What To Do When an Insurance Adjuster Requests Your Medical Records

The Short Answer…

Do not sign a blanket authorization form or grant them unlimited access to your medical history. Only provide records directly related to your accident injuries. Never allow direct access to your medical history. Consult with a personal injury attorney to ensure your rights and privacy are protected.

Key Takeaways

• Insurance adjusters request medical records to minimize payouts. They evaluate your injuries, check for pre-existing conditions, and assess whether your treatment was “necessary and reasonable.”
• You are NOT required to provide full access to your medical history. In Texas, insurers are only entitled to records directly related to your accident injuries.
• Never sign a blanket medical authorization form. Doing so could allow insurers to access years of unrelated medical history and use it to downplay your claim.
• Independent Medical Examinations (IMEs) are often biased. You are not legally required to attend an IME for a third-party claim. However, if you’re filing a claim under your own insurance (known as first-party insurance), your policy may require you to attend one.
• Only submit necessary medical records, request copies of what you provide, and consult an attorney before signing anything.
• A personal injury attorney can help safeguard your rights by limiting unnecessary disclosure, challenging biased IME findings, and negotiating a fair settlement on your behalf.

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Why Do Insurance Adjusters Request Medical Records?

If you’ve been injured in an accident and file an insurance claim, the insurance company will likely request access to your medical records as part of their claims investigation. They do this to try to determine a few key pieces about your claim:

To Evaluate the Extent of Your Injuries

Insurance adjusters review medical records to determine how serious your injuries are and whether they align with the details of the accident. They will assess the severity of your injuries, the types of medical treatment you received, and whether your injuries require ongoing or future care.

Texas follows a fault-based insurance system, meaning the at-fault party (or their insurer) is responsible for covering damages. Adjusters will closely examine your medical records to limit their liability and minimize the amount they must pay. 

To Determine Whether Your Injuries Were Pre-Existing

One of the most common tactics insurance adjusters use is to search for pre-existing conditions which they can argue were the real cause of your injuries. If your medical records mention prior injuries, chronic conditions, or past treatments related to the affected area, insurers may try to claim:

• Your injuries were not caused by the accident but were instead pre-existing.
• The accident only aggravated a prior condition, meaning they should pay only a portion of your treatment costs.

However, under Texas law, the “eggshell plaintiff” rule (aka the “thin skull” rule) states that the negligent party is still responsible for your injuries, even if you had a pre-existing condition that made you more vulnerable to harm. Insurance companies may ignore this principle to pressure you into accepting a lower settlement.

To Assess the Necessity of Medical Treatment

Adjusters also analyze your medical records to decide whether the treatment you received was:

• Necessary and directly related to the accident
• Consistent with the severity of your injuries
• Reasonable in cost and duration

If they believe you received excessive or unnecessary treatment, they may refuse to pay for certain medical expenses. For example, if you continue chiropractic treatments for months after a minor accident, the insurer may argue that extended care was not medically necessary. Similarly, if there are gaps in treatment—meaning a delay between the accident and when you went to the doctor—they may claim your injuries were not serious or were caused by something else.  

Should You Release Your Medical Records to an Insurance Adjuster?

While you may need to provide some medical information relevant to your claim, it is not required to grant unlimited access to your medical history. Blindly signing a medical records release form from an insurance adjuster can put your injury claim at risk (remember, the insurance company is looking for any reason to deny your claim or minimize your compensation). 

What Medical Records are Necessary to Share?

In Texas, you are only obligated to provide medical records that are directly relevant to your accident-related injuries. 

This often includes:

• Emergency room visits immediately following the accident
• Diagnosis and treatment records from the healthcare providers treating your injuries
• Imaging results (X-rays, MRIs, or CT scans) related to your accident injuries
• Any doctor’s notes regarding your recovery and prognosis

These records help establish the extent of your injuries and how they were caused by the accident. Medical records of expenses also help provide an accurate calculation of necessary compensation. 

Why You Should NOT Sign a Blanket Medical Authorization Form 

Insurance companies often ask claimants (like you) to sign a blanket medical release, which allows them to request any medical records they choose. 

This can be problematic for your claim, because:

• They can request records going back years, even decades
• They may find irrelevant health issues and use them to downplay your injury claim
• You lose control over what information they see and how they interpret it

Under Texas law, you are NOT required to sign a broad medical release form for the at-fault party’s insurance company. Instead, you are allowed to limit what records are shared by providing only specific necessary documents or having your attorney handle the requests. 

How to Protect Your Medical Privacy

Insurance companies are not entitled to unlimited access to your medical history, and providing too much information can hurt your injury claim. Knowing how to safeguard your medical privacy ensures that insurers only receive the necessary records while preventing them from using irrelevant medical history against you. 

Understanding Medical Authorization Forms

After an accident, an insurance adjuster may ask you to sign a medical authorization form allowing them to obtain your medical records. While they may frame this as a routine step, these forms often grant broad and unrestricted access to your health history. Make sure to review these medical release request forms very carefully.

Key Points to Know About Medical Authorization Forms:

• Blanket Releases Are Risky – Some forms allow the insurance company to request all your medical records, not just those related to the accident.
• You Control What You Release – You are not legally required to sign a broad authorization form. Instead, you can limit access to only relevant records.
• Texas Law Protects Your Privacy – The Texas Medical Records Privacy Act (Chapter 181, Health & Safety Code) provides strong protections against the unauthorized disclosure of medical records.

How to Handle a Medical Authorization Request:

• Read the fine print carefully – Look for language that allows insurers to request entire medical histories and reject those terms.
• Modify the release form – If you must sign one, specify that it only applies to records related to your accident injuries and limit the time frame.
• Consult an attorney – A personal injury lawyer can review the request and help you avoid signing away your privacy rights.

Why You Should Never Allow Direct Access to Your Medical Records

Insurance adjusters may try to convince you that it’s easier if you simply allow them to request records directly from your healthcare providers. This is a major mistake that could put your claim at risk.

Dangers of Allowing Direct Access:

• They Can Search for Pre-Existing Conditions – Even if a past injury is unrelated, insurers may argue that your current pain stems from a prior issue.
• They May Take Records Out of Context – Adjusters aren’t medical professionals; they may misinterpret notes, tests, or treatments in ways that hurt your claim.
• They May Request More Than They Need – If they obtain full medical records, they may scrutinize old injuries, medications, or conditions to downplay your case.

Alternative Approach:

• Request Copies Yourself – Always obtain your own medical records and submit only those related to your accident.
• Use a Limited Release Form – If necessary, provide a narrowly tailored release that restricts access to relevant treatment records only.
• Let Your Attorney Handle It – A lawyer can control what is shared and prevent the insurer from overreaching.

How to Respond to a Medical Records Request 

When an insurance adjuster asks for medical records, it’s important to respond strategically. Never rush to provide information without considering the potential impact on your case.

How to Protect Your Medical Privacy:

1. Ask for Specifics – Request a written explanation of exactly which records they need and why.
2. Limit What You Provide – Only supply records directly related to the injuries sustained in the accident.
3. Redact Sensitive Information – If possible, remove unnecessary medical details that insurers don’t need. Careful… This does not mean removing necessary medical details you don’t want the insurance company to see.
4. Get Legal Guidance – A personal injury attorney can ensure you provide the right information while protecting your rights.

By controlling the flow of medical information, you prevent insurance companies from using unrelated health history to devalue your claim. Always be cautious and, when in doubt, seek legal advice to safeguard your medical privacy.

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Independent Medical Examinations (IMEs): Do You Have to Comply?

Insurance companies may request an Independent Medical Examination (IME) to assess your injuries, but these exams are often biased in favor of insurers. IME doctors, chosen and paid by the insurance company, may downplay your injuries to minimize or deny your claim.

How to Protect Yourself in an IME

To protect your claim during an IME:

• Bring a witness and take notes on what is discussed
• Be honest, but brief 
• Request a copy of the IME report and dispute any inaccuracies
• Consult an attorney to challenge any bias 

Are You Required to Attend an IME in Texas?

• Third-Party Claims (Against the Other Driver’s Insurance): You are not legally required to attend an IME. Refusing will not automatically hurt your case.
• First-Party Claims (With Your Own Insurance): If your policy includes an IME clause (common in PIP and UM/UIM claims), skipping the exam could affect your claim—check your policy and consult a lawyer.

Common Tactics Insurance Companies Use to Reduce Your Claim

Remember, the insurance company is a for-profit business. Their primary goal is to protect and maximize their bottom line. This means doing everything they can to undermine your claim in order to deny it or minimize how much they need to pay you. 

When the insurance company requests your medical records after you file a claim, they’re doing so to (1) confirm that you actually have a legitimate claim and then (2) find anything they can use to minimize the payout.

But this is not the only tactic insurance companies use. Learn more about how insurance companies undermine your claim and become better equipped to protect your claim and secure much needed compensation.  

How an Attorney Can Help You Protect Your Rights

Dealing with insurance adjusters and medical record requests can be overwhelming. At Braker White, our team can help protect your rights and privacy by ensuring only necessary medical records are shared, and by preventing the insurance company from overstepping legal boundaries. 

How Our Attorneys Can Safeguard Your Injury Claim:

• Limiting the Release of Medical Records – An attorney ensures that insurers only receive records directly related to your accident injuries, preventing them from accessing irrelevant or pre-existing medical history.
• Preventing Insurance Company Tactics – Insurers often use broad medical release forms, independent medical examinations, or gaps in treatment as excuses to reduce or deny claims. A lawyer pushes back against these tactics to keep your case strong.
• Handling All Communications with the Insurance Company – Once an attorney represents you, the insurer must go through them instead of pressuring you directly. This protects you from making statements that could be misinterpreted and used against you.
• Challenging Biased Medical Reviews – If an insurance adjuster or IME doctor downplays your injuries, an attorney can present medical evidence from your treating doctors to dispute unfair assessments.
• Negotiating a Fair Settlement – Insurance companies often offer lowball settlements, but an attorney understands Texas injury laws and can fight for the full compensation you may be entitled to for medical expenses, lost wages, and pain and suffering.

When Should You Contact an Attorney?

• If the insurance adjuster asks for broad access to your medical history
• If you’re being pressured to attend an Independent Medical Examination
• If your claim is delayed, disputed, or denied
• If you want to maximize your potential compensation and protect your rights

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Frequently Asked Questions