If you want to win your personal injury claim or case, medical records will definitely be a major factor. Insurance adjusters will scrutinize your records, medical expenses, and the rest of your claims with a fine-toothed comb. You have to prove every penny and give a good reason, such as how the accident exactly affected your physical, mental, and financial position.
How To Prove Negligence
When you’re requesting medical records, you’re hoping to get proof of your injuries in addition to the long-standing costs and implications of the insurer’s client’s negligence. There are four factors that impact “proof of negligence,” also known as preponderance of evidence.
- The defendant will need to describe the duty of care the alleged negligent party should have used. For example, the proper duty of care would be if a truck driver was cutting lanes in heavy traffic, making it unreasonably unsafe for other drivers.
- The plaintiff will need to prove a breach of duty, where they provide evidence that shows how the defendant breached their duty of care. A reasonable driver, for instance, knows that driving over the legal alcohol limit may lead to a breach. Often, evidence and eyewitness testimonies are used to show how the defendant was knowingly acting negligently.
- Next, you need to consider causation. Causation is when you were injured because of the defendant’s breach of duty of care. If it weren’t for the drunk driver, you wouldn’t have been sideswipped.
- If a negligent employee failed to mop up a spill in aisle four and you slip, you would have to show damages. Damages and monetary (special) as well as long-standing disruptions to your life before the accident (general).
These four factors in the preponderance of evidence make or break a case. An injury claims lawyer can help you deal with insurers and in the courtroom if a claim escalates to a case.
Medical Records and Privacy Laws
HIPPA has protected the rights of your personal health information since 1996. The act limits who has access to your medical records, and allows you to get copies if you need to share them with, for example, an insurance company.
HIPPA is designed so other people can’t access your medical records without your consent. The act also lays out the processing fees for each request, how much time hospitals or other health professionals have to send you the records, how you can review your records, and places other restrictions on your personal information. It’s important to note that each state has different laws about medical records and privacy. Contact a claims lawyer if you’re unsure about who to request records from or what the insurance company is allowed to request.
Requesting Medical Records
Most healthcare facilities allow you to fill out a simple form. Typically, you (or sometimes a guardian or spouse) or a legal representative will need to submit a request in person and in writing. You may have to submit an actual letter to the medical provider and include all of your information, why you’re requesting your patient history, and the types of documents you need (x-rays, histories, lab results, etc.).
Why Do Insurance Companies Need My Medical Records?
If you’ve opened an injury claim against a negligent party’s insurer, you’re likely going to need to provide proof of damages (financial and medical). It’s important not to submit your medical records until you’re in a stable condition. Your situation may change, and the value of your claim could go up dramatically if, for instance, you need another surgery.
Insurance companies may request “independent medical examinations” before or after they receive your medical records. This is normal. The defendant’s insurer can request you, the plaintiff to be examined by a physician of their choice for a second opinion. You have the right to refuse IMEs, and if you go through with one the insurer has the right to disclose the results unless the claim becomes a lawsuit and your lawyer requests it during discovery.
If you believe an insurer makes unnecessary requests that seem invasive or burdensome, it’s important to contact a local injury attorney. These are called bad faith insurance tactics. By submitting too much information, you can figuratively shoot yourself in the foot by providing medical records and expenses that falsify your claim.