Life insurance companies often request medical authorizations because they want permission to obtain records that may affect whether a death benefit is payable. The request is especially common when the insured dies during the contestability period, when the insurer questions an answer on the application, or when the cause of death may relate to a policy provision.
A medical authorization request does not mean that the claim will be denied. It gives the insurer permission to seek medical information within the scope of the authorization. Before signing, you should understand which records the insurer wants, the time period covered, the providers included, and how the requested information relates to the claim.
Trief Olk & Dror represents New York beneficiaries in disputed and delayed life insurance claims. The firm can review a medical authorization request when its purpose, scope, or relationship to the claim is unclear.
Why Insurers Ask for Medical Authorization Before Payment 
A beneficiary may expect the claim process to involve submitting a claim form and death certificate followed by payment of the policy proceeds. Some claims receive closer review because the insurer believes it needs medical information before deciding whether benefits are payable.
A medical authorization may allow the insurer to request health information from physicians, hospitals, pharmacies, laboratories, specialists, and other medical sources identified in the form.
The insurer may use medical records to examine questions such as:
- What diagnoses or symptoms were documented before the policy was issued?
• What medications had the insured been prescribed?
• Did the insured receive testing, treatment, or referrals related to an application answer?
• Was there a medical condition relevant to an exclusion or accidental death claim?
• Did a reinstatement or increase in coverage involve new evidence of insurability?
• Does the medical timeline match the information in the application and claim file?
For more information about how medical records may affect a life insurance claim, see:
https://lifeinsurancelawfirm.com/do-life-insurance-companies-care-about-medical-records/
Contestability Is a Common Reason for a Medical Records Review
Medical authorizations are especially common when the insured dies during the policy’s contestability period. Individual life insurance policies issued or delivered in New York generally contain an incontestability provision that limits the insurer’s ability to challenge coverage after the policy has been in force during the insured’s lifetime for two years, subject to statutory exceptions and policy-specific issues.
When death occurs while the insurer may still contest coverage, the company may compare the application with medical records to determine whether an answer was inaccurate or incomplete. This type of review is often described as post-claim underwriting.
You can read more about post-claim underwriting here:
https://lifeinsurancelawfirm.com/life-insurance-claim-denials-and-post-claim-underwriting/
Finding a difference between an application and a medical chart does not automatically establish a valid basis for denying benefits. Under New York Insurance Law Section 3105, a misrepresentation generally must be material before it can defeat recovery. Materiality focuses on whether the insurer would have refused to issue the contract if it had known the true facts.
For more information about New York material misrepresentation disputes, see:
https://lifeinsurancelawfirm.com/denial-due-to-claimed-material-misrepresentation-2/
Medical Records Do Not Always Tell a Simple Story
Medical files are created for treatment, diagnosis, communication, and billing. A chart may contain shorthand, preliminary impressions, copied problem lists, billing codes, duplicate entries, older diagnoses, or information entered by staff members. A later note may also describe an earlier symptom in a way that makes the timing unclear.
That distinction can matter when an insurer claims that the insured failed to disclose a condition. A medical record showing a diagnosis does not always establish when the insured learned about it, what a doctor explained, or how the insured understood a question on the life insurance application.
For example, suppose a New York insured applied for coverage in January and answered that no physician had diagnosed a particular condition. A specialist’s record created in March may later refer to symptoms that began the previous fall. The insurer may view the record as evidence that the condition existed before the application.
A beneficiary may need to examine several separate questions:
- Had the insured actually received the diagnosis before the application date?
• Did the application ask about symptoms, diagnoses, treatment, testing, or all of those subjects?
• What did the insured know when the application was completed?
• Who completed or entered the application answers?
• Did the insurer’s underwriting rules treat the information as material?
A careful review should consider the full medical and application timeline rather than relying on one sentence from a medical chart.
We contacted Trief, Olk & Dror to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.”
- John Ramig
If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome.
Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.”
- Kathleen Brown
Trief, Olk & Dror is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients.
- Christopher Hughes
The Cause of Death May Also Affect a Medical Authorization Request
An insurer may request medical records for reasons unrelated to an alleged application misrepresentation. Medical information may be relevant when the claim involves an accidental death rider, a suicide exclusion, questions about the cause or manner of death, or another policy provision that depends on medical facts.
A focused request tied to a defined coverage issue differs from an authorization that seeks every medical record from every provider for an unlimited period.
A contestability review does not make every category of personal information relevant to the insurer’s stated coverage investigation. The wording of the authorization, the policy provisions at issue, and the reason provided by the insurer should be considered together.
For more information about the timing of contestability reviews, see:
https://lifeinsurancelawfirm.com/two-year-contestability-period/
Settlements & Verdicts
What to Review Before Signing a Medical Authorization
You do not need to assume that every medical authorization is improper. You also should not treat every authorization as routine paperwork. Read the form carefully and identify exactly what it allows the insurer to obtain.
Review these points before you sign:
- Providers: Identify the physicians, hospitals, pharmacies, laboratories, and other sources covered by the authorization.
• Date range: Check how far back the authorization reaches and whether the period appears related to the claim issue.
• Categories of information: Determine whether the form requests general medical records, mental health records, pharmacy history, laboratory results, treatment records, or other categories.
• Purpose: Look for language explaining why the information may be disclosed.
• Expiration: Check when the authorization ends.
• Repeated requests: Determine whether the form permits the insurer to make more than one request under the same authorization.
• Other releases: Review whether the document authorizes disclosure beyond the medical records that appear relevant to the claim.
A medical authorization should be read as a legal document, not treated as routine claim paperwork.
Before returning the form, consider these practical steps:
- Keep a complete copy of the authorization before signing it.
• Ask the insurer to explain the purpose of the request if the reason is unclear.
• Confirm which providers or categories of records the insurer is seeking.
• Review whether the requested date range appears connected to the stated issue.
• Keep copies of letters, emails, portal messages, questionnaires, and records sent to the insurer.
• Do not guess about the insured’s medical history in a separate questionnaire or written explanation.
• Track any deadlines stated in the policy, denial letter, plan documents, or insurer correspondence while records are being collected.
If the authorization appears unusually broad, asks for information that does not appear related to the stated investigation, or accompanies a detailed investigation questionnaire, legal review may help clarify what the insurer is requesting and how the request relates to the claim.
Does Signing a Medical Authorization Mean the Insurer Can Deny the Claim?
No. Signing a medical authorization gives the insurer access to records within the scope of that authorization. It does not establish that the insured made a material misrepresentation, that an exclusion applies, or that the insurer has a valid basis to refuse payment.
The insurer still must evaluate the policy, application, claim evidence, and governing law. If the company later issues a denial, you should obtain and review the written explanation rather than relying only on a telephone summary.
A denial based on medical records may raise questions such as:
- What did the application actually ask?
• What did the insured know when the application was completed?
• Who completed or entered the application answers?
• Is the medical information cited by the insurer accurate?
• Does the insurer have underwriting evidence supporting its materiality position?
• Had the contestability period expired?
• Does the policy provision cited by the insurer apply to the facts of the claim?
A medical record can become evidence in a claim dispute, but the record still has to be read in context.
How Medical Authorizations Can Affect Claim Timing
Collecting medical records can take time. Different providers may respond at different speeds, and a provider may send an incomplete set of records that requires a follow-up request. A delay may have a legitimate explanation when the insurer is actively investigating a defined issue and waiting for relevant information.
You can still take steps to keep the claim moving. Ask the insurer:
- Which records remain outstanding?
• When were the records requested?
• Has the insurer received partial responses?
• Does the insurer need anything else from you?
• What step will follow after the remaining records arrive?
Written status requests can help create a clear chronology if the investigation later becomes disputed.
If your claim is already delayed or denied, you can review the firm’s New York denied life insurance claim attorneys page:
https://lifeinsurancelawfirm.com/new-york-denied-life-insurance-claim-attorneys/
When a Lawyer Can Help With a Medical Authorization Request
A life insurance claim lawyer can review the authorization together with the policy, application, claim forms, insurer correspondence, medical-record requests, and relevant dates.
The goal is not to reject a legitimate request for claim information. The goal is to understand what information the insurer seeks, whether the request has a defined relationship to the claim, and what legal issues may arise from the records.
Legal review may be useful when:
- The authorization covers a very broad period.
• The insurer requests records that do not appear related to the stated claim issue.
• The insurer has identified a possible application misrepresentation.
• The claim involves reinstatement or an increase in coverage.
• The claim involves an accidental death provision or another coverage limitation.
• The insurer has sent a detailed investigation questionnaire.
• The claim has been delayed while records are being collected.
• The insurer has already issued or threatened a denial based on medical information.
In those situations, the medical authorization may be one part of a larger life insurance claim investigation.
Speak With a New York Life Insurance Claim Lawyer
If a life insurance company has asked you to sign a broad medical authorization before paying benefits, Trief Olk & Dror can review the request, policy, application, insurer correspondence, and explanation for the medical records request.
The firm represents beneficiaries in New York life insurance claim disputes and offers consultations at no charge. No result can be promised because each claim depends on its own policy language, facts, records, and applicable law.
Call Trief Olk & Dror at (917) 914-2005.
tel:+19179142005
You can also contact the firm here:
https://lifeinsurancelawfirm.com/contact/
This article is for informational purposes only and is not legal advice. Consult an attorney about your specific situation.
