The Adjuster Sent a Medical Records Authorization — Should I Sign it?

What the form usually is

Within the first couple of weeks after a claim is opened, most people receive a packet that includes a medical records authorization. It is presented as routine — and processing the claim genuinely does require some records.

The question is not whether the insurer gets medical records. It is how many, covering what period, and from whom.

Blanket versus limited

A blanket authorization typically permits the company to request records from any provider, for any condition, without a date limit. Some versions also reach pharmacy records, employment records, and in some cases records held by other insurers.

A limited authorization identifies the specific providers who treated the injuries from this accident, and confines the request to a defined date range — usually beginning shortly before the accident.

Both forms look like paperwork. They do very different things.

Why the breadth matters

Once the file contains your full history, the search is no longer for what this accident did. It is for anything that could offer an alternative explanation.

A note about back stiffness from 2013. A physical therapy course after a soccer injury in high school. A single mention of a headache in a visit about something else entirely. None of it has to prove anything. It only has to be available to argue that your pain has a different source.

Pennsylvania law does not require you to have been healthy before the accident. An at-fault party generally takes the injured person as they find them, and aggravation of a pre-existing condition is a recognized injury. But those arguments are far easier to make when the record is proportionate to the claim.

A reasonable middle ground

Most claims are resolved without anyone signing a blanket release. Common alternatives include:

• Providing the records yourself. You can request your own records and produce them, which keeps you aware of exactly what has been sent.

• Signing a limited authorization naming specific providers and a specific date range.

• Asking the adjuster to identify what records are needed and why, in writing, before anything is signed.

• Having an attorney manage the records exchange entirely, which is standard practice and usually faster, because the office does this routinely.

What if they say the claim stalls without it

An insurer can decline to evaluate a claim on an incomplete file. It cannot condition payment on access to records that have nothing to do with the accident.

If a claim is being held up over the scope of an authorization rather than its existence, that is worth a conversation with a lawyer — often a short one.

If you already signed

Signed authorizations can generally be revoked going forward, in writing. Revocation does not retrieve records already obtained, but it stops the collection from continuing indefinitely.

Ask, in writing, for a list of what has already been requested. Knowing what is in the file is the first step to responding to it.

Talk it through with someone local. If you have questions about your own situation, the attorneys at Joyce, Carmody & Moran can review what happened and explain your options — no cost for the first conversation, and no obligation. We are based in Pittston and handle injury matters throughout Luzerne County.