QuestionQUESTION: Hi Jane,
My mom was in an auto accident where the other driver was at fault (100%). The other driver's policy had a maximum of $50,000 for personal injuries. Due to the high medical bills (~$100,000) the other driver's insurance paid their max. We are now in the process of preparing a UM claim for our insurance.
We have repeatedly been asked to provide a blanket medical release (including access to bank info, employer info, etc) but we are hesitant in providing it because the insurance company would have access to so much information. We pushed back and complained about such an open release form and they came back with a refined version that was limited to medical info. We are still reluctant to sign because they would still have access to ALL my mom's records, which is very private and personal. We do not understand why the insurance company would need access to records other than those related to her injuries.
They have also asked for us to provide SSN and HICN numbers for something related to Medicare. My mother is not a medicare beneficiary, so I do not know why they need this information.
I understand that for UM claims, the insured must "cooperate". I wasn't sure what the limits were for cooperation. Do we have to do everything that our insurance company asks us to do (e.g. medical release form, SSN/HICN numbers, etc)? I anticipate our insurance company asking my mom to be examined by one of their doctors. Would we be required to comply with this request?
Thanks in advance.
ANSWER: Hello Samuel,
In my opinion, the insurance company is overstepping its bounds. Let's just say that I would not handle a claim in this matter, as I believe it comes dangerously close to bad faith claim handling. Again, my opinion based on what you have told me. Why? Because one cannot help but conclude that they are searching for ways to keep the UM settlement as low as possible.
But here's the catch. Yes, because UM is first party insurance, you must cooperate with your insurance company. No matter how intrusive your company is, you really do have to cooperate. if you don't, in all likelihood they will deny the claim for failure to cooperate. Although, before they do that they would be compelled, in my opinion, to call your mother in for an Examination Under Oath and then deny it if she refused to submit the materials.
Is there any recourse? At this point, no. Your mother must cooperate. Is there recourse later? Only under a bad faith lawsuit if the claim is denied despite your cooperation, and if the circumstances warranted it. And that can be a long climb.
Your mother has a substantial loss. Regrettably, you cannot assume that the insurance company will do the right thing. In my experience, I can say that insurance companies like the UM premiums, they just don't like the UM payouts. Hence, they will do whatever to minimize those payouts. Wear you down, make outrageous demands, lowball the claim. Fortunately for your mother, the other driver has been found 100% at fault, so at least your carrier cannot argue liability, which is another too-common tactic.
If I were in your place, I would not even consider settling on my own. Not with these damages. Do yourself and your mother a favor - get a competent personal injury attorney! Yes, the attorney will take a portion (settling usually means about 30%), but you need the experience of the attorney to get you what you deserve.
Do a search online, and perhaps contact the TX bar to find reputable, experienced personal injury lawyers. I've seen way too much of this stuff over many years to recommend any other course.
I wish you the very best.
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
---------- FOLLOW-UP ----------
QUESTION: Hi Jane,
Thank you for your response. I agree, I feel the insurance company is trying to find ways to minimize the value of our claim. We were planning on going at this on our own at first to see how much we can get from the insurance company and then seeking help of an attorney.
In regards to the medical release, would we be able to limit the insurance company's access to just the records related to her auto accident injuries? She doesn't have any related injuries/issues in the past, but we would like to keep as much of her medical records private as possible.
We have asked why they need a blanket release form and the adjuster simply states that it is needed so they can get the related records. We have offered to obtain and provide the records for them, but she has demanded the release form by some artificial/random deadlines. I've asked her to put in writing why they need the release form and any legal or contractual language that requires us to provide the release form by the specific dates. This was all done over the phone, so is not in writing. I'm thinking of sending a letter to them with these questions so we can have it documented. Is this advisable, or should we simply sign and send the release form right away?
Thanks
Answer Hello again, Samuel,
They are absolutely trying to minimize the value of your claim. This is precisely why you need an attorney.
No, you cannot limit what you give to the insurance company. You must give them everything they ask for. To do otherwise puts you dangerously close to a denial. The deadline alone proves that. Why a deadline? Think about it. Could it be that they want to force you to sign something before you can seek legal representation? Insurance companies do not want you to retain counsel. With an attorney involved, they are afraid of a lawsuit. This, of course, works to your favor.
And believe me on this one, they are documenting whatever you are saying on the phone. I believe they'll take whatever they choose and will use it to their advantage, not your's.
In my opinion, they are not doing the right thing. This is not going to turn out well for you. Do not try to settle this on your own.
Good luck
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
