Detailed Answer

After a car accident in New Mexico, thorough documentation and prompt submission of your medical treatment records can strengthen your injury claim. Follow these steps to organize, obtain, and submit the required information to the at-fault driver’s insurance company.

1. Gather and Organize Your Medical Records

1. List every provider: Note the names, addresses, and contact information for all doctors, clinics, hospitals, imaging centers, therapists, and labs you visited.
2. Obtain complete records: Request your full medical file from each provider, including:
   • Initial intake notes and history
   • Physician progress notes
   • Diagnostic reports (X-rays, MRIs, CT scans)
   • Physical therapy or chiropractic records
   • Prescription records
   • Billing statements and Explanation of Benefits (EOBs)
3. Document expenses: Keep itemized invoices showing dates of service, procedure codes, provider fees, and amounts covered by insurance.
4. Create a medical chronology: Develop a timeline charting each treatment date, diagnosis, and outcome. This helps insurers see the connection between your injuries and recommended care.
5. Maintain website links: If any records are provided electronically, download PDFs and note the source URL for reference.

2. Comply with HIPAA and New Mexico Authorization Requirements

• Signed Authorization: Send a HIPAA-compliant release form to each medical provider so they can share records with the insurance company. Use the insurer’s form or a standard authorization template.
• Timeline: New Mexico law requires insurers to acknowledge receipt of proof of claim within 15 days. Under N.M. Stat. Ann. § 59A-16-20(C) (https://nmonesource.com/nmx/nmstatutes/title59a/chapter16/article16), an insurer must promptly review submitted documents and respond.

3. Prepare Your Submission Package

1. Cover letter: Write a concise summary stating your name, claim number, accident date, and that enclosed are your complete medical records and bills.
2. Table of contents: Include a page listing each document by provider and date, so adjusters can locate information easily.
3. Copies only: Send photocopies or electronic copies. Retain originals in a secure folder.
4. Format:
   • Mail: Use trackable mailing (e.g., certified mail, return receipt requested).
   • Electronic: If the insurer offers a secure upload portal or accepts email, compress large files into clearly named PDFs (e.g., “2023-06-15_JohnDoe_MRIReport.pdf”).

4. Follow Up and Track Your Claim

• Confirmation: If you mailed your records, track delivery and save receipts. If you uploaded them, save email confirmations or portal acknowledgments.
• Request status updates: Contact the adjuster every two weeks to confirm they have reviewed your medical records and to ask if additional information is needed.
• Respond promptly: Provide any follow-up records (e.g., ongoing therapy or new diagnostics) as soon as you receive them.
• Dispute inadequacies: If the insurer claims your records are incomplete, refer to your table of contents and request a written explanation of missing items. You can resend any overlooked documents.

5. Consider Professional Help

If the insurance company delays, undervalues, or denies your claim despite complete records, consider consulting a personal injury attorney. An attorney can:

• Ensure your records meet evidentiary standards
• Handle communications and follow strict deadlines
• File suit in district court if negotiations fail (see N.M. Stat. Ann. § 41-5-13 for statute of limitations: https://nmonesource.com/nmx/nmstatutes/title41/chapter5/article1)

Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a licensed attorney in New Mexico for advice specific to your situation.

Helpful Hints

• Keep a digital and physical binder of all records.
• Label each file clearly by date and provider name.
• Request electronic EOBs from your health insurer to avoid paper delays.
• Make notes of all phone calls with adjusters (include date, time, and summary).
• Store backups of electronic files on a secure cloud service.
• Ask your medical providers for summary letters if you had complex or multiple treatments.