The purpose of insurance is simple. You pay monthly premiums, and when something bad happens, the insurance company provides funds to help in your time of need. Often, we assume that paying our premiums on time means that we’re covered should we need to make a claim with the insurance company after being injured. Sadly it’s not always that simple.
While you’re using your insurance premiums to gain peace of mind, your insurance company is using your insurance as a way to make money. After all, the companies are a business and those monthly premiums add up significantly for every month and every year that you don’t make a claim. Sometimes, unfortunately, insurance companies are blinded by the profits they earn and start to shave away some morality in favor of higher profits. This results in fewer payouts to deserving customers.
The “Independent” Medical Consultation
In order to claim medical benefits, you must visit with a doctor to determine the extent of your injuries. A good doctor cares about your wellbeing and works with you to find the best method of treatment for all of your injuries. This is part of the doctor’s job description, and you’d expect no less from a professional who has taken the Hippocratic Oath to care for and advocate for his patients.
While there are many, many good doctors in the world who genuinely care about their patients, there are some who have walked away from their oath to objectively care for patients. These doctors have begun to care a great deal more for financial gain than patient advocacy.
Insurance companies and these corrupt doctors work hand-in-hand, and it’s to the detriment of the patients. You.
The insurance company sends a patient to see one of their independent medical consultants to determine the extent of his injuries. While the conscientious doctor would spend time looking over the patient to determine his overall condition, the “independent” consultants that the insurance companies prefer to give the patient a cursory glance and write their reports.
The reports are returned to the insurance company and then used in discussions, or even in court, to determine the number of benefits to be paid to the patient.
Making Good on Promises
Insurance companies have an obligation to provide customers with the payouts their premiums entitle the customers to. At times, however, insurance companies make good only on promises to these corrupt independent medical consultants.
When an insurance company pays an independent medical consultant, they can become much less independent. In fact, you could easily argue that the doctor has become bought and paid for. That’s not to say that every doctor these companies use is corrupt. Some are legitimate advocates for their patients and these doctors report well in hopes of helping patients.
Once they realize that a doctor has his patient’s best interests at heart, however, the corrupt insurance companies don’t seek out that professional for evaluations any longer. Instead, they turn to the doctors who tend to favor the side who pays them – the doctors who are in bed with the insurance companies.
These doctors might spend only a few moments with a patient and then write up detailed reports of healing or play down legitimate injuries. The doctors even fabricate observations in order to support the insurance company’s position rather than the patient’s.
After all, if the insurance company is pleased with the doctor’s assessment, it stands to reason that the insurance company will come back and pay for more. All the doctor has to do is be sure to keep the insurance company happy. Sadly this happens at the expense of the patient.
Lying Under Oath
An unfortunately common scenario plays out like this: An insurance company demands that one of its clients submit for an independent medical evaluation to determine benefit payouts. The doctor chosen to perform the independent evaluation is one who is known to dance to the tune of the insurance company.
The doctor spends just a few minutes with the patient and prepares a report. The report is then used to determine payouts, and the patient almost always winds up the loser in the negotiations. Many of these cases are settled in courtrooms. During the court session, the “independent” medical examiner is called as a witness and proceeds to lie under oath or at the very least evade the truth in support of the insurance company.
The cycle of insurance companies relying on corrupt doctors repeats itself over and over again. Often the same doctors – those who are well known to insurance companies for being easily bought – show up over and over again in courtrooms where their testimony decides cases. It goes without saying that all of that testimony helps to make the doctors richer as well.
Experienced lawyers are fighting back against the corrupt doctors and cronyism in the courtroom. Lawyers who have seen these doctors over and over again in the courtroom are calling foul and working to protect their clients’ rights.
In a well-known case in New York, Dr. Michael J. Katz was recently caught in a blatant lie while in court. Katz claimed to spend fifteen minutes with a patient looking over injuries. The patient in question, however, had been advised by his lawyer to secretly video his “independent” medical consultation. It turns out Dr. Katz had spent less than two minutes with the patient and did very little observing. It was found that he had lied about the extent of the patient’s injuries as well.
New York’s court system is trying to come to terms with how to handle a doctor who may have lied under oath hundreds of time over the course of more than ten years. His testimony has likely decided most of the cases in which he was called, and that is a great many victims.
New York is not the only state where these sorts of dirty tricks are played out. It happens that a doctor was publicly unmasked in New York, but you can find corrupt doctors working hand-in-hand with insurance companies in every state.
The best way to defend yourself against the unethical treatment by some insurance companies and physicians is to work closely with a legal representative who has extensive knowledge of the key players in the field – including those immoral doctors who are well paid by insurance companies to work against you.