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What medical information do I need to provide a claims adjuster for a personal injury case without signing a HIPPA Authorization
Anonymous6 views8 answers
I was in a t-bone collision last December. Other party was cited at the scene for failure to yield and GEICO "accepted liability" the next day. I suffered cervical spine injuries - herniated discs and lower back strain leading to extreme pain, sleeplessness, loss of work and diminished capacity in my job resulting in my eventual "mutual parting" with my company. My car was totaled and that has been settled satisfactorily. I have finally begun to assemble the demand letter for the med portion. I have police reports, lost wage info, photos, medical bills and EOB summaries, medical records from the ER, my orthopedist and my PT account statement. I want to ensure that I prepare this letter correctly and I would prefer not to sign the HIPPA. Advice?
This sounds serious. I would suggest that you retain a good local personal injury lawyer to assist you. Generally, a good lawyer can obtain substantially more money than an injured person can obtain on their own. Good luck.
Christian K. Lassen IIPersonal Injury LawyerPhiladelphia, PA ·
It is HIPAA not HIPPA. Have a local lawyer investigate. has a terrific "find a lawyer" tool to locate a top-rated attorney with a low contingency fee. Good luck.
Unfortunately, you will not be able to have the insurance company fairly compensate you by trying to do this on your own. Moreover, you may make mistakes that will come back to haunt you later on even if and when you retain an attorney. The insurance company knows that if you do not have an attorney that ultimately they will have the upper hand, especially after you are forced to file suit have to conduct discovery and ultimately forced to go to trial with all of the risk and expense that goes along with that. Whether or not you want to sign a HIPPA release form, you are unlikely to obtain any reasonable settlement without doing so. Moreover, if you are forced to commence a lawsuit you will be required to do so anyway. If there is anything in your past, such as prior similar injuries, and they are not portrayed correctly, this could also seriously impact the success of your claim. You can read all of the relevant materials that you want and be given guidance, but there is no substitute for having an experienced personal injury in your corner evaluating all the factors, both obvious and nuanced, in helping you to maximize the value of you case and minimize your risk.
Remember, the insurance industry hires and trains college graduates in defending the assets of the insurance company. Without an attorney representing you, they will take advantage of you. You also will never know whether you received fair compensation. Have you discovered all available sources of insurance?
Your first move would be to retain a local personal injury attorney. I do not give insurance companies any HIPAA releases. I give them the relevant records. If a lawsuit has to be filed, then your attorney, will know under your State's discovery rules, what the other side is entitled to. it sound like you have a serious injury, so don't mess around and think you can get fair compensation. Good luck to you.
Dear Sterling, Virginia - First let me offer my sympathies for your situation. Second - remember that Geico's adjuster is a professional "loss prevention" expert - their job is to minimize Geico's loss. Third - and to your HIPPA objection - Geico wants to get your medical records DIRECTLY from the medical care provider, in order to be sure they are complete (that you did not omit some of them) and to see if you had any pre-existing condition. I doubt that you will be able to resolve your claim if you refuse to give the HIPPA release. Finally - you are indicating to Geico that you are not familiar with handling a personal injury claim, with serious injuries and lost wages/loss of earning capacity claims. I wish you well, but think that you should retain personal injury attorney to assist you. Going forward alone is like getting involved in the Redskins' soap opera!! Good luck.
I assume you are handling your own claim, because you believe you will be net dollars ahead compared to paying an attorney. Most experienced PI attorneys avoid taking cases where the client ends up worse off financially, because he or she had to pay an attorney fee. That said, most of the cases where that occurs are fairly small. Insurance companies have separate strategies for unrepresented claimants and will make representations about "taking care of you" that seldom are sincere. I suggest you take advantage of a free consultation with an experienced and reputable PI attorney to get a clear idea of the settlement negotiation process. This includes identifying all of your sources of recovery, some of which are counter-intuitive. For example, in Virginia under certain circumstances, a claimant can legitimately receive reimbursement from medical payments, health and liability insurance coverage for the same bills. Any good Virginia PI lawyer can explain that to you.
You should get some guidance on the value of your claim and develop a strategy for negotiating a settlement. You should also decide whether an attorney might get considerably better result than you. Know that if your efforts fail, many attorneys will not want to take your case on. Getting maximum dollars is the result of presenting a case that will be maximally compelling to the insurance company. Carriers love to close files without litigation, but they will not pay their best dollar until they are convinced that they will soon be spending substantial costs on litigation if they do not come up with a reasonable offer. Unfortunately, the only compelling thing about an unrepresented claimant is the opportunity to underpay the claim.
You do not need to sign the HIPPA compliant release. You can get your own records and bills. You need to get the "entire chart" from each of your docs. If future medical treatment is likely, you may need an opinion letter from your doctor to that effect.
An hour with a capable lawyer is the best use of your time right now.