The Scenario. To help you see if you might be affected by these unusual legal battles, a hypothetical example is given below. Suppose you have your auto insurance with State Farm, and you bought an optional coverage called “uninsured motorist” protection as part of your policy. This is commonly referred to as “UM” or “UIM” coverage. State Farm calls it “D” coverage in their paperwork. This is usually a very good coverage to have. It’s intended to protect you and your family if you’re injured in a collision with a driver who had no insurance; it also kicks in if the other driver did not have enough insurance to cover the full amount of your medical bills and injuries. Now suppose a drunk driver runs a red light and crashes into your car and injures you and your family. And suppose it turns out he had no insurance, which is not unusual with drunk drivers. UM coverage provides you protection, through your own insurance policy, for this situation. UM is an optional coverage that many folks buy to protect their family from just this kind of predicament. There is an extra cost for this kind of protection, meaning your insurance premium payment goes up some, but it is well worth the protection it gives you and your family.
In our example, when you notify State Farm of this UM claim they will probably inform you that your insurance policy requires you to provide them with a signed medical authorization, so State Farm can obtain the medical records and bills you incurred from the collision and evaluate your claim. OK, that sounds perfectly reasonable.
But when you receive the medical authorization form, if you read it, you find it’s worded so broadly that it gives State Farm access to all your medical records - for any conditions, diseases or treatments you have ever had at any time in your life. The authorization form also allows State Farm to meet privately with your doctors and discuss your care, even though you are not present, and you do not even have to be notified when such meetings are scheduled. And, you read the form and see that it gives State Farm permission to re-disclose your personal medical information to other insurance companies, which can result in all or part of your medical history being entered into digital databases. OK, now all this may not sound entirely reasonable. So, you decide to talk to a lawyer about whether you should sign the form or not.
Most experienced personal injury lawyers will advise that such a broad, unlimited medical authorization form is unnecessary and may well violate your right to privacy. They will tell you that Colorado law protects the privacy of your medical information for conditions, diseases, medicines and treatments that are not related to the injuries you had in the car accident with the drunk driver. For example, if you broke your leg and hurt your back in our collision example, a woman’s gynecological records or a man’s prescription history for Viagra, as well as records of some other unrelated disease, condition or psychological treatment you had in the past, should remain private. Colorado law protects the privacy of such unrelated medical information. The reason is this: an insurance company does not need access to unrelated medical information to evaluate the particular injuries you suffered in the accident with the drunk driver.
In our example, now suppose State Farm makes an unreasonably low offer to settle your injury claim. If you do not accept the offer of what State Farm claims your injuries are worth, your only option may be to file a law suit to get the uninsured motorist protection you paid an additional insurance premium for in your auto policy. If you have to file suit to be fairly compensated, it must be done before the statute of limitations expires, or your claim is lost forever.
In our example, after you file a law suit, you may find to your surprise that State Farm is not treating you like a good customer who paid their insurance bills on time for years. Instead, you may find you are treated like a stranger. In some recent cases State Farm has taken the position that some persons in your position have forfeited their UM coverage, and the UM protection you bought need not be paid to you – not even for your medical bills. This, State Farm has argued in other court cases, is because you failed to cooperate by not giving them that very broad and unlimited medical authorization. You respond “Well, we sent you all the medical records and bills for the injuries we had from this collision – what else do you need?” State Farm may claim that is not good enough. Because you did not sign their unlimited medical authorization form, they may take the position, as they have in some recent cases, that there is a loophole in the insurance policy that allows them to not pay you any of your UM coverage.
State Farm has taken a number of such uninsured (UM) motorist cases like this to trial in Colorado recently. State Farm’s lawyers will argue that by not signing the medical authorization form, you failed to cooperate with State Farm. It will argue that their insurance policy has a specific clause in it requiring you to give State Farm a signed medical authorization form, and you didn’t do that. Based on this, State Farm will ask a jury to decide that you failed to cooperate with them. If the jury agrees that you did not cooperate, State Farm will refuse to pay you any of the UM protection you bought from your State Farm agent, and the court will probably allow this result.
In a number of recent trials State Farm has won such cases and successfully used this approach to avoid having to pay UM insurance claims to some of their own customers and policy holders.
Is that acting “like a good neighbor?” Is that fair and reasonable? Should your own insurance company be able to deny you uninsured motorist protection just because you try to keep unrelated medical information private? Should any insurance company be allowed to refuse to pay insurance protection you paid for, unless you give them access to all of the medical records generated over your entire life? Or be allowed to deny a valid claim, just because you chose not to agree to them putting all your medical records and information into an insurance company’s digital database, even records that are totally unrelated to the injuries you claimed after our hypothetical car accident with a drunk driver? You be the judge.