Just Because They Sent It, Does NOT Mean You Have to Sign It, As Is

This is what my life has felt like in the last two weeks, but in a good way

This is what dealing with insurance companies can feel like

We were recently in a car accident. We were in stop and go traffic. We stopped. The car behind us continued to go. That car was not going very fast, but fast enough that we all got a bit of whiplash and continuing back pain. Due to this, we were all seen by doctors, and C and I have referrals for massage.

First, the good news- it is standard practice in WA state for your automobile insurance to have a personal injury rider, and we have a great insurance agent who makes sure we are well taken care of. So we have a personal injury rider, to the tune of $35k. That’s not a lot if one of us ends up hospitalized, but for most things, it is more than adequate.

Also good news is that since we were not at fault (and we have witnesses to verify that fact), our insurance is not actually responsible for paying for these claims. The other party’s insurance is. However, because we have the PIP, our insurance pays for it as we go, and once all claims are in, they send the bill to the other insurance company and get reimbursed.

This makes it easier on us, because we can go to our providers and give them our insurance information, and be assured they will get paid in a reasonable time frame. There is no us paying and waiting for reimbursement, nor is there an extended period of time during which our massage therapists have to wait for payment.

So what is the bad news? It is the paperwork the other insurance company is asking us to sign.

In order to pay the claim, and to be assured that the treatment we are seeking is directly related to the accident, the insurance company needs medical records. They also ask for employment records in case there is time missed at work due to the accident. (We do not need to worry about that paperwork as C is a student, and I was not working at the time.)

The paperwork from our insurance company, Safeco, is straight forward and simple. It asks for a release of medical records directly related to the accident, and states that it will only be used in investigating and paying our personal injury claim. Simple, straight forward, inoffensive. We signed it and mailed it back.

The paperwork from the other insurance company (who I will not name, but will say is a major and well respected company) is complicated, full of legalese, and actually rather offensive, if you bother to read it and understand your rights.

This paperwork requests access to ALL of your medical records, past, present, and up to two years in the future, regardless of how they relate to the accident. It states that they may use those records to adjudicate the current claim, or in any way they wish in order to underwrite insurance. What does this mean?

Say you suffer from depression. Your depression was not a factor in the car accident (as the other person hit you), and you are not claiming your depression worsened or was in any way effected by the accident, so you also are not asking for the insurance company to pay for any treatment related to that. However, with the paperwork this second company sent us, they would still be entitled to your medical records about your depression, and in the future could then use that information, should you try to get insurance through them, to deny you or charge you higher rates, based on that depression.

And if that were not enough, the paperwork goes on to say that because they are not a health insurance company, they are not bound by HIPAA, and are therefore free to share your information with anyone they choose, for any reason they choose, and they do not have to inform you that they are sharing it, let along who they are sharing it with.

So you have now signed paperwork giving an entity full rights to your complete medical record, and that entity is not bound by any rules and regulations regarding your privacy or the sharing of that information. In other words, they can choose to make your private medical records as public as they wish. And this is with information that is not even related to the accident you were in or the treatment you are seeking because of that accident.

The kicker was then the statement at the end that if you do not sign this paperwork, you lose any right to compensation for your injuries.

C is a conspiracy guy, and a bit of a privacy freak. I read through this paperwork, and I did not like it. I knew he would refuse to sign it as was.  But here is the good thing about understanding your rights. You have the right to request modifications to any contract. I read through the contract. I crossed out sections about them being allowed to use this information to underwrite insurance in the future, being allowed to share our medical history freely, or even that they have the right to our complete medical histories. I added in phrases such as “only as it relates to investigating and paying this claim”.

We signed our paperwork with the added note that it was only authorized with the changes made.

Now we get back to the good news. This is not my fight. If they choose to try not to pay because we made changes to the contract they sent us, I am not the one who has to fight it. Because I have personal injury protection through my auto insurance, Safeco is the one paying my claims. Safeco is who will be seeking reimbursement from this other insurance company. It is Safeco’s legal team they will be going up against if they try to deny payment because they sent us an unreasonable contract.

And again, I know it was unreasonable because Safeco also sent us a contract for getting our medical records in relation to paying this claim, and it did not have any of the gross privacy violations of the one sent by the other insurance company.

The “funny” part is, this other insurance company is one I had considered switching to. As I said, they are well known, well respected, and get great reviews on their customer service. And maybe they treat their actual customers better than they treat people who are not their customers. But I can guarantee you, they will never get our business now.

Still, the moral of this story is- you do not have to sign the contract that is placed in front of you. Even if there are threats on the contract such as “by not signing, you give up all rights to this and future claims”. An unreasonable contract is unreasonable. You have the right to make or ask for changes. Read what is in front of you. Understand your rights. Stand up for them. If you do not, no one else will.

And honestly, this is once again the best argument I can make for filing a claim through your insurance company and using your health insurance to cover medical treatment. Because then, you are not the one seeking reimbursement. It is not your money on the line, but the money paid out by your insurance. An insurance company knows that it can out-lawyer you. But when it has to face another insurance company (either auto or health), then it is facing someone with the same legal resources it has. And it creates a whole different story.