Today's Practice: Changing the Business of Medicine TP2018Q2DigitalEditionWeb | Page 50

L E GA L
Adjusters.
The challenges of working with Insurance Adjusters...
and what you, the Physician, can do about it.
By Paul A. Samakow, Esq.
Automobile collisions happen, and anyone can be a victim. When injuries follow,
doctors are the first to be asked for help, but more, doctors can be the most important
element later, when their injured patient seeks reasonable compensation for both the
medical bill, and for the other harms caused by the collision.
This second role a doctor often unknowingly happens upon the review of the medical
record, notes and reports that follow the treatment and care of the injured patient.
When notes are poor, incomplete, illegible, and when they fail to causally “connect”
the collision the injuries, auto insurance claims adjusters have a proverbial field day.
The doctor’s records, when poor, will serve to victimize the injured party financially,
because the claims adjuster will often deny, or partially deny claims. This hurts both
the patient and the doctor, who might otherwise be looking for the patient to obtain
compensation to pay the bill.
In fairness, there are some people who are fraudulent, and others who will exaggerate
injuries and losses to take advantage of insurers. Insurers should investigate, and they
should pay what they owe. Unfortunately, in too many instances when problems arise,
adjusters go overboard, or worse, claiming they are being fair. The reality is they are
watching the company’s bottom line.
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TODAY ’ S P R A C T I C E: C H A N G I N G T H E B U S I NES S OF M EDI C I NE