When the victim of an accident in the workplace or on the roads is victimized by the denial of legitimate benefits, the only winner is the insurer, who manages, through the law, to commit fraud and get away with the crime.
These exams rise to the level of conspiracy. So much so, that in New York, some years ago, the U.S. Department of Justice conducted a RICO investigation into the manner in which they're handled. To this day, district attorneys, state attorneys general and federal prosecutors continue investigating "sham exams" conducted by exam mills.
In a recent conversation with a well-respected plaintiff's counselor in Charleston, he disclosed the reason why plaintiffs' lawyers don't push to close such exam mills. Ultimately, the doctors and their reports become so well known to the courts that they can often be challenged. But for every one that is challenged, many more succeed, letting the insurer off the hook for injuries caused in an accident.
What does this mean for the accident victim? Elimination of long-term care for one thing, which should be paid for by the insurance, but ends up paid by both the state and federal government through Medicaid or Medicare. It impacts your tax bill. For another thing, these exams slow down the legal process, and factor into the backlog of the courts.
West Virginia is one of the nation's leaders in the protection of medical privacy rights, yet these exams open up the records of the plaintiff to additional third parties and effectively violate the rights of the individual that the courts endeavor to protect. The federal health information privacy law may be routinely violated and without proper oversight, the right of the individual to keep medical records private becomes a travesty. At the end of the day, the injured party is left humiliated, harassed, and forced to bear the burden of future medical costs, while the insurance company funding the whole matter escapes with record profits.
The time is come to put an end to insurance fraud -- by the insurers and their medical examiners. Contact your local and state representatives and tell them to protect your right to privacy and to protect West Virginians from insurance fraud by the insurers themselves.
Angelone is an economist in Wall Township, N.J.