Why are medical records important in a car accident insurance claim?

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After suffering injuries from a car accident, your client may be counting on their auto insurance policy to pay off their medical bills and other expenses. Unfortunately, their insurance claim may be wrongly denied due to weak documentation.

You should advise your client to seek medical attention immediately after the accident, tell their doctors every detail related to their injuries, follow their doctor’s instructions, and participate in all medical treatments. Taking these steps will enable your client to acquire medical records like:

  • Ambulance or paramedic records
  • Emergency room records
  • Laboratory test results (e.g., CT scans, MRIs, and bloodwork)
  • Records from hospital admission/visit and follow-up appointments
  • Medical prescription records
  • Treatment records received from different medical practitioners involved (e.g., primary care doctor, physical therapist, psychologist, chiropractor, acupuncturist)
  • Diagnoses, opinions, and conclusions offered by medical practitioners who treated your client

Related article: Post-car accident record retrieval checklist

“Insurance claims may be wrongly denied due to weak documentation.”

Having medical documentation is crucial to your client’s car accident insurance claim because:

Medical records may prove that the claimant (i.e., the driver) was not at fault

Car accidents sometimes happen as a result of the claimant’s negligence. Specifically, they may have been:

  • Driving under the influence (DUI) of alcohol or drugs
  • Driving too fast
  • Driving without having obtained a driver’s license
  • Using a mobile phone while driving
  • Not following traffic signals

If medical records do not indicate that your client was guilty of DUI, then their insurance claim has a better chance of getting approved.

Medical records show that injuries were sustained from the accident

Medical records serve as evidence that your client was indeed injured during and because of the car accident. This helps rule out the possibility that the injuries existed beforehand and/or stemmed from your client’s underlying medical condition.

Medical records help determine the insurance claim’s value

To figure out how much compensation your client should ask for, you need an estimated total amount of damage that your client will suffer as a result of their injuries. Medical records can help provide cost estimates since these detail the timeline and severity of your client’s injuries. This information can help you establish the impact of those injuries on your client’s life and the extent to which those injuries will continue to affect your client.

How will those injuries affect your client’s daily life? Will those injuries prevent your client from going to work? If yes, for how long? Will your client still be capable of performing their job role after they have recovered? Will they still be able to work at all? Answers to these questions will help you compute lost wages and quantify non-economic damages, such as physical pain, mental anguish, and emotional suffering.

Medical records also reveal all financial costs related to the medical care that your client has already received (e.g., ambulatory services, diagnostic exams, prescription drugs) and the outcomes of rendered treatments. These records may also include medical recommendations on the future treatments your client has to undergo, such as surgery and physical therapy, and the projected outcome of such treatments. This allows you to keep track of how much your client’s injuries have cost them so far, as well as estimate future healthcare costs.

Related article: 3 Tips for medical record retrieval after a car accident

Seek help with retrieving medical records

With your client injured, they may have difficulty obtaining or expect you to be the one to obtain their medical records. Fortunately, Record Retrieval Solutions can take that burden off your and your client’s shoulders. With our help, you can quickly get all the medical records you need so you can settle your cases and claims faster. Partner with us today.

About The Author

img Chuck Dart
Chuck Dart started in the record retrieval business three decades ago. As the industry evolved from analog to digital, he recognized an opportunity to create a single, simple online solution that standardizes the record request and retrieval process across the entire healthcare industry.