Does The Bad Guy’s Insurance Company Get to See All Your Medical Records

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One of the questions we often deal with arises when we gather medical records of a client from BEFORE the injury collision.   To understand why we do that, you have to understand the law and the injury claims process

If an injured person claims  he was injured through the fault of another, the law allows compensation for only those injuries that are caused by the incident or accident.  Sometimes it is obvious that an injury was caused by a collision but many times it is hard to tell.

Because the law appropriately limits recovery from the bad guy to problems caused by the bad guy, the question is often presented whether there was a “pre-existing condition” or prior medical problems.   This is invariably the case when neck or back symptoms occur after a collision.

The insurance company wants to make sure that they are not compensating someone for an injury that was not caused by their insured.  Though they sometimes use prior health care issues inappropriately to try and escape responsibility for what their insured bad guy did to an injured person.   Nonetheless, the only way for attorneys and insurance companies to properly evaluate your claim is to have information about your prior medical history.

Because of the complexity of the human spine and the wear and tear of daily activities, many people suffer from back problems at some point in their lives.  Insurance companies want to (and in the course of a lawsuit) are entitled to know whether the injured person had previous other medical issues that significantly affected the person’s health and daily functioning.   Thus, in trying to resolve claim before litigation we want to know the answer to your prior health history as well.   While even in litigation there are some limits as to what has to be disclosed, generally speaking, the more forthcoming you are the less friction there is and the faster your claim can be resolved.

In cases where causation is unclear, a medical professional must make a determination regarding the cause of the injury and whether the injury will be more likely than not to affect the injured person in the future.  For example, x-rays can disclose not only acute (current) injuries but can show past bony injuries as well.  A trained medical professional must have the chance to evaluate such evidence.

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  1. Thank you for this information on injury claims, its really helped me in my research for my project on personal injury claims

  1. […] of comparative fault and the “50/50 Rule” is here. 4.  Prior Injuries –  If you have significant prior medical issues, it may affect the value of your claim either positively or negatively.  There is a saying in the […]

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