Please do not fall prey to recent insurance industry propaganda. Insurance companies, like United Automobile Insurance Company, are planting stories about fraud that bear no relationship to reality. The public should realize the insurance industry has embarked on a strategic campaign designed specifically to poison the pool of potential jurors while at the same time filling its bloated coffers with premiums Florida citizens are legislatively mandated to pay. Insurance companies, like United Automobile Insurance Company, use business models that require their insureds to attend compulsory medical examinations (CMEs), also known as Insurance Medical Examinations (IMEs), and Examinations Under Oath (EUO) at alarming rates.
An examination under oath is where the insurance company demands the insured go to the office of the insurance company to answer questions about a claim. A compulsory medical examination (CME) is where the insured is compelled to be physically examined by a doctor selected by the insurance company. A CME is supposed to be used by insurance companies to determine if future care is needed. Under Florida law, an insurance company can only cut off care if the insurance company obtains a report from a doctor stating no further care is medically necessary. These insurance doctors are supposed to be independent, fair and neutral.
In reality, insurance companies will immediately schedule these examinations, even before the insurer receives a single bill. Insurance companies know that a certain percentage of people will not attend these examinations if requested. This “no show” results in a basis for the insurance company to deny care. Additionally, many of the doctors used by the insurance companies are far from independent, fair and neutral. Typically, these doctors generate reports stating no more care is needed in the vast majority of times the doctor examines the patient at the request of an insurance company. Many of these doctors earn the majority of their income by working for the insurance companies. These doctors know that the insurance companies want the patient to be cut off. This saves the insurance company money. Alternatively, the insurance companies use doctors to do paper reviews of the medical records and opine that the only care that is reasonable will fall under the patient’s deductible. This means the insurance company would not have to make a payment. Accepting premiums and denying claims is a very profitable business model.
For some reason, the stories posted by the insurance industry, including United Automobile Insurance Company, fail to inform the public of this practice of scheduling compulsory medical examinations knowing a percentage of insureds will not appear so that the “no show” can be a basis to deny care as well as the practice of using doctors to cut off care the vast majority of time. It true there is a small percentage of fraudulent claims. However, it is just as true that insurance companies fail to act in their insured’s best interest, as opposed to protecting their own greedy profit motives. For this reason, virtually every jury trial results in a verdict for the patient or the doctor and against the insurance company. Jurors are smart and have more common sense than the insurance companies give them credit for having.
