What injury and medical treatment information can an attorney provide to an insurance company?

What Information Is Usually Included in an Insurance Update?

After a Durham car accident, the liability insurance adjuster may ask the injured person’s attorney for a letter of representation and an update about medical care. A representation letter and a medical update serve different purposes.

The representation letter normally identifies the person represented, the date and general type of incident, the insured person if known, and the insurance claim number if one has been assigned. It tells the insurer to direct claim communications to the attorney. The letter does not, by itself, give the insurer unrestricted access to the client’s medical history.

With appropriate client authority, an attorney may provide a focused update containing information such as:

• The general nature and location of the injuries being claimed.
• The names of hospitals, clinics, or other medical providers involved in accident-related care.
• The dates or general period of treatment.
• Whether treatment is continuing, completed, or awaiting further evaluation.
• Documented activity restrictions or symptoms relevant to the claim.
• Itemized medical bills and visit summaries.
• Selected medical records that document diagnosis, treatment, causation, or progress.
• Future-care information when it has been documented by a medical provider.

An attorney should not independently diagnose an injury or predict a medical outcome. The information provided should accurately reflect the client’s reports and the available medical documentation.

Client Authority and Medical Privacy Matter

A lawyer has confidentiality obligations to the client. Information learned during the representation should not be disclosed merely because an adjuster requests it. The attorney should determine whether the disclosure is authorized by the client, reasonably necessary to handle the claim, or otherwise permitted by law.

Obtaining records from a medical provider usually requires a properly completed authorization. Under N.C. Gen. Stat. § 8-53, confidential medical information generally may be furnished with the patient’s authorization, although a court may order disclosure in appropriate circumstances.

An authorization should be reviewed for its recipient, purpose, date range, expiration, and categories of information covered. A request for an update does not automatically justify releasing an entire lifetime medical file. Records from before the accident may be relevant when the insurer raises a prior injury, similar symptoms, or another causation issue, but the scope should be evaluated rather than assumed.

Summary Information Versus Complete Medical Records

An attorney may respond to an adjuster with a short summary before sending a complete claim package. For example, the response may identify the affected body areas, list known providers, and state that treatment information is still being collected. This allows the attorney to communicate without guessing or presenting an incomplete record as final.

A later submission may include complete accident-related records, itemized bills, and a more detailed explanation of how the injuries affected the client. Records and bills should be checked for correct patient information, dates of service, duplicate charges, and whether they actually relate to the accident.

The attorney may also withhold information temporarily when verification is needed. It is better to tell the insurer that the matter or records are being confirmed than to disclose information about the wrong person, accident, or claim.

When Broader Records May Be Requested

Some insurance requests have specific legal requirements. For example, a person requesting automobile liability policy limits before litigation under N.C. Gen. Stat. § 58-3-33 must satisfy several conditions. These include written consent for the insurer to obtain records concerning the claimed injury and records from the three years before the claim arose. That is a particular statutory process, not a rule that every routine medical-update request requires three years of prior records.

Once a lawsuit is filed, formal discovery rules may also require disclosure of relevant medical information. The proper scope can depend on the injuries claimed, disputed causation, prior conditions, court orders, and objections available under North Carolina law.

Information That Should Be Reviewed Carefully Before Disclosure

Before sending medical information to an insurance company, an attorney should consider whether the material is accurate, relevant, and authorized. Particular care may be appropriate for:

• Records concerning treatment unrelated to the accident.
• Social Security numbers, financial account information, or other unnecessary identifiers.
• Especially sensitive medical information that is not connected to the claimed injuries.
• Draft summaries containing unverified diagnoses or treatment dates.
• Records belonging to another patient or relating to another claim.
• Broad medical releases that allow direct contact or unrestricted collection beyond the claim’s needs.

Providing relevant records can help an insurer investigate an injury claim, but disclosure should be deliberate. Once information is sent to the opposing insurer, it may influence decisions about causation, fault, and damages.

Documents and Details to Organize

An injured person can help the attorney prepare an accurate update by preserving:

• The insurance claim number and adjuster’s contact information.
• The crash report and date of the accident.
• A list of medical providers and dates of service.
• Medical bills, records, discharge papers, and visit summaries.
• Written restrictions or work notes from providers.
• Letters, emails, and medical-release forms sent by the insurer.
• A current description of symptoms and daily limitations, stated accurately.

The client should tell the attorney about earlier injuries or treatment involving the same body area. Prior treatment does not automatically defeat a claim, but an unexpected record can create credibility and causation disputes if it is not addressed carefully.

How This Applies When the Claim Cannot Initially Be Located

If an insurer asks for a representation letter and updated medical information but the matter cannot be found in the firm’s initial system search, the first step is verification. The attorney or staff should confirm the client’s identity, accident date, insurer, insured person, claim number, and whether the firm has authority to act.

No one should guess about the injuries or send records based only on the adjuster’s request. Once the representation is confirmed, the firm can send an accurate letter, identify what treatment information is available, and explain whether additional records are still being collected. The firm should also document what was sent, when it was sent, and the client authority supporting the disclosure.

Exchanging letters or medical records with an insurer does not file a lawsuit or automatically extend a legal deadline. Many North Carolina personal injury actions are subject to a three-year limitation under N.C. Gen. Stat. § 1-52, although the correct deadline depends on the claim and facts.