Home > Insurance Law > Auto insurance companies adopt "Delay, Deny, Defend" to maximize profits at consumers expense
Posted on March 4, 2007 by Scott Grossman
- "Delay, deny, defend" is the battle cry for the auto insurance industry to protect their multi-billion dollar empire. In a recent report filed by CNN's Drew Griffin, he uncovered that this practice is rampant among the nation's auto insurance companies when people are injured in what insurance representatives consider a "minor impact" auto accident. New Jersey attorneys representing persons who have suffered injuries in auto accidents have long experienced first hand these tactics of the nation's largest insurance companies. Throughout the past decade I have represented many individuals that were involved in what the insurance company deemed a "minor impact" and as a result of the accident they suffered serious permanent injuries such as a herniated disc. Many times the injuries were so debilitating that after multiple steroid injections, extensive narcotics usage, physical therapy and chiropractic care, spinal surgery became the only option. The suffering was very real.
- The auto insurance companies do not want the public to understand the most important of Newton's Laws on Physics. Energy does not dissapear, it is transmitted to the impacted vehicle and hence to the occupants. Often times at trial, after years of delays from the insurance company, defense counsel will blow up a photo of the impacted vehicle that does not show significant property damage. A strategy frequently successful in having jurors draw an inference that the injuries claimed by the plaintiff are either untrue or if true they must have been from some other cause unrelated to the auto accident. The CNN news story referenced above did an excellent job exposing the tip of the iceberg when it comes to insurance companies doing whatever it takes to put corporate profits above the interests of those very individuals they are supposed to help.
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- In New Jersey when you are involved in a motor vehicle accident, your medical bills are supposed to paid for through the PIP, Personal Injury Protection benefits of the injured persons' insurance company without regard to who caused the accident. So in New Jersey, the medical benefits through PIP coverage follows the person and not the vehicle. However, the policy of denial often times happens through the issuance of a medical treatment cut-off or denial letter on the basis that the patient has reached MMI or maximum medical improvement. This frequently occurs without consulting the treating physician or without even examining the patient. Often the denial will be on the reccomendation of a physician advisor review. This means that a physician of like specialty will review some of your medical records and decide for your insurance company, while being paid by that insurance company if you should be cut-of from further treatment regardless of what you may be feeling. The system is driven to maximize profits by minimizing costs of medical care to insurance companies own insureds. To add insult to injury, these corporate profits aren't even passed onto the consumer in the form of auto insurance rate reductions. The PR spin shall continue........Blame the lawyers for your exorbitant auto insurance rates. It works each year after year along with the deeply ingrained favorite phrase of the insurance corporate elite ..."TORT REFORM".
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- Please read the CNN article linked above and I invite all who are interested or who have personal stories to tell to respond to this post.
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Reading this made me feel both better and worse.
My accident occured two years ago. I had PT, I tried pain management, including heating the nerve ends to block the pain impulses. I've had spinal blocks, and pain drugs.More than five months ago, I had two surgeons suggest surgery to correct the injury. I had an IME (Report from an insurance doctor) that said the injuries were the result of the accident. And yet with all of that, they delayed the surgery I needed for five months, while my condition worsened.
They have tried every trick in the book---including canceling IME's---and then tried to dismiss the claim because I "failed to attend them".
When my last surgeon suggested surgery, he wanted new studies---mine were over a year old. They refused them, stalling yet again.
Do I have an attorney? GOD yes. Pity the fool who doesn't in NJ.
What consumers need to know is that only about 40 percent of the doctors in this state accept accident cases anymore. Sixty percent just don't bother---because the paperwork and hassles made it so expensive, they don't need the trouble.
If you have an accident, you have no choice but to seek care through PIP. If you make a claim on your health insurance, knowing you were actually injured in an accident, you can be cited for insurance fraud. If you go through the system, you are at the Insurance Company's mercy---and trust me, they don't have much.
Even more absurd---equating car damage to driver damage? I know a dozen people who have walked away from a totaled car---without a scratch. Following the logic of bad damage equals bad injury, perhaps they should have been declared legally dead? But no...that would be absurd. So why is the inverse so unthinkable?
I've kept track of my experience with this accident through a blog. It keeps me sane, after I read one of the absurd EOB's they send. I had one recently where an RN contradicted the suggestion of two surgeons. Where in the known world is that allowed?
Only in the world of the auto insurance industry...if you have an injury, but don't have a lawyer? God help you...because no one else can.