Today's Practice: Changing the Business of Medicine TP2018Q2DigitalEditionWeb | Page 52

L E GA L
Adjusters
Insurance was once something we could rely upon. In
today’s world of automobile collision claims, it is too
often quite the opposite. Insurance companies now
routinely “fight’” claims rather than fairly investigate,
and the adjusters justify the delays, denials and reduc-
tions with the flimsiest of reasons. Sometimes, what is
said is unfathomable.
In the world of automobile insurance, we buy “unin-
sured motorist” and “underinsured motorist” protec-
tions. These protections provide a safety net if the at
fault driver does not have any, or not enough insurance,
or flees the scene and remains unidentified. We pay
premiums for these protections, and we rely on “our
company” in those situations.
Yet, even when dealing with our own insurer, major
aggravation can follow.
Long ago, if a disaster struck, we knew insurance was
there to protect us. We felt secure. We felt safe.
Insurance was our safety net. For most of us, without
insurance, there is a constant threat of financial ruin if
just one unaffordable loss occurs; even one moderate
disaster could be our complete financial end. A lifetime
of savings could otherwise be wiped out by a single loss.
How could we pay all of the medical bills and recover
from income losses? Insurance was critical.
Insurance was also a profession. The agent was similar
to our banker, our priest or our doctor or attorney.
Insurers were not just about making money; our needs
were first, above theirs.
All of this changed in the early 1990's. Insurers went
from trusted advisors to profit centers. Profits that
boggle the mind. Profits so outrageous that honestly, it
almost seems criminal.
Historically, insurers subscribed to two principles that
guided their work. The first, the Fiduciary Principle,
required prompt payment of claims. We relied upon
this principle and still do today; we somehow intuitively
feel it exists, or that it should. When we have a signifi-
cant loss such as a car accident, we rely on the insurance
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Paul A. Samakow, Esq.
to get us back to normal, to make our "down time" as
short as possible. We count on getting our car repaired
so we can get to work, to take the children to day-care
or to school, or to run household errands. We need our
car to go to the doctor for medical appointments. We
need our insurance to do what we paid them to do, to
pay for the car repair and for the medical appoint-
ments, because we do not have the money for those
things. We rely on insurance.