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Legal-Kal, Criminal Defense Lawyer
Category: Criminal Law
Satisfied Customers: 584
Experience:  Attorney at Law Offices of Khaled Issa
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In Massachusetts - I was in a car accident and went to the

Customer Question

In Massachusetts - I was in a car accident and went to the hospital, do I have to give my insurance company access to my medical records in order for them to pay? They said I need to sign a form that will give them access to my medical records before they pay me. They told me it was a massachusetts law that if I have subsidized health insurance or something like that, I need to sign. I have health insurance through the healthconnector but I do pay a premium. Will my health insurance pay If i askt hem? I am afraid there might be some kind of incriminating information in the medical records since I do not know what kind of test were done at the hospital.
Submitted: 10 months ago.
Category: Criminal Law
Expert:  Colleen Grady replied 10 months ago.

Hello. I will help you today. I have been an attorney for 27 years. I am reviewing your question and will be back to you shortly.

Expert:  Colleen Grady replied 10 months ago.

Give me a short time. I'm preparing an answer for you.

Expert:  Colleen Grady replied 10 months ago.

May I ask if another car was involved in the accident? If so, is the other driver claiming injury?

Customer: replied 10 months ago.
This was on the highway during a storm and it was a tractor trailer that was parked on the breakdown lane. I do not believe the driver was in it but I do not know.
Expert:  Colleen Grady replied 10 months ago.

I asked because the insurance company may require your records to check for anything that may have impaired your driving.

I think I should opt out for an expert that is more familiar with insurance law.

Good luck.

Expert:  Brandon M. replied 10 months ago.

Good day, my name is Brandon. I have been a practicing attorney for ten years. Do we know why your medical records might be relevant to your case?

Expert:  Brandon M. replied 10 months ago.

The reason I ask is that medical records usually aren't requested unless someone is claiming bodily injury. Are you claiming bodily injury?

Customer: replied 10 months ago.
I believe its for the pip coverage, The hospital visit was around 10k and they said they will pay 8k of it then the health insurance the rest.
Expert:  Brandon M. replied 10 months ago.

An insurance company generally has a right to review medical records if it's necessary to evaluate their coverage liability. In those situations, it's not that the insured "must" provide the requested information, but your claim is usually likely to be denied if you don't, leaving you with responsibility for the bills. It's also noteworthy that if you caused an accident while under the influence of drugs or alcohol, that's something that normally won't be covered by your insurance anyway. Do you want to discuss your specific concerns about releasing the information, or does that answer your question?

Customer: replied 10 months ago.
how can I check if there is anything on my medical records I got them from the hospital but I dont know where to look and what to look for? Also will my health insurance pay for the bills?
Expert:  Brandon M. replied 10 months ago.

What do you believe might be in your medical records that would be a problem?

Customer: replied 10 months ago.
The ambulance driver wrote that I have a history of abusing xanax, he asked me if I take anything I told them yes they r prescribed to me, but I may have had 3 drinks within 4 hours so I'm not sure.
Expert:  Brandon M. replied 10 months ago.

Do you know if you had any blood tests taken that would reveal consumption of alcohol or use of the Xanax?

Customer: replied 10 months ago.
I do not know, I did get my medical report from the hospital but dont know where to look and what it would say
Expert:  Brandon M. replied 10 months ago.
It's difficult to guess what information is on these medical records that I haven't seen. Obviously, this information should not be construed as completes or advice until it has been examined by someone who can see the records in person. That said, my main concern would be with any blood tests that have been run. Usually, if they test for drugs and alcohol, it will be part of the same blood panel. You would see a collection of tests for things like marijuana, cocaine, amphetamines, alcohol. If there is something like that in your medical records, I'm happy to take a look at it if you would Tatsch it as a file, but you would probably recognize it if you saw it. It's entirely possible that they didn't test you for anything, but it's there is no way of knowing without examining the entire file.
Expert:  Brandon M. replied 10 months ago.
I hope that answers your question. Basically, if you can't figure out for yourself if there is any drug test included in your medical records, I would just have someone else take a look at it and see if they see anything either. If there's nothing in there, great… No problems. If there is something in there, then you have to think about whether or not It is worth your time to mess around with the insurance company.
Customer: replied 9 months ago.
Hi again, sorry it took my a while to upload the report. Please look over it and let me know if you find anything that will result in them not paying or any other problems I may have.
Expert:  Legal-Kal replied 9 months ago.

Good afternoon:

My name is ***** ***** I would be happy to provide general information regarding your question. As a reminder, all information provided here by JustAnswer is general in nature and does not constitute advice.

It looks like the previous expert has opted out of this question. I will try to help.

Please allow me some time to review everything that has been typed between you and the prior two experts.

Expert:  Legal-Kal replied 9 months ago.

So I have reviewed what has been discussed before along with the documents attached.

Besides a notation from the emergency room doctor stating that the patient has a history of benzodiazepine abuse and that is a risk factor, there does not appear to be any other notation nor lab testing for the determination of whether or not there was any substance in the patient's system nor any amount.

Additionally, PIP or medical payments claim are generally "no-fault," meaning that, unless there is a language in the provision that establishes otherwise, any negligence on the part of the insured in creating the accident (including, but not limited to being under the influence of any substance), will not affect the ability to use said PIP or Medical Payments coverage.

Questions based on this?

Expert:  Legal-Kal replied 9 months ago.

If so, please ask!

If not, please remember that experts here are not employees of JustAnswer and do not get credited for taking the time to provide general information to individuals until the individual clicks ACCEPT and rates the assistance with three stars or higher.Your cooperation in this regard would be appreciated!

***General information provided here is for educational and informational purposes only and does not constitute legal advice, nor should it be relied upon as such. It is always wise to consult with an attorney licensed in your jurisdiction as they would be in the best position to assist***