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LETTER OF THE DAY - Speed up insurance claims

Published:Tuesday | June 5, 2012 | 12:00 AM


Garth Rattray's column 'Burdensome, excessive injury claims' (The Gleaner, June 4, 2012) was very interesting and enlightening to the public. However, there is another side to the problem.

There is urgent need for upgrading of medical treatment of the severely and moderately injured from these motor vehicle crashes (MVCs)! The medical profession, especially older doctors, need to believe in their patients' symptoms. The legislators can make laws that decrease the hassle of claiming from an accident.

Take, for example, a patient with a Grade I open fracture tibia from an MVC, who has to wait a week or two to get surgical treatment which leads to a poor outcome. Therefore, the insurance payout has to be higher than necessary!

In most standard centres, this can be treated early within six hours, with less chance of infection and no permanent deficit. In our setting, it is treated late, with a high risk of infection and poor outcome.

Insurance companies make a significant profit annually. They can invest in critical care and allow proper treatment of these injuries so that the outcome is better and the payout less.

Another approach could be that hospitals tap into this great pool of resources to fund treatment of accident victims such as buying implants which are expensive.

One should also bear in mind that the persons who sustain minor injuries turn up later in life with the long-term sequelae of the injuries such as cervical spondylosis and chronic back pain, with no history of subsequent injuries.

no test for pain

There is no test available to detect pain or the extent of pain. Patients have different pain thresholds, and so minor injury to one can be significant to another. Pain and suffering are real, and as doctors we need to believe our patients. Why should we believe a patient has a headache, but not a back ache from an injury?

We also need to realise that the next thing coming will be claims against doctors who have treated patients badly in some cases, but because of ethical, credible, expert medical evidence against another doctor, there is no room for claims.

The country also lacks a patient advocate, and so these things go unnoticed. Doctors have malpractice insurance and so should settle claims from this, and patients should be encouraged to claim so that we see improvement in medical treatment.