Legal Question in Personal Injury in Ohio

Release of Medical Information

My wife was recently injured in an automobile accident where the other driver was clearly at fault and cited by police. Claim is being file with the insurance of the other driver. The insurance company is requesting release of medical information. Is my wife legally required to comply? Medical bills were paid for by my health insurance.

Must information be released about amount the health insurance actually paid compared to amount billed by medical providers?


Asked on 1/01/04, 8:10 pm

2 Answers from Attorneys

Robert Guehl Guehl Law Offices

Re: Release of Medical Information

You have two issues: 1) the insurance company will be entitled to see your wife's medical records DIRECTLY RELATED to the injury -- they typically will ask for a general release, however, which allows them to secure any and all medical records.

2) The "collateral source" rule says that your wife is entitled to recover the reasonable value of her medical care, even if someone else (your medical insurance company)pays all or a discounted part of the bill. Your medical care provider usually has a "subrogation" or reimbursement provision -- you'll have to repay the amounts they paid for medical care. So one way or another, the negligent party's insurance company finds out how much was actually paid. It is more a question of how much do you get to keep from any settlement. And remember -- the insurance company does this everyday, so they have a distinct advantage in evaluating your claim. How do you know if their offer is reasonable or not? Allstate's own claims manual indicates that represented claimants recover on average THREE TIMES more than claimants without legal counsel.

Good luck!

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Answered on 1/02/04, 9:58 am
Timothy Hess T. Hess & Associates, LLC

Re: Release of Medical Information

When ever your medical condition is brought into question on a claim the insurance company is entitled any and all records relating to that injury. Ultimately, they will know how much was paid by your insurance but you still go by what was billed when figuring out a settlement. Even if you don't contact me for representation, I highly suggest that you get an attorney. Your chances of a higher recovery amount are greater with a mouthpiece who does it for a living.

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Answered on 1/02/04, 1:25 pm


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