Auto Insurance Claims: Medical Record Release Form, health insurance coverage, coverage limit

Question
Dear Dr. Settlement,

I was rear-ended a month ago, and have been seen a physical therapist since.  Other insurance called me the other day and asked me to sign a medical record release form and any receipts that I paid for the treatment so that we can settle soon.  

Now that I am going to settle this on my own, I am wondering if it is wise to sign a medical record release form and send it in.  I have a bad feeling to do so, and as you may tell this is my first time dealing with auto accident claims.

Is releasing my medical record to the insurance company required by law (I line in CA) or is this a neccessary step to settle a claim?  If it's a must, I have no choice, but can I just state every damage including medical payment in my demand letter and send it in along with the receipts?

Also, does my own health insurance coverage limit the amount of my conpensation?  When they say the actual cost of medical bill, does it mean the actual co-pay you paid (ex. $10 each visit) or the total cost has been paid by my insurance company and myself? Personally, it's none of insurance company's business whether if my medical bills are paid by my own health insurance...  

Lastly, When the accident happened I had a child carseat in my car (fortunately, my child was not in the car), and I feel like the carseat should be replaced even it does not have any visible damages.  How can I claim the replacement?  Should it be in the same demand letter or can I just purchase one and send the receipt in?

Thank you so much for your time to read my questions and suppot me to file the claim on my own.

Macky

Answer
Dear Macky,

Yours is a question everyone has to face, and—at the risk of being considered suspicious characters—most of us would like to limit the scope of information we give to the insurance industry.

Take a look at one of our newsletter articles on this topic and you can see that you did the right thing: Should I Sign the "Authorization for Release of Medical Records" Sent by the Insurance Adjuster?http://www.settlementcentral.com/newsletter0309.htm

You will have to make your own choice, depending upon what you see worth hiding from prying eyes.  I suppose if your record is clean, with nothing that you do not want shared, then go ahead and sign.  Otherwise, we have a section on our members' side that shows how to limit the release, including a letter for your doctors to sign regarding no similar symptoms or accidents being in your medical record.

Here is how it will work with your health insurance payments.  Unless you have an excellent health insurer, your company will subrogate its claim for reimbursement onto your claim for damages.  Thus, your medical insurer will be paid at the time of your settlement.  

Let’s set up an example.  Say that your health insurer paid out $5,000 in medical payments, and you paid out $500 in co-pays; your total medical "special damages" would be $5,500.

That is the amount that you would put in your demand letter (plus transportation, and miscellaneous other expenses).  When you settle, your insurer will get the full $5,000 back, UNLESS the tortfeasor has only minimal policy limits and your claim has substantially more value in "general damages" (i.e. pain and suffering).  

But that is an entirely different story, and you can get an idea about some issues regarding insurance policy limits here.  Directory of Legal Information Liability Insurance Policy Limits Settlements in Personal Injury Insurance Injury Claims http://www.settlementcentral.com/page0451.htm


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You know what—since you are new at this and going to go on alone, why not take some time to learn about how this is done?

Learn how to submit and settle your own personal injury insurance claims—DO IT YOURSELF SETTLEMENTS.  Here is a series of pages that you can review.  Take what makes sense to you and don't worry about the rest.  Just get a flavor of how the system works without spending a ton of time right now.  You can do this on your own since you are the type of person who paid enough attention to ask about the release form!  That is the sign of a good claimant, Macky.  

Overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm

Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm

Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements http://www.settlementcentral.com/page0217.htm

Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm

Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm

Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm

By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters?  Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm

Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm

Do It Yourself Advantages, or do these claims need an attorney?  As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages.  Why should you pay someone one-third to do what you can do yourself?  Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm

Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member.  Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm

This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate.  But hundreds of people are doing it each day, and they are getting good results.  

What if you get only two-thirds the way to your settlement goal?  Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees.  Thus, you could go it alone just to get an insurance settlement offer, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees.  Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm


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As for the car seat, you are entitled to repair or replacement for all personal property damaged in the accident, but nothing else.  Even though you may feel that the seat was compromised, speculation is insufficient grounds to merit payment from the insurer.  

You might want to look up a local accident reconstruction mechanical engineer and ask her about how the integrity of the car seat could be impaired with trauma.

I doubt that she will be able to assist you inasmuch as the mere fact it was sitting in the car during an accident is unlikely to impact its integrity.  But it would not hurt to prove me wrong.

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FINAL TOPIC: Effective communication with insurance claims adjusters.  Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm

Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more.   Always have your information and ammunition in writing to give to the adjuster.

Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.

Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.

I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the feedback form on this site and leave some feedback for me.

Best Wishes,

Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com