I got food poisoning after dining at a restaurant when on vacation. We lost our flight back home the day after because of it (I had extreme symptoms). Instead of flying back home, that day I went to an urgent care clinic before ending up at the ER. In the ER they gave me fluids and medicine, so I was able to fly the next day.
I submitted a claim to the restaurant’s website (a chain), included all the expenses I incurred because of the illness (last minute flight reservations, and extra hotel night, walk in clinic and ER copays). They are asking now for my medical records and all the labs and tests they did at the ER, claiming they need them in order to proceed with the claim.
I hesitate to share this info with them, as I feel they are looking for any excuse to dismiss my claim. They said that they need to prove with the medical records that I got food poisoning, but as I understand, food poisoning is not a medical term and it won’t appear as that on the records.
Should I get a lawyer? Total expenses were less than $2k. It’s a lot for an out of the blue situation but probably not something a lawyer would be interested in pursuing. Is there anything else I can do? Thank you.
Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.
At this time, the insurance company does not have a legal right to see copies of your medical records.
The only circumstances under which they would have a legal right to see your medical records is under a court subpoena “duces tecum.” This is a court order compelling a person (or corporation) to produce certain books, documents, memos, emails, etc., in court, or to produce them so an attorney can review them.
However, in turn, the restaurant’s corporate entity does not have a legal duty to pay you any amount of compensation for your injury.
It is certainly reasonable for the restaurant to request copies of your medical records directly related to treatment for your food poisoning injury. They need some reasonable basis upon which to determine the type of injury you sustained, the type of medical treatment you required, and the amount of out-of-pocket expenses you paid.
If you decide not to cooperate, the insurance company will very likely refuse to pay your claim. In that occurs, your only recourse would be to pursue a civil action against them.
You are correct when saying it would not be worth an attorney’s time and effort to accept your case. There just isn’t enough supporting evidence to prove the restaurant caused your food poisoning. Even if there existed sufficient evidence, the amount of your monetary loss would not make it worth the attorney’s time and effort.
If the restaurant corporation will not cooperate, you may consider filing a small claims court lawsuit against the restaurant. Keep in mind, if you do end up in court, you will almost certainly have to provide the same medical records and bills requested by the insurance company.
While you didn’t mention where you were at the time of the food poisoning, in Monroe County, NY (7th Judicial District of the State of New York) where Rochester is located, Small Claims Courts have jurisdiction to hear cases up to $5,000.
Read more information about filing a Small Claims Court in Monroe County here.
Learn more here: Restaurant Food Poisoning Claims
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.
Best of luck with your claim,
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