medical research.

Challenging the Connection Between Your Injury and the Accident

If your medical history includes treatments for similar issues before the incident, insurers might argue that your injuries are not directly related to the event in question.

Insurance companies can more easily make this argument if there is a gap in time between when you were injured and when you sought treatment.

This is why crash victims should always seek medical treatment right away. Another way to dispute the connection between your injury and the accident is to say it is a natural change because the victim is getting older.

How Can I Protect My Privacy During a Fort Worth Car Crash Claim?

A car accident claim puts your medical condition at issue and so a release of medical records is to be expected. However, that does not mean you should give the insurance company full access to your entire medical history.

Here are a few steps you can take to ensure your privacy when the insurance claims adjuster requests access to your medical records:

• Review Requests Carefully: Before consenting, ensure that the insurer’s request is specific to your claim. You can ask for details about why certain records are needed. Never sign a blanket agreement giving the insurance company direct access to review your records.
• Narrowing Access to Your Medical Records: When providing consent, specify that only records related to the injury in question should be shared. This helps prevent unnecessary disclosure of unrelated information.
• Consult Your Fort Worth Attorney: Your attorney can help you navigate requests and ensure that your privacy is protected, such as by removing information unrelated to the case. Insurance claims adjusters can be pushy and tell you that your claim may be denied if you do not release the information they are requesting. But that is not always the case, and if the information they are asking for does not pertain to your current injury case, a lawyer may be able to argue this issue in court on your behalf. They can also challenge any requests that seem excessive or unrelated.

How Can Your Medical Records Prove Your Case?

Your medical records contain a wide spectrum of information about your medical condition, treatment and long-term prognosis:

• Emergency room reports detailing initial examinations, vital signs and immediate treatments administered.
• Admission records if hospitalization was required, including intake assessments and daily progress notes.
• Diagnostic test results such as X-rays, CT scans, MRIs, and blood work, along with doctors’ conclusions on the test results.
• Physician notes describing the nature and extent of injuries, treatment plans and prognosis.
• Surgical reports if any procedures were performed, including pre- and post-operative notes.
• Medication records listing all prescribed drugs, dosages and duration of use.
• Physical therapy and rehabilitation records, including treatment plans and progress reports.
• Mental health evaluations and treatment notes if psychological trauma is part of the claim.
• Follow-up visit notes documenting ongoing symptoms, recovery progress and any complications.
• Discharge summaries outlining the overall course of treatment and future care recommendations.
• Medical bills and invoices for all services rendered.
• Any correspondence between healthcare providers regarding the patient’s condition and treatment.

These records provide a timeline of the injury and recovery process. It is important to note that doctors have the right to withhold information if it meets any of the following criteria:

• It would significantly harm the patient or other people
• Would create public panic that is unnecessary
• Is related to treatment of a minor
• It was received from other doctors
• Has no direct connection to your medical care
• Is on a list of things you told doctors not to disclose

Anderson & Cummings is Here to Help Crash Victims. Call Today

Is the insurance company requesting access to more medical information than necessary?

Contact our law office to find out how we may be able to assist you. We have obtained millions in compensation for Fort Worth crash victims, all while protecting their privacy and only releasing the medical information related to the accident.

We deal with insurance companies every day, so we are prepared for the tactics they use to devalue or even deny claims.

Our lawyers are prepared to go to trial to maximize your compensation. If your case does end up before a jury, you do not have to worry about paying any court costs because we do not charge you anything up front or while we work on your case. And you do not owe us anything unless we recover compensation on your behalf.

Call us today at (817) 920-9000 to schedule your free consultation.