Auto Insurance Claims: Car wreck - HIPPA Medical Release Authorization, auto, accident

Question
Hi there. I need some advice. I was in a accident on 12/22/09. I went to urgent care on 12/23/2009. Doc said I may have fractured ribs and gave pain killers, said to allow 6 wks to heal. I was still having some slight pains in Feb so I went to hospital er on 2/10/2010. About 7 wks after the first appt. They said the fracture wouldnt show on xray (now) but said I had contusions of bruising and gave more pain killers. I am starting feel better now. I have not settle with the (person at fault) insurance yet. They sent me a HIPPA medical release authorization form as below. Is that a normal one? Will that allow access to everything of mine or only records pertain to wreck injuries? Thanks. I never been in a wreck before.


AUTHORIZATION TO USE OR DISCLOSE PROTECTED HEALTH INFORMATION

1. I hereby authorize _______________________ and its physicians, employees and agents to release or disclose to the below-named person or organization all of my medical records including any specially protected records such as those relating to psychological or psychiatric impairments, drug abuse, alcoholism, sickle cell anemia or HIV infection.

2. Information to be disclosed to:   Travelers Ins
           P.O. Box 681746
           Franklin, TN 37068-1746

3. Patient’s Name: ___________________________ Patient’s SS#: _________________   
   Patient’s Date of Birth: ____________
   Address: ___________________________________________________________
       Street         City          State,      Zip

4. Disclosure the following information for treatment dates: __________________ to _________________

__ Complete Records   __ Consult      __ Physical Therapy      
__ Abstract      __ Outpatient Reports   __ Emergency Reports   
__ Face Sheet      __ X-Ray      __ Other Specified _______________
__ Discharge Summary   __ Laboratory      ____________________________
__ History & Physical    __ Pathology      ____________________________

5. The above information is disclosed for the following purposes:

___ Medical Care      ___ Legal   __ Insurance   ___ Personal   ___ Other _____________

6. I understand I may revoke this authorization at any time by requesting such of the above referenced hospital/physician practice is writing, unless action has already been taken in reliance upon it, or during a contestability period under applicable law.

7.  I understand that I am not required to sign this Authorization. The clinic/physician listed in Section 1 and any employees and/or agents will not condition treatment, payment, enrollment or eligibility for benefits on whether I provide this Authorization.


8. This authorization expires on (upon) ____________________________ (Insert applicable date or event)

________________________________________   ____________________________________
9. Signature of Patient or Legal Representative   10. Date

________________________________________   ____________________________________
Printed Name of Patient or Legal Representative      11. Relationship to Patient or Authority to Act for Patient


IMPORTANT:   THIS AUTHORIZATION SHALL BE DEEMED INVALID UNLESS ALL
        NUMBERED ENTRIES ARE COMPLETED

N.B. IN CERTAIN SITUATIONS, AN ADDITIONAL AUTHORIZATIONS TO RELEASE SENSITIVE, LEGALLY PROTECTED INFORMATION MAY BE REQUIRED

Answer
Well is it normal to ask for medical and wage authorizations. But you can read this as well as I can and it sounds like even records beyond the accident are included. If it were me, I would just write on the form "I only authorize release of records pertaining to my injury resulting from the wreck on (date)", and line out the words you don't like, and initial both.

Keep in mind though, they will be less likely to settle with you if they think you have some pre existing condition to hide. And also, if your case did go to litigation, then they could probably get all your records if they wanted to.

You can check this with a lawyer.