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Trust your family doctor; not the doctor paid by your insurance company

I think it’s fair to say that North American society has become more skeptical over the years. We are more skeptical of government. More skeptical of science. More skeptical of our leaders. More skeptical of large businesses. More skeptical in general.

Or perhaps, a more accurate comment is that social media has amplified voices for skeptics and conspiracy theorists alike.

The internet has also amplified our access to information and misinformation as well; thus giving rise to easily accessible and LOUD opinions online.

What always amazes me is that with the vast amount of information available at our fingertips; that people don’t research very basic things about their health; particularly when it comes to car accident cases.

In an age of skepticism, there is a portion of the population which still takes what the insurance company says as gospel. How do I know this? I see it almost every day with accident victims in my line of practice as a personal injury lawyer.

After a serious car accident, your own car insurance company will have a line of assessments set up for you. The insurance company will want to send their own occupational therapist to your home to conduct an in home OT assessment with Form 1 to determine your healthcare and attendant care needs.

The insurance company will have their own preferred list of physio or rehab clinics lined up for you to visit.

The insurance company will have its own preferred list of body shops for you to send in your vehicle for repairs.

The insurance company will have an army of medical doctors waiting at the ready to see you in some shared professional office setting where accident victims are lined up with military precision timing to conduct “independent assessments“. This mill setting for an assessment centre is not uncommon. For more information about these practices, read the Globe & Mail exclusive:

Licensed to bill: How doctors profit from injury assessments that benefit insurers

Or you can look at this article again from the Globe & Mail regarding the writing of reports of medical reports for car accident and other insurance related cases:

Insurance assessment firms altered, ghostwrote accident victim reports

Or there’s another interesting article from the Globe & Mail regarding the ethical side for doctors retained by insurance companies in doing “independent medical assessments”:

Insurance work puts doctors in an ethical bind

Insurance companies pick these doctors and health care professionals. These doctors and health care professionals do not bill OHIP for these services. Their bills are paid by the insurance companies which they serve.

With this in mind, I always find it hard to understand how and why so many people put their trust in large insurance companies to handle their post accident health. What’s even more frustrating is that seeing a doctor in Canada is FREE! Your family doctor or nurse practitioner knows you best. Your first stop for treatment ought to be to your own doctor and not a hired gun insurance doctor who the insurer has hand picked to see you.linkedin-2-300x300

Your family doctor or nurse practitioner has no skin in the game per se. They’re only interest is to serve you; their patient and get you better. There are no ethical strings at play behind the scenes. Your family doctor can make referrals for you via the OHIP system and prescribe prescription medication to you. An insurance doctor won’t likely write you a prescription for medication because you aren’t their patient although they may recommend that you take certain medication. Nor will the insurance doctor make a referral for you for any diagnostic test or to see a specialist through the OHIP system.

The insurance company is the insurance doctor’s true client. The patient is a necessary evil to their billing relationship. No patient. No billing.

Seeing an insurance doctor for a medical examination is not a warm and fuzzy feel good visit to see a doctor. The appointment is more business transaction than medical appointment.

Here are some helpful tips to avoid getting stuck in the middle between the hired gun doctor and insurance company:

  1. Empower yourself! It’s your body. It’s your health. It’s your life. You see the doctor or therapist you want to see. There is no need for you to go where the insurance company wants you to do. Unless it’s for a Section 44 Examination under the Insurance Act (IME), you don’t need to go where the insurance company wants you to go. Go where you want to go. Go where it’s most comfortable and convenient for you. Go close to home. Go where they understand you and your needs. Keep in mind that there is a reason why the insurance company wants you to go to see a certain doctor or to a certain assessment centre.
  2. Don’t have a Family Doctor or Nurse Practitioner? That’s no excuse not to get the medical treatment you need. Go to a walk in clinic, Emergency Care Centre and get on a wait list for a Family Doctor or Nurse Practitioner. There are plenty of new doctors out there who are accepting new patients. Do your research and find one. Get on the wait list if necessary. You will be surprised at how quickly wait lists dwindle down and service begins. Keep in mind that you can also contact TeleHealth Ontario for assistance.  1-866-797-0000
  3. You get to pick where you get treatment! If the insurance company tells that you that their preferred clinic is Clinic “A”, but you don’t want to go to Clinic “A” and instead want to go to Clinic “B”; then go to Clinic “B”. You are allowed to go where you want for treatment. You are under no obligation to go to a certain clinic just because the insurance company wants you to go there.
  4. Don’t get bullied or give up the fight! If you’re feeling down or depressed don’t lock yourself up in a shell of isolation. It’s important to reach out to friends, family, loved ones and your personal injury lawyer to get the help you need. Stay positive. We will get through this together. 


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