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Past medical history

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Nexcompac

Junior Member
What is the name of your state? AZ

Recently I was hit from behind when I was at a complete stop. I am insured by Country and Geico was the other insurance. I am using Med Pay for covering the Chiropractor from my own policy. I had their insurance cover the repair of the Car. It was minor damage, about $1200.00, and was sent a letter from their adjuster stating they felt that because the damage was very minimal, the medical would be too.
Now, just today, I received a phone call that an adjuster wants to go over my medical history all the way back to '99. This will include 5 auto accidents according to them.
My concern is how much do I have to release to them? I assume the insurance companies have a database that shares information about individuals, but not details as that would violate the privacy of medical records. HIPA right?
 


Nexcompac

Junior Member
Additional info

Some additional info would include:
I was at a complete stop. The impact sent my phone flying which popped off the back cover and sent my battery flying. I was pushed back in my seat and head smacked the headrest.
Geico could not reach their client for over a month or even if they ever did, but it took that long to get approved to get my car fixed.
I missed 1 day of work as I was sore the next day.
Medical and police arrived on scene.
I am seeing a MD and a chiropractor.


Can I include muscle therapy such as massages as well?
 

RMK

Junior Member
Years ago in CA, I was rear ended. Due to a prior medical condition from a back injury, my settlement was higher than it would have been for someone who had NOT had a prior back injury. Point is, if you have a pre-existing medical condition that was aggravated by this accident, that could be to your favor, not to your detriment financially.

It took longer as all my medical background info had to be submitted and the paying insurance company took their sweet time going through it all, but after two years, and refusing to sign for a few paltry amounts in settlements, I did receive a decent settlement, most of which was used to pay off after insurance medical bills for chiro, etc.

Insurance companies want to try to break you down by offering you less than you could receive and they hope that your medical condition will wear on you. Also, they know that by obtaining your medical records they can justify the foot dragging due to 'needing more time' to investigate your claim.
 
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tranquility

Senior Member
You don't have to release any records to them at this time. However, they don't have to offer you a settlement if you fail to cooperate in their investigation. Then, you have to sue the other driver and the insurance company will make a demand for the records and you have to give it to them then.

Have you been in five accidents since 1999? Have your injuries been about the same? That is, minor fender bender and then you go to a chiropractor for awhile? If so, it is quite possible your file will go to a special unit of the insurance company. That seems like indicia of fraud. That's not to say you were not in an accident or that your injuries were not exactly as you say. However, some try to increase the settlement amount by overtreating in such cases. If you get all twitchy about providing information from the insurance company's reasonable requests, they will not offer you a settlement anywhere near what you hope.
 

Nexcompac

Junior Member
Interesting.
I have heard similar cases where the insurance company has paid less as they do not want to pay for pre-exsisting medical issues too.
 

Nexcompac

Junior Member
So do insurance companies always "pre-screen" these cases?
And I have nothing to hide, so I can technically give him access and it can help the case?
 

ecmst12

Senior Member
Interesting.
I have heard similar cases where the insurance company has paid less as they do not want to pay for pre-exsisting medical issues too.
It depends on the specific situation. If your previous conditions were stable prior to this accident, and you had been out of treatment for some time, then they should not negatively affect your case's value. Your history does make you more susceptible to re-injury, but that doesn't mean the other driver is any less liable for your current condition - had this accident not happened, your condition would not have worsened.

It gets more complicated if you were still actively treating for a prior injury, making it harder to distinguish what percentage of your current condition is due to this accident vs the prior recent trauma.
 

Nexcompac

Junior Member
I assume they are fishing for more information and I will learn more soon. This is what I do know at the moment. The most recent letter I had received from the adjuster states the following:

"I am the examiner responsible for the handling of this claim. Our initial investigation indicates that your claim arises from an accident in which your vehicle sustained just $928.66 in property damage. As such, it is difficult to relate serious injuries arising from this minor loss."

Kinda sounds like, because the damage was so little to your car, you can not really be hurt.
:confused:
 

ecmst12

Senior Member
No, the letter said it is DIFFICULT to relate serious injury to a minor impact. If you want them to relate your injuries to the accident, you will have to submit medical evidence of the connection. That means your medical records relating to your recent treatment, as well as relating to any similar injuries/problems in the past. If you want the money, you will have to provide them with the evidence they need.
 

Nexcompac

Junior Member
Settlement

I know it has been a long time since the last post, but I wanted to follow up to close this out. What is a good "baseline" to expect when asking for a settlement. Is there a magical calculator? I had a lawyer settle a claim once and I remembered he told me he would start at 3 times the medical. But I know that did not happen.
Advice?
Thanks
 

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