Review requests for records authorizations and medical examinations

By Jacob Alford

What does a medical authorization permit?

In the approach Jacob Alford describes on InjuredTexan.com, his firm obtains and reviews the relevant records rather than giving the opposing insurer a medical authorization. That lets the firm address the actual history, explain what changed after the wreck and respond to requests through the appropriate process. Bring any authorization request to your lawyer before signing. Policy duties, discovery requests and court orders still need a timely response.

It gives specified people permission to disclose specified health information for the stated purpose. It is not the same as approving treatment or accepting a settlement.

Read who may release records, who may receive them, which information and dates are included, the purpose, the expiration and the revocation instructions. HHS explains that a valid authorization contains these kinds of identifying limits. HHS: consent and authorization.

Keep the completed version you signed, including every page. Do not sign a blank form or rely on a verbal assurance that an unlimited written request will be used narrowly. If you already signed and have concerns, obtain the document and advice about its effect. Revocation can limit future reliance when properly received, but it does not undo disclosures already made in reliance on a valid authorization. HHS: revoking an authorization.

Why is the insurer asking for earlier medical or work records?

Earlier records can help evaluate what changed after the wreck, whether a condition was aggravated, or whether claimed lost income is supported. That does not make every record from every year relevant.

Ask how the requested body part, condition, time period or employment record relates to the claim. A tailored set of records may answer the legitimate question more directly. Do not conceal a prior condition or alter an employment record. Explain the before-and-after facts accurately and preserve the full originals. Symptom records and missed-income records help document what changed.

A request for tax returns deserves a separate look. Texas restricts requiring federal income-tax returns as a settlement condition, with exceptions that include a court order and claims involving lost profits or income. Claiming wage loss can therefore change the analysis. Do not assume tax returns are always required or always off limits. Insurance Code §542.004.

How do I distinguish an insurer examination from a court-ordered one?

Ask whether the examination is proposed by an adverse insurer, demanded under your policy, agreed upon in litigation or ordered by a court. Those are different sources of authority.

Obtain the written request or order, the claimed basis, examiner’s identity, scope, timing, location and proposed tests. Ask about accommodations, expense arrangements and access to the resulting report. Have your lawyer review restrictions or disputed terms before the appointment.

Texas Rule of Civil Procedure 204 generally requires a motion and written order, good cause, and the circumstances specified by the rule for a compelled physical or mental examination. The order must define the examination’s scope and conditions. A letter bearing the words “independent medical examination” is not itself that order. Texas Rules of Civil Procedure, Rule 204.

Do not assume the examiner is taking over your treatment, or that the examination is necessarily favorable or unfavorable. Continue appropriate treatment with your providers. Do not skip a policy-required or court-ordered examination based on a general internet warning.

What if a request seems broader than the claim?

Identify the problem in writing: unnecessary dates, unrelated categories, unidentified recipients, open-ended future access or unclear purpose. Ask for the reason and a narrower request. Keep the original and proposed revision so the change is visible.

Supplying relevant records yourself may be an option, but do not assume that it satisfies every policy duty, discovery request or court order. Obtain a written agreement or legal review where necessary. A concern about scope is a reason to address the request, not to ignore it until the deadline passes.

Why is someone requesting a Social Security number or other identifying information, and how can I verify the purpose and recipient?

There may be a legitimate identification, benefits or reporting purpose, but verify it before sharing. CMS imposes reporting duties on certain insurers involving Medicare beneficiaries and settlements. That does not mean every unsolicited caller needs your complete identifier. CMS: mandatory insurer reporting.

Ask who is requesting the information, the precise purpose, which fields are required, whether a less sensitive identifier will work and how it will be protected. Verify the recipient through a number or portal you independently know to be genuine. Use the confirmed secure method rather than replying to an unexpected text or emailing an unprotected document. If the explanation is unclear, have the request reviewed instead of supplying extra identifiers “just in case.”

Attorney reviewed by Jacob Alford · November 11, 2026