Expert: Doctor Settlement - 3/24/2008

Question
hi. Im dealing with my landlord insurance co for a trip and fall. They hired an independent adjuster. He wrote me a letter saying i can sign a hipaa or i can forward everything to him so i did that. The lady for the main insurance co said my claim is at a halt because i didnt sign a hipaa and that she cant evaluate it w/o it. She has everythimg med records and bill also prior records going back 6years. Liability is pretty clear. Should i call her super?

Answer
Hello again, Gb,

Thank you for the great feedback and comments you left for me.  I appreciate that.

What I am going to do is to give you a public answer and then a private answer if need be.  For the private answer, all you will do is to make a brand new question and mark the response as private.  

The first thing I would do is to figure out just what it is that the adjuster is asking you to do.  Here is why.  Maybe she just feels that the form you sent to her via the independent adjuster did not have a satisfactory HIPPA acknowledgment that you are waiving certain rights.  If that is all it is, AND IF THERE IS NO MENTION OF HIV, etc. (as spelled out below), then just get her to send you the exact wording she wants, and then send it to me via the private response option on this website.  Likely you will just sign it.

ON THE OTHER HAND, if in fact what she wants is a HIPPA waiver of all of your rights to privacy concerning HIV, addictions, abortions, STDs, and the like, then you have two choices.  

I guess that before you make your choices, you might want to take a look at HIPPA, which was to promote privacy for consumers.  
Here are two HIPPA pages for your information.
http://personalinsure.about.com/od/health/a/aa041806a.htm
http://www.hhs.gov/ocr/hipaa/consumer_rights.pdf

Choice #1.  If you want to stand firm for what is right, then you can tell her to go fly a kite.  I am assuming that there is no way that any of those conditions could impact your injury treatment or your continued pain and suffering from the injury.  Your doctor reports will be the key.  If there could be anything you are suffering from that could be tied to something hidden (one of the kinds set forth above), then the adjuster has the right to look at those records.

If she insists that she cannot adjust the claim without proof that your medical records are silent as to any of those kinds of entries, then it is time to complain to the state insurance adjuster http://www.settlementcentral.com/links.php

I would include copies of your medical records to show that there is no need to go on a fishing expedition through your medical records.  Point out that one purpose of HIPPA was to ensure privacy of medical records, and it is not necessary to divulge private information in order to be compensated for a personal injury loss.  

I would argue that even if she does have a right to subpoena all of your records (as part of the discovery process should you commence a lawsuit), the office of the insurance commissioner should stand for settlement of claims, not litigation.  Hence, if the idea is to settle claims, we do not need to encourage fruitless fishing expeditions through the records of victims.  

I would argue that her real purpose is to discourage claimants from pursing the full value of their claims.  See what your insurance commissioner has to say.

Choice #2.  Many people just go with the flow and let them have all that they want to see since there is nothing to hide and they do not want to fight the adjuster.  If that is the case, then just sign off on her form.


So, in summary, if you want to get the form and send me the wording, use a new question, and make it for a private response.  That way you can tell me if you have any of the events above that people try to keep private.  

Good luck with this, Gb,

Dr. Settlement, J.D. (Juris Doctor)
Http://www.SettlementCentral.Com