What do insurance companies look for in medical records?
Hey, it’s Drew from Champlain Valley Law. In today’s video, we’re going to talk about how insurance companies mine your medical records for dirt, and what they do with it.
Now, if you watched our video on how far back an insurance company can go into your medical records, you know that they’re looking for things that they can use to argue against your case.
You know that they’re looking for ways to argue that you weren’t hurt, that somebody else hurt you, or that you were already hurt before this accident.
That’s the way insurance companies do business.
But you may be wondering, what is it that insurance companies are looking for specifically?
Well, the first thing they’re looking for is any old complaints of pain or discomfort. They will specifically look for complaints in the body part that was injured in the accident. Insurance companies are looking for any slight differences in the way that you describe what happened, how it happened, how it hurts or where it hurts.
They’re looking for old x-rays, CAT scans or any other tests that might show that you already had an injury or some condition in that particular body part or system, something they call a pre-existing condition.
What insurance companies argue
An insurance company is going to want to be able to argue that you are going to need that treatment or that your body was going to hurt anyway, even if this accident never happened.
In particular, the insurance company loves to find anything in the medical record, in your own handwriting. That means questionnaires, intake forms, pain description charts. Anything where they can find just the slightest difference in what you’ve said so they can use it to cross-examine you.
Imagine you’re at the chiropractor for your first treatment. You’re filling out a form and you circle pain in your lower back because that’s what bothering you today, but you forget to mention that your shoulder hurts. You don’t circle the shoulder on the chart.
Three years later, the insurance company is going to come back at you and say, your shoulder never hurt.
Remember, the insurance company is there to cherry-pick little things that they can use to kick up some confusion. They’re not here to play nice.
Review your medical records
You can do yourself a favor by periodically reviewing your own medical records.
You’d be surprised very often what you hear from the doctor in the exam room, is not the same thing that’s written down in your chart.
So, your takeaway from today’s video is this, insurance companies are looking to cherry-pick their way through your medical records. They look for any way to get out of paying you fairly for your injuries.
Make sure you know what’s in your medical record, and correct any errors before it’s too late.
As always, I hope you found this video helpful. And if you did, please give us a thumbs up and subscribe to the channel.
And if there’s anything else you’d like to hear more about, please let us know in the comments section below. Thanks for watching, and we’ll see you next time.