The unethical connection between insurance companies and the medical profession

In recent days there has been a focus on insurance companies delaying payments on medical grounds to people who need

In recent days there has been a focus on insurance companies delaying payments on medical grounds to people who need financial payments. The implication has been that doctors are pressured by insurance companies to change their assessment or that insurance companies are choosing doctors who will make assessments that favour the insurance company, not the patients.

In my experience this is not new.

In 2009 I was in a serious motor vehicle accident. After more than a year of rehabilitation, it was obvious I would not walk again without a walking stick, and chronic back pain would be my lot. As I had been driving home from work, I was, at the time covered under Workers’ Compensation. It is interesting to note that had I stopped for petrol or to go to the ATM I would not have been covered.

After eighteen months of dealing with the insurance companies used by the workers’ compensation people I began the process of seeking a compensation payment through our family solicitor.

I was examined by one of the doctors approved by the insurance company and recommended by my solicitor. He recommended a fairly substantial sum for my extensive injuries. This, naturally enough, the insurance company rejected. I would have to see their recommended doctor.

When I received the report from that doctor through Freedom of Information laws I was shaken to find that my physical was caused 0% by my accident, but was due to age, 64, and probable osteoporosis. At 63 I had been running round sporting fields referring touch footy and was constantly on my feet in a classroom four days a week.

My solicitor recommended I contact someone more used to handling compensation matters, and the law branch of my union took the matter up for me. A third doctor appointed by a dispute resolution party, found that while my injuries were not nearly as severe as found by the first doctor, I had permanent disabilities from the accident. In the end a satisfactory financial agreement was reached.

I will never believe the doctor who found that none of my injuries were related to my car accident was not employed because he found what was favourable to the insurance company.

And I’m sure there are other stories like mine.

Do you know someone who has been through similar?

    • We had probs with them 2 yrs ago when my 20yr old daughter went out on stress leave due to bullying at work cos of new owner. They flew up their own psychiatrist who basically told her the boss could do what he wanted! Utterly disgusting! Even her own doctor told her to walk away due to the stress and bullying tactics of QBE! I will never forget the whole experience!

  1. Not a new situation, but seems to be escalating, unfortunately. I f doctor shopping is unethical for patients, it should be the same for companies.

  2. Omg I am battling BT insurance now and my story is the same. Their “doctors” etc not only work for insurance company but also tell blatant untruths in their reports. I will not go to any of their drs again without recording the whole appointment. They just want to stress you out so that you give the claim up. Not me!!! Happy to take payments for years but not happy when you claim is apparently BTs motto

    • our son is going through something similar and being told he is a liar and it is all in his mind and the Dr’s reports are ludicrous and as you say blatant lies! Exactly, they want you to give up and go away!!

  3. Wat u Doris go to your own dr first and gat a report then if ins wants u to go to their dr u have your own Drs report to fall back on in court

  4. My husband is going through the same .. 21 years a casino croupier suffering bad tendinitis ..Drs say it’s an aggravation to a pre existing condition ..osteoarthritis .. and the self insured company is paying the claim for tendinitis .. The fact that he has virtually no cartilage around the effected area and osteoarthritis is known as the wear and tear arthritis ..They are denying that over 20 years of a repetitive movement has anything to do with it .. at the same time telling him his hand is now “cactus” and will probably never deal again WONT let him continue to floor manage after work cover ceases as that is seen as a promotion ..obviously over 20 years of service means nothing ..His future till retirement age seems very bleak.

  5. Doctors get deals from insurance companies as well as drug companies !!!! I knew a doctor that gave bad advise to a pstient so he could get endorsements from companies …..disgusting

  6. Angie B  

    Gosh that is awful, Vivienne. A scary prospect for anyone injured in an accident, especially as we are getting older. This leaves a nasty stain on the medical profession, doesn’t it?

  7. My brother was a truck driver and slipped off the truck step, they went in for a look and said yes he has done his knee. Then tried to say that he didn’t do it slipping off the truck step.After months and months of physio ect no better but they are refusing to do the op that he needs to fix it.His surgeon says that’s the only thing that will fix it. Theirs just says it didn’t happen that way and keep on with physio .

  8. I was finished up by Westpac after over 20 years service because they could no longer allow to work there and aggravate my ” degenerative condition” . Wrongly diagnosed tendonitis, was actually a rotator cuff tear.Corrected with surgery and haven’t had any more problems with it. That was well over 20 years ago so this is nothing new. Never have had principles, we are numbers not people. Profit and Shareholders mean no consideration for workers!

  9. Jacosmum  

    The laws surrounded Workers Compensation were changed in NSW by the current government. I know, i came under the new rules after having a MVA while during to a work conference in a work car. The insurance company GIO behaved in an immoral and illegal manner, and everytime i challenged them ( i pursued them through nearly all available channels) simply quoted another regulation at me. Until recently there was no Work Cover Ombudsman in NSW, this role having been dismantled by the current Liberal government under their so called reforms. And the Office of Fair trading can only investigate certain matters, there powers severely curtailed in regards to Workers Compensation. I can never work again, am in constant pain and basically houseboubd. I was employed as an oncology professional yet cannot and will not receive one cent. How is that fair?? And yet its the law

    • Nett  

      It is unfair. The workers comp insurance company can now stop workers payments after 12 months whether they are able to return to work or not. I had to walk away, I couldn’t cope with the stress I was under.

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