Some doctors charging corporation thousands to examine claimants
PETE MCMARTIN
The Vancouver Sun
I’ve come to the conclusion that the question is no longer, “What’s wrong with ICBC?”
The question is, “Is there anything right?”
I wrote two previous columns on ICBC’s financial woes — one on a seniors discount that costs an estimated $100 million annually, another on the climbing cost of litigation. Those were but two contributors to the corporation’s financial woes. There are many strands that one can pull to explain ICBC’s unravelling.
Readers responded. Some, no surprise, were civilians complaining about what they felt were ICBC’s unfair tactics. But several were from insiders to the process — lawyers, doctors and claims adjusters. They identified a problem affecting ICBC’s bottom line the public never hears about.
The high cost of medical reports.
One senior ICBC injury adjuster, whose job is to settle lawyer-represented claims, wrote:
“Lawyers routinely hire experts (doctors) to produce reports to support how badly injured the individual is/was from the accident. It is quite common to have two to five different experts report on a single file. These experts charge between $4,000-$6,000 to examine the patient and write a report. ICBC will have to hire their own experts, typically one to two per file for the same costs as above.
“We often settle a claim, for example, between $50,000 to $100,000 and then pay on top of that between $30,000 and $40,000 for costs and disbursements. So not only are the lawyers making tidy sums, but the medical experts make a fair chunk off the litigation process as well.”
This system of costs and disbursements, which dictates ICBC must pay its legal costs as well as those of the injured party, was the subject of an email from Wes Mussio, a personal injury lawyer. Medical reports, he wrote, cause costs to skyrocket:
“Our good doctors have ‘jacked up’ the cost of medical legal reports exponentially over the last two decades. When I was a young lawyer, a medical report would cost somewhere in the range of $200 to $800, but now even a one- or two-page report is in the range of $1,500 to $5,000. Some doctors charge over $10,000 for a report on the basis that they are worth something in the range of $800 to $1,000 an hour. The end result is that the current system requires that ICBC pay these massive bills.
“There is a large number of medical professionals in B.C. that are making well in excess of $1 million per year from writing medical reports now. This money is coming from ICBC ratepayers … (and it) is a cost the ratepayers should not be required to pay. ICBC has to challenge doctors that are grossly overcharging ICBC for their services.”
An ICBC spokesman responded by stating the corporation pays “far more” in reimbursing plaintiffs’ counsels for expert reports than it pays for its own reports, which it obtains at negotiated rates, and it doesn’t have any control over the cost of reports ordered by a plaintiff’s lawyer.
As for ICBC’s need for medical reports, the spokesman said: “We don’t think anyone would reasonably suggest we should pay out on an injury claim based solely on someone’s self-reporting of the injury and subsequent financial loss, without any substantiating documentation.”
As if to triangulate this round of recriminations, a doctor offered his opinion of medical reports. Cost was not so much on his mind as the questionable need for them. He wrote:
“I occasionally have to fill out medical reports on (patients’) behalf for ICBC. The vast majority … are fender bender type of accidents with minor vehicle damage. The most common injuries are soft-tissue injuries and sprains, from which most people should recover uneventfully in days to weeks.
“In my experience, the biggest barrier to patients making a recovery from these minor injuries is the act of hiring a lawyer … Many times, they have hired a lawyer before they even make their initial ICBC claim! Whiplash is the most common injury and I always explain to patients that is a lawyer’s term, not a doctor’s. It is notoriously difficult to confirm objectively, and patients who hire a lawyer may complain of pain for many months.”
(Author’s note: A significant body of peer-reviewed literature exists that debates whiplash and the effect of minor vehicle crashes as a cause. One researcher sent me his study that concluded people were more likely to suffer the effects of whiplash in daily life than in minor car crashes.)
“(Whiplash) often miraculously resolves shortly after they get a financial settlement,” the doctor added. “In medicine we sometimes invoke the concept of ‘secondary gain,’ where a patient maintains illness behaviour in the absence o f any measurable illness, injury or disease, because they gain something else, whether it be sympathy, attention or financial award.”
There you have it. The lawyers are to blame. The doctors are to blame. ICBC is to blame. The public is to blame.
Glad I could help.
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