I'm an insurance adjuster. I get to hear people tell lies all day and try their hands at committing fraud. It's the most rewarding job you could ever dream of having. Oh well. At least it pays okay.


When I was a boat mechanic, the lies people told to get their boats repaired for free was sickening, and the insurance companies paid the claims, it was easier for them to just pay than go to court.

That's just the problem Mariner. There are so few cases where I can prove someone is lying to me, and if I deny their claim my company gets sued. I have to pay a lot of claims when it is clear to me the person is being dishonest. People hate insurance companies for ripping them off, but the real blame needs to go to all the dishonest people out there committing fraud and trying to make money off minor car accidents.

And don't even get me started on lawyers:) They're the real reason you pay the premiums you do.

"And don't even get me started on lawyers:) They're the real reason you pay the premiums you do."

Do not go there.

That's just the problem Mariner. There are so few cases where I can prove someone is lying to me, and if I deny their claim my company gets sued. I have to pay a lot of claims when it is clear to me the person is being dishonest. People hate insurance companies for ripping them off, but the real blame needs to go to all the dishonest people out there committing fraud and trying to make money off minor car accidents.

And don't even get me started on lawyers:) They're the real reason you pay the premiums you do.


Actually, lawyers keep people from getting screwed over by insurance companies that would otherwise not be paying. The system being screwed up is certainly a two-way street.

If you're going to claim that the insurance business handles all claims highly morally, please take a look at some of the moral debacles in the medical insurance biz. I understand that many things are done in the name of keeping rates down, but trust me, lawyers simply react and capitalize on the flaws already in the insurance system.

For example, fraud would not be nearly so rampant if insurance companies would pony up and spend a little money in court defending themselves from bogus claims.

I dont really blame insurance companies on the rising cost of insurance, it is the people who abuse the system that costs us all more money. Lawyers dont hlep much either, but then again, if people would not abuse the system, we would not need the laywers, it is a viscious circle.

...and I still stare at a door....

...and I still stare at a door....


?????

i hurt my back when some truck hit me and ran. The doc, at i believe it was at SW Integris(44th street and western), from ER told me to just dismiss it because it was just my muscles.

Visited my physician and he prescribed me high doses of ibuprofen. Went back a month later and my physician sent me to um...a back place I cant remember..haha
They took x-rays and then had an mri done. Turns out I have a ruptured (bulging) disc.

Never did anything about it even thought the specialist wanted to operate. I've left it alone because he told me it is possible that it will partially heal after some years.

Actually, I've tried acupuncture therapy and it has helped to relieve pain that I had when I had to work manual labor. It sucks but hey its life I guess. When I get surgery I'll use my health insurance to care for it. I don't even want to think about the hassles of auto insurance.

Who, by the way, you would need if you are sued or arrested?

Midtowner, I'm not criticizing all attorney's--just those who capitalize off of minor car accidents. The insurance industry is highly regulated and as an adjuster I'm scared to death of even THINKING about stepping outside the line that has been drawn for me by insurance laws. Attorneys, however, have no real checks and balance system. This is why we desperately need tort reform. And I'm not talking about serious accidents where cars are totalled and people are put in the hospital and miss work. In those cases, you made need representation to get the maximum pay out. I'm talking about the tiny fender benders, rear-endings, and parking lot accidents where there is no more than a scratch on someone's vehicle and yet they have to spend weeks in a chiropractor's office. Insurance fraud is and blatant dishonesty is the reason people spend so much on premiums. And a lot of attorneys out there play into this whole concept of entitlement. I'm not saying all lawyers are bad, but you do have to admit it is a serious problem.

And Mr. Anderson, this thread was long dead until I posted what I did. Someone posted a reply to it, and it spurned a tangential discussion. It didn't hurt anyone. And it is still fairly related to the topic as it relates to what I do for a living. I'm so tired of all the rants on here about "staying on topic" and threats of editing and deleting threads. No one is attacking anyone, and this is a fairly interesting discussion for me as it relates to what I do for a living. Chill out.

And Mr. Anderson, this thread was long dead until I posted what I did. Someone posted a reply to it, and it spurned a tangential discussion. It didn't hurt anyone. And it is still fairly related to the topic as it relates to what I do for a living. I'm so tired of all the rants on here about "staying on topic" and threats of editing and deleting threads. No one is attacking anyone, and this is a fairly interesting discussion for me as it relates to what I do for a living. Chill out.

I'll take care of it guys. I'll just move these to a new thread on attorneys.

Actually, the job of a moderator is to make sure people play fair, and to keep people on topic. If you want to discuss another topic, it might be wise to start a new thread! Most threads typically stay on topic, but occasionally I'll split a thread if it starts to get off topic. I'll just do that here.

Okay guys, the new thread is up and running. Discuss attorneys here, discuss where you work in the other thread!

To blame attorneys for the rising cost of insurance is a true red herring perpetuated by the insurance industry. The fact is that around 9/11, the stock market and investments took a dive. As we all should know from our business 101 classes, insurnace companies do not make any profit off of their premiums -- in fact, in the long run, if you ran an insurance company with just premiums and payouts, it would go under really fast.

Insurance companies make their money through investments. The fact is, that when their investments started to go south, they had to get money from somewhere else -- their customers.

It is very easy for them to point their fingers at trial attorneys and a few nutsy jury verdicts and tell us all that "There is the problem!". But that is simply not the case. Absolutely nothing has changed in tort law and insurance really in the last 10 years. However, only over the last 4 or so have rates really started climbing.

Also, if you want to look at medical insurance specifically, you have a broken system. The system does not hold doctors accountable when they cost it money. The fact is that about a small number of doctors (that still have their licenses) actually account for the vast majority of claims.

In our state, it is especially untrue that medical malpractice suits bring overly damaging verdicts. Insurance companies know that in our state, due to the amount of negative publicity and general public perception about trial lawyers and medical malpractice that Oklahoma juries are VERY unfavorable to handing out big verdicts.

Harvard study done in 1991 concluded that as far as medical malpractice goes, the fault is largely with the doctors, and that the real problem is that they are "not sued enough". It also gave an alarming statistic that doctors through negligence/mistakes kill as many as 80,000 patients per year in the United States.

by Leo Boyle
© Trial, April 2002

Skyrocketing medical malpractice insurance premiums. Doctors abandoning their practices. The insurance industry wants the public to think these trends are the result of “frivolous” lawsuits and “out-of-control” juries, and medical care providers are only too happy to agree.

But what's the real story?

The problem with medical malpractice is that it occurs far too often. It is the eighth leading cause of death in America, killing more people than AIDS, breast cancer, or automobile crashes. Is this the patients' fault? Certainly not.

The Institute of Medicine's 1999 report, To Err Is Human: Building a Safer Health System , reported that up to 98,000 patients die—and many more are injured—in U.S. hospitals each year as a result of preventable medical errors. That's 268 deaths every day from errors like surgeons operating on the wrong side of the brain and nurses administering lethal doses of medication.

Most injured patients and the survivors of those who die never learn that they or their loved ones were victims of medical malpractice. Peer review and a conspiracy of silence protect many negligent doctors.

There is no reason to think the statistics have improved since 1990, when the Harvard Medical Practice Study Group published its report, Patients, Doctors, and Lawyers: Medical Injury, Malpractice Litigation, and Patient Compensation in New York . The study found that only one in eight instances of malpractice resulted in a claim. And of suits that are filed and tried, the latest study by the Justice Department's Bureau of Justice Statistics says plaintiffs win only 26 percent.

All of us want to trust our doctors. But the fact of the matter is that some cannot and should not be trusted.

An investigation by the West Virginia Sunday Gazette-Mail revealed that just 40 doctors were responsible for more than one-fourth of the 2,300 cases of medical malpractice reported to the state's Board of Medicine between 1993 and 2001. And a recent analysis of medical negligence records in Kentucky found that from 1992 to 2001, only 16 percent of the state's doctors were responsible for 100 percent of the medical malpractice there.


In the face of such compelling evidence that bad-apple doctors commit a large percentage of medical malpractice, one might assume that the profession and its insurers would weed out the repeat offenders. Not so.

According to one recent study, fewer than 30 percent of doctors disciplined for “substandard care, incompetence, or negligence” or for misprescribing or over prescribing drugs had to stop practicing—even temporarily. And unlike auto insurers, most medical malpractice insurers don't base premium rates on the doctor's experience. In other words, good doctors—and far too many innocent patients who are injured or killed—pay for bad doctors.

So why has a “medical malpractice crisis” arisen now? There were similar “crises” in 1976 and 1986, when, as now, the economy had recently declined. The insurance companies, which derive most of their profits from investments, suffered from bad business decisions. Then, as now, they covered their losses by raising insurance premiums dramatically, then blamed innocent patients who sought compensation for negligence-related injuries—and, of course, their lawyers.

When St. Paul Insurance Co., one of the major medical malpractice insurers, announced earlier this year that it was getting out of the business, it claimed growing malpractice verdicts were the problem. The company conveniently failed to mention that its economic hardship was really caused by poor investments—including the $108 million it lost when Enron collapsed.

Nor has the medical or insurance industry mentioned that, according to the federal Health Care Financing Administration (now the Centers for Medicare and Medicaid Services), health care costs increased almost 75 percent from 1988 to 1999 - far more than the rate of inflation - while medical malpractice premiums increased by less than 6 percent. Of course, verdicts based on actual losses have increased over the past decade. But according to the 2000 edition of the Statistical Abstract of the United States , doctors in 1997 paid 25 percent less of their average annual incomes for malpractice insurance than they did in 1985.

And what about claims that doctors are quitting the profession or moving out of their home states? A Philadelphia Inquirer investigation found no such trend, and the same is true in West Virginia. Now we are hearing that doctors are fleeing Nevada and other states, but this is not the first time doctors—at their insurers' prompting—have cried wolf.

Doctors and insurers say that limiting malpractice awards would hold down insurance costs. But the truth is that insurance premiums are slightly higher in states that cap damages. The American Medical Association itself reports that doctors in California, the state with perhaps the most restrictive limit on damages in the country, pay 20 percent more for malpractice coverage than the national average.

The negligence of bad doctors and the bad business decisions of insurance companies are not the fault of patients who are mistreated. Yet it is patients who will be punished—more than they already have been—if doctors and insurers succeed in convincing the public that limiting justice is the solution to their troubles.


###

seem to hear a lot about negligence in hospitals

ugh..integris SW...dad just got surgery there
two out of the two times ive been there i have had bad experiences

seem to hear a lot about negligence in hospitals

ugh..integris SW...dad just got surgery there
two out of the two times ive been there i have had bad experiences

And who protects you against the negligence? Attorneys.

seem to hear a lot about negligence in hospitals

ugh..integris SW...dad just got surgery there
two out of the two times ive been there i have had bad experiences

Sounds familiar. Last year, my father was preparing his bass boat to put on a lake. He slipped and fell off, twisted his leg (wrenched it) when it got caught between the boat's trailer and the boat on his way down, then he hit his head really bad on the pavement.

He was bleeding quite a bit from the head. He drove up in one of our driveways bleeding and limping, and I took him to the Emergency Room down at Baptist.

At Baptist, of course the stitched up his head wound. This is where it gets bad though. After MULTIPLE XRAYS, they diagnosed him with having a severe sprain and gave him a splint. Doctor giving the diagnosis... of course a D.O. from OSU.. Patrick, I'd love to hear your opinion on these future colleagues of yours :D

The next day, he went to his general practitioner who took off the splint and looked at the leg. Just from looking at the leg (no xray needed) he remarked that it sure as heck wasn't a sprain. It was a severe break!

Of course, we've handled some eye-popping medical malpractice cases. Sometimes the doctors kill people through gross negligence. For example, one of our former clients spouses went to their general practioner with a sudden fever , severe headache, tiredness, deep muscle pain, chills, nausea, a rash, and a tick bite...

Easy diagnosis? Yeah?

Rocky Mountain Spotted Fever...

Doctor diagnosed it was the flu, sent patient home, told to take asprin, drink plenty of fluids. 3 days later, patient dies.

The doctor still practices medicine today and short of the lawsuit we won against him which was covered by his insurance (and wasn't really that much money), he suffered no professional repercussions.

I feel like the medical licensing board needs to be given more power to pull licenses of the few doctors that cause the majority of these lawsuits through their incompetance, negligence and arrogance. The medical/insurance communities would rather point their fingers elsewhere when the real problem lies within their ranks.

And who protects you against the negligence? Attorneys.

People generally despise attorneys until they need one.

Doctor giving the diagnosis... of course a D.O. from OSU.. Patrick, I'd love to hear your opinion on these future colleagues of yours :D


Multiple x-rays is standard protocol in the ER, even if the injury is minor. Supposedly, this is to cover the physician. Obviously it didn't work in this case.

Did you get a chance to see the x-rays? I tend to wonder if the x-rays were clear. I could see how in certain positions a break could look like a severe sprain. X-ray film isn't always perfectly clear. It's all up to interpretation. Still, a break shouldn't be difficult to establish if a variety of positions and angles were used when taking the images.

If the physician wasn't certain, he should've had the x-ray tech take more images, and at more angles. The ER physician can make specific requests to the x-ray tech, i.e., certain angles, etc.

Sounds to me like this doctor was too dependent on x-rays when he should've been able to extablish the diagnosis from a general orthopedic physical exam, performing several movement tests and palpations to determine whether the leg was broken.

The physician probably didn't spend enough time with your father. Unfortunately, that's quite common in the ER, mostly due to the patient load. There's been a trend over recent years for people to use the ER for non-life-threatening injuries/illnesses. Personally, I think ER's need to start turning away flu cases, colds, etc. to a general family medicine clinic. Only problem with that is, what happens when that 1 flu case gets turned away and it ended up being something more serious? Of course, you see the problem here.

Obviously, I'm not aware of the whole situation, so I'm just speaking from the information I know.

I don't think the physician's education at OSU can be blamed for this. There are many competent physicians that come out of OSU, and just as many incompetent physicians that come out of OU.

Oh, and about the Rocky Mt. Spotted Fever case....that's just pure negligence. Some of the symptoms of the flue and Rocky Mt. Spotted Fever overlap, but a properly trained physician should be able to distinguish between the two.

My family used used to have cleaning contracts for a lot of buildings and I've always had an admiration for the chiefs at the law firms.
They were usually the only ones who acknowledged our presence while the rest either just ignored us (which is okay) or treated us like their housekeeper. I was a kid back then and when I was absent they would always ask where I was and why I wasn't helping out. Maybe it was because they were old school or something.

I had much admiration for them because of the way they can present themselves and communicate effectively. Heating them yell at the other lawyers was always fun too, hehe

It's funny how after a little discussion and information that it can be so clearly obvious to people that attorneys really have very little to do with the current insurance crisis in the medical community.

But I guess the members of OKCTalk are smarter than most folks out there.

"But I guess the members of OKCTalk are smarter than most folks out there."

Yes. Most are.