Disclaimer: This article is for educational purposes and does not constitute legal advice.
Detailed Answer
When you file an injury claim in New Jersey, you must prove your damages with clear medical records and bills. Follow these steps to gather and submit your documentation efficiently.
- Obtain a HIPAA authorization. Before you can request medical records, sign a Health Insurance Portability and Accountability Act (HIPAA) release. This lets providers share your treatment information. Use your insurer’s form or a general HIPAA authorization.
- Identify all health care providers. List every doctor, hospital, urgent care, physical therapist or specialist who treated your injury. Include pharmacies if you filled prescriptions related to the claim.
- Request complete medical records. Send each provider a written request with your HIPAA authorization. Ask for charts, progress notes, imaging reports, operative reports and discharge summaries. Under New Jersey’s PIP statute (N.J.S.A. 39:6A-5 and 39:6A-8), insurers can demand these records when you claim Personal Injury Protection benefits. Link: N.J.S.A. 39:6A-5.
- Gather all medical bills and EOBs. Request itemized bills from each provider. Match them to your Explanation of Benefits (EOB) statements. Itemized bills show what was billed; EOBs show what insurers paid or denied.
- Organize documents chronologically. Create a tabbed binder or digital folder sorted by date and provider. Include a cover sheet summarizing each provider’s name, treatment dates, total charges and amounts paid or outstanding.
- Review before submission. Check for gaps in treatment records or missing bills. Follow New Jersey Court Rule R. 4:10-2(c) on mandatory disclosure of damage evidence. Link: R. 4:10-2(c).
- Submit to the insurer or opposing party. Send copies of your organized records and bills to the insurance adjuster or defense counsel. Use certified mail or an online claims portal with delivery confirmation. Include a cover letter listing each enclosure.
- Keep thorough records. Maintain duplicate sets of everything you submit. Record dates you sent requests and submissions. This timeline can prove compliance if disputes arise.
Helpful Hints
- Ask for electronic records to speed up the process and reduce copying fees.
- Track all communications in a written log: date, recipient, subject.
- Follow up on records requests if you don’t receive documents within 30 days.
- Use a spreadsheet to compare billed amounts vs. paid amounts for accuracy.
- Consult a personal injury attorney early to meet all court deadlines and rules.