Can insurance companies access my medical and work history?

Simple answer: It depends on whether you filed a claim or a lawsuit.

Why are medical records important?

Your medical records are vital to your injury case. They effectively document your injuries and are used to determine the value of your settlement. They provide a detailed account of your treatment, recovery, and any ongoing medical needs. Additionally, your medical history can demonstrate the impact of the injuries on your daily life and future well-being. This information can significantly impact the compensation you receive.

Why are work history documents important?

If you make a lost wage claim, loss of earning capacity claim, or loss of future earnings claim, your work history is relevant to your claim or lawsuit. This can include examining your past and current employment, job performance, income, and how your injuries have affected your ability to work. Your work history helps establish your economic losses. This information can also impact the compensation you receive.

In the Case of an Injury Claim

When you file an injury claim, the insurance company will need your medical records to evaluate your claim. However, insurance companies can only access the medical and work records that you or your lawyer provide to them.

Filing an injury claim does not automatically open up your medical and work history to examination. An insurance company cannot access your medical information unless you specifically authorize their request. When you file a claim, you or your lawyer will first collect relevant medical and work history to support that claim and send those records to the insurance company.

In the Case of an Injury Lawsuit

Alternatively, when you file a lawsuit, insurance companies have the power to issue a subpoena to access your medical and work records, if they are at issue. Your medical and work history effectively become an open book, allowing the insurers to scrutinize medical and work histories to assess the validity of your claims and determine the potential compensation.

If you haven’t been completely honest about your medical or work history, it could significantly impact your lawsuit. For example, suppose you claim in your lawsuit that an injury has prevented you from working, but your work records show that you’ve been employed during this time or engaged in physically demanding activities. In that case, the insurance company could use these facts to challenge the validity of your claim and also your credibility.

Similarly, if you fail to disclose a pre-existing medical condition that might be relevant to your current injury, and the insurance company discovers it through your medical records, this could reduce or eliminate settlement. However, if you are truthful about your pre-existing injuries and you can articulate the differences or aggravation of your injuries, you could use the egg shell plaintiff doctrine to help you get the compensation you deserve.

In all Injury Claims and Lawsuits

Whether you file an injury claim or a lawsuit, transparency and honesty are crucial. Your medical and work history play a significant role in determining the outcome of your case. While HIPAA provides protection for your medical information, once you file a lawsuit, you have put your medical history at issue, and defense will access your records through subpoenas. If you are not fully honest about your medical or work history, it could jeopardize your case. It’s essential to work closely with your lawyer to ensure that all relevant information is accurately presented to support your claim or lawsuit.

Better Call Sahar

Have you been injured in an accident? Better Call Sahar 619-649-2440 or Contact us here for a no obligation consultation.

This information is specific to California law and may not apply in other states.