How Medical Records Can Help Your Insurance Claim

Updated on January 27, 2021

Filing an insurance claim can be frustrating especially if you have never done it before. However, filing for one is important as it can lead to compensation you need to recover from your injuries, pay for your medical expenses, and keep living your life as you wait to recover enough to get back to work. Your insurance company will likely ask for medical records when you file a complaint. These might be past records or records that concern your accident. Medical records can make getting your claim approved easier and we are going to look at how they can do that.

Wheelchair, Disability, Injured, Disabled, Handicapped

Royalty-free image

They Can Eliminate Reasons for Doubt

One of the first things an insurance company will most likely do before assessing your claim is trying to see if there are any preexisting conditions that might have led to the accident. For example, if you have a condition that impairs your judgment, an insurance company can use that to make the accident your fault and, therefore, say they are not obliged to fulfill your claim.

Having proper medical records that show you have been managing any conditions you have and have been treated extensively can give your argument some merit and give you a better chance of getting compensated.

Medical Records Can Determine Your Compensation

A common factor that an insurance company might consider when deciding how much to pay your compensation is the extent of your injuries. If you have minor injuries, they may pay for your treatment and leave things at that. If you have life-changing injuries, you might get worker’s compensation plus other benefits, such as the insurance company paying for medical expenses or offering long term benefits and payouts.

They Can Help Prove Your Case

If you want to prove something happened, you need to have evidence that backs up what you allege. In cases such as medical malpractice suits, it is up to you to prove the case and provide documentation that puts a doctor, hospital, specialist, or medical professional at fault.

To establish fault, you need to have complete, accurate, and up to date medical records. You should be able to show proof of malpractice or negligence to have a chance at getting compensated. 

The process of getting these records can be difficult, expensive, and time-consuming, and this is why a lot of law firms use medical record retrieval outsourcing services from companies, This speeds up the process of collecting all the relevant documents that will be the bedrock of your case.

They Can Help Prevent the Insurance Company from Terminating Your Benefits

One thing a lot of people do not think about is the long-term payments and benefits they would get from their insurance provider. In many cases, people do not report any discomfort or pain they have during doctor visits and this does not go into their records. Once the insurance company sees that there are no additional or recurring symptoms, they may use that as a reason to terminate long-term benefits.

It is therefore important to ensure your doctor documents every new development or change in your condition and that your insurance company knows about these developments and changes.

Documentation is the basis on which many insurance claims are paid out. You need to have proof that you have an injury, and that the injury has affected your life substantially. Having the right medical records is an important step in proving your case or proving someone else was at fault and can be the first step in getting your claim paid out. 

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.