Can the insurer receive the medical bills and records once they are collected?

Why the Insurer Wants the Medical Records and Bills

In a North Carolina personal injury claim, an insurer normally uses medical documentation to evaluate the injuries attributed to the incident. The records may show when treatment began, the symptoms reported, the services provided, and the course of care. Itemized bills identify the charges associated with those services.

Medical bills and records serve different purposes. A bill shows what a provider charged, while the corresponding record explains the visit or service. For that reason, it is useful to match each provider’s records with the provider’s itemized billing statement before submitting a claim package.

The adjuster may use the materials to consider issues such as:

• Whether the documented treatment followed the reported incident.
• Whether the records describe injuries connected to the claim.
• Whether there are unexplained gaps or missing providers.
• Whether prior medical history may be relevant to the same body part or condition.
• Whether each claimed medical charge has supporting documentation.

The records do not automatically resolve every issue. The insurer may ask follow-up questions, request missing documents, or dispute whether particular treatment or charges relate to the loss.

Authorization and Medical Privacy in North Carolina

Medical information is private. N.C. Gen. Stat. § 8-53 generally provides that confidential medical-record information may be furnished with the patient’s authorization. Before a law firm sends records to a liability insurer, it should confirm that the disclosure is authorized and consistent with the client’s instructions.

There is an important difference between the firm sending selected claim-related documents and the client signing a broad authorization that lets the insurer request records directly from medical providers. A direct authorization may cover more information or a longer period than the records currently being submitted. Its language, scope, expiration date, and purpose should be reviewed before it is signed.

Records relating to earlier treatment may sometimes be relevant, especially if the insurer questions whether an injury existed before the incident. That does not mean every part of a person’s medical history is automatically relevant. The proper scope depends on the claimed injuries, the insurer’s stated reason for requesting additional material, and the circumstances of the claim.

What Should Happen Before the Records Are Sent?

Finishing treatment does not always mean the records package is immediately ready. Providers may process medical and billing requests separately, and one may arrive before the other. A careful review can reduce confusion and avoid sending an incomplete package.

Before submission, the firm may take the following steps:

1. Confirm every provider. The provider list may include an ambulance service, hospital, imaging facility, physician practice, therapy office, pharmacy, or another facility involved in the injury-related care.
2. Obtain records and itemized bills. Account summaries, payment receipts, or insurance explanations may not contain the same details as an itemized provider bill.
3. Match bills to treatment records. Each claimed charge should be checked against the available documentation for that provider and date of service.
4. Check for missing pages or dates. Missing reports, diagnostic records, discharge documents, or billing entries may lead to questions from the adjuster.
5. Review private information. Unnecessary Social Security numbers, financial account information, or unrelated confidential material may need to be removed or protected.
6. Organize the submission. A clear provider list, treatment timeline, and supporting documents can make it easier to understand what has been provided.

If lost income or other injury-related losses are also being claimed, those items generally require separate support. Medical records alone may not establish time missed from work, reduced earnings, or every out-of-pocket expense.

How This Applies to the Current Treatment Status

Here, the adjuster requested an update about the injured client’s treatment. Because treatment has ended and the firm is collecting the bills and records, the next step is usually to finish obtaining and reviewing the documentation before sending it to the insurer.

The firm may provide a general status update while collection is underway, such as confirming that treatment has concluded and that the supporting materials are being gathered. Once the package is complete, relevant records and itemized bills may be sent together or included with a written injury claim submission. The exact timing depends on whether all providers have responded and whether the documents appear complete and accurate.

The client should make sure the firm has the names and locations of every provider involved in the injury-related care. It is also helpful to preserve:

• Medical bills, statements, receipts, and visit summaries.
• Health insurance explanations of benefits.
• Prescription or medical-supply receipts related to the injury.
• Letters, emails, and claim notices from the adjuster.
• Any denial letter or request for a medical authorization.
• Documents showing injury-related time missed from work, if lost income is part of the claim.

Sending Records Does Not Stop a Filing Deadline

Collecting records, sending a claim package, or discussing the claim with an adjuster does not automatically extend the deadline for filing a lawsuit. N.C. Gen. Stat. § 1-52 establishes a three-year period for many North Carolina personal injury actions, although a different rule may apply depending on the type of claim and the parties involved.

The loss date should therefore remain part of the claim calendar while records are being collected. An insurer’s continued communication or request for documents should not be treated as confirmation that the legal deadline has changed.