In Personal Injury Protection (PIP)

When The Insurance Adjuster Requests Medical Records

It’s a common occurrence for the adjuster for the at-fault insurance company to ask your patient to sign a medical records release authorization. Until your patient is medically stationary, this is a bad idea.

Here’s the reason why.

The at-fault insurance company adjuster will use the medical records to interfere with your patients Personal Injury Protection (PIP) claim.

Once they have the records, they will look for anything they can to claim that the injuries are not related to the collision and/or the treatment is no longer necessary. Then they will contact the PIP adjuster and use their influence to stop the PIP payments for your patient’s medical bills.

Guess what happens next?

The PIP carrier will demand an Independent Medical Exam (IME) and stop paying for your patient’s medical treatment.

If you receive a request for medical records from the at-fault insurance company while your patient is still treating, talk with them about the risks involved. They may not be aware of the consequences of signing the authorization, and how that will impact their medical care.

It is not unusual for your patient to feel they’re being uncooperative by not signing the authorization.  The adjuster will say they cannot evaluate the claim until they have the medical records. Although this is true, it isn’t necessary to sign the authorization until the patient has finished treating.

You can help ensure your patient is getting the medical treatment they need by understanding the problems that might occur if they sign a medical release before they are done treating. If your patient insists on releasing the records before they’re done treating, refer them to a personal injury attorney who can explain the consequences of this choice.

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