Record reviews can slow a claim down, but delays often begin even earlier, in the stretch between opening a claim and having a complete record in hand.
Claims professionals are under pressure to evaluate severity quickly, but before they can, someone has to work out which providers treated the claimant, request their records, follow up on the ones that don’t arrive, and confirm nothing is missing. In both bodily injury and workers’ compensation claims, that stage can quietly add days or weeks.
Delays in injury claims often begin before the medical record review process, while teams are still identifying providers, requesting records, following up, and checking for completeness. The longer it takes to assemble a complete record, the longer a claim goes without a clear view of severity and exposure. The impact grows as the claim progresses.
The numbers show how common this problem is. The 2025 Workers’ Comp Industry Insights Survey found the following:
Together, these figures point to a retrieval stage that is often fragmented before review even begins.
Delays can enter the retrieval process at multiple points, especially when requests move across different systems and channels. Electronic exchange has expanded, but providers still operate across a mix of electronic and manual channels. For claims teams, that can mean more follow-up, more handoffs, and more chances for a request to sit.
Even when a request is valid and complete, the response timeline can still be lengthy. For example, even patient requests can take up to 30 days, showing how long a single request can remain outstanding before a claims team receives the records.
Even after records arrive, gaps can delay the next step. A missing provider, an incomplete date range, an unclear authorization, or a gap in the medical history can trigger another round of requests and follow-up.
With multiple providers involved, those extra steps can add up quickly. Delays introduced during record retrieval can carry forward into review and slow the point at which the claims team has a complete picture.
Once a claim enters litigation, retrieval delays can reach well beyond the records process. An American Bar Association Business Law Today article identifies records retrieval as one of the most consequential operational components of a case, and one highly sensitive to compounding delays. According to the article, a late record can:
Inside claims operations, each of those setbacks also creates additional follow-up and rework.
The stakes are high on both sides of injury claims. In bodily injury and casualty, Swiss Re Institute reported that social inflation, driven largely by large court verdicts, increased U.S. liability claims by 57% over the past decade. In workers’ compensation, litigation ranked as the industry’s top challenge in the 2025 survey, cited by 61% of respondents. In either case, a claim that reaches litigation with an incomplete record starts at a disadvantage.
Getting the records is only half of it. Once they arrive, teams face the next question: how quickly can thousands of pages become a clear understanding of the claim?
Where AI medical record summaries and insights fit
AI medical record summaries and insights reduce the time spent reading and organizing large files. Medical insights go further, surfacing patterns, timelines, inconsistencies, and changes in severity that might otherwise take hours to find. They’re most useful when they help claims professionals answer three core questions:
Industry analysts see real potential. Bain & Company estimates that generative AI could reduce P&C claims leakage by 30% to 50%. Adoption is still early, though: only 24% of respondents in the 2025 survey reported implementing a beneficial AI or analytics investment.
The goal isn’t to replace claims professionals’ judgment. It’s to give them a complete, understandable record sooner, so their time goes to evaluation and decision-making.
You don’t have to fix everything at once. Below are six steps that can help shorten the path from request to complete record, starting with the easiest changes to make.
1. Build the provider list early
Start identifying providers at the beginning of the claim, including prior treatment relevant to the injury. A provider found late means another full round of requests.
2. Get the request right the first time
Confirm authorizations, date ranges, and provider details before sending. Errors at this stage are a common reason requests come back incomplete.
3. Track every request in one place
Keep a single view of what’s been requested, what’s outstanding, and when each follow-up is due. Note how each provider sends records, so timelines reflect electronic channels where they exist and mail or fax where they don’t.
4. Check completeness as soon as records arrive
Compare what came in against what was requested before starting a deep read. Look for missing providers, date gaps, and unexplained breaks in treatment, so problems surface in days instead of weeks.
5. Start review while records are still arriving
For claims with multiple providers, consider reviewing early records as they come in rather than waiting for the last one. It can narrow the range of likely outcomes sooner.
6. Consider record retrieval services at volume
For teams managing hundreds of open claims, record retrieval services can take on request tracking, provider follow-up, and completeness checks, freeing claims professionals for investigation and evaluation. Whichever route a team chooses, measure turnaround so improvement is visible.
Review can only move as fast as the record allows. Teams that treat retrieval as part of the claim timeline, not a step before it, are better positioned to assess severity sooner, reserve with more confidence, and avoid the rework that comes from starting with an incomplete picture.
Want the full picture? Download Ontellus’s whitepaper, The Cost of Delay in Claims Decision-Making, for more data, a clear look at how delays start at retrieval, and practical ways to get complete records faster and make the information inside them easier to act on.
What is medical record retrieval?
Medical record retrieval is the process used to identify providers, request records, follow up and ensure they're complete to enable a claims team to assess a medical claim.
Why does medical record retrieval take so long?
Responses from providers are done electronically and manually, requests may require follow-up, and incomplete or unclear requests may result in additional follow-up.
What are medical record retrieval best practices?
Early development of the provider list, obtaining authorization and date range corrections, maintaining a single record of all requests, completeness review on arrival, and start review as records are received.
How do retrieval delays affect claims?
They delay the time that teams have to evaluate severity and exposure. In litigation, they can also move to change depositions, delay expert review, and extend discovery.
Do record retrieval services replace claims professionals?
No, they are responsible for tracking and following up requests as part of administration, and claims professionals concentrate on the evidence and claim decision making.