Finding this blog was like reading an autobiography

tricks-insurance-companies-use

In a perfect world, workcover insurers (and their case managers) would exist to help you recover, and to accurately assess and pay damages and costs after a workplace injury. But the truth is, workcover case managers work for the insurance companies they represent, and as a result, they are often more interested in protecting said insurance companies than protecting your best interests, including your recovery. The following Guest post highlights again some common dirty tricks insurance companies use to try to get out of paying for your claim.

Finding this blog was like reading an autobiography

Going to conciliation

By “Renepogel”

I am currently entering month 9 of living hell with Allianz due to [an injury to my] knee, finding this blog was like reading an autobiography!

From day one Allianz have threatened and bullied me with regards to this injury even though it is clearly visible on MRI, I have now been forced to go to a conciliation conference with intention of cutting off my payments through work cover WA, which happens to  fall  on the day before my orthopaedic surgeons appointment!( to decide if I should go for surgery! )

This all stems from a report from one of the”doctors” [IME] that Allianz sent me to stating that I am not “totally unfit for work” and I should be able to do my job as long as I sit in the office and don’t walk on uneven ground… My job requires me to climb through confined spaces on board navy and commercial vessels while they are in dry dock (ascending and descending flights of steel stairs in ship yard just to get on board).

Even after I spoke with workcover and pointed out that this conference is going to be a total waste of time and money they cannot do anything because Allianz requested this date???

Allianz are also refusing to pay for my psychologist visits as according to them it is a knee injury and the pain  has nothing to do with my mental state…

How can they have so much power?

I am not a malingerer and only want the best for my knee after an injury at work for which liability was accepted.

I have endured the threats, surveillance and intimidatory behaviour for long enough but also realise that even though I have legal representation this is a well choreographed system seemingly run by insurers to benefit insurers!
Something needs to be done to put the balance of power back with the victim and their treating physician instead of this well oiled money making machine with no consideration for humanity!

There are two big reasons why workcover insurance companies want to delay your claim. First, there’s the chance that you’ll become so frustrated with the process that you’ll “give up” and walk away in order to preserve your sanity or what’s left of it. Second that you accept a lowball offer that you otherwise wouldn’t accept, out of desperation. They don’t care about you, nor your recovery, they’re pea-brained clerks interested in only one thing and that is their $ bottomline $.

They will happily spent $2000 on conciliation to save, literally, payment of a $5 pair of flip flops for some poor sod with 8 broken toes.

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3 Responses to “Finding this blog was like reading an autobiography”

  1. Great comments – and so true – exactly my reality – as well as that of so many others. Just hang in there! Once you realize that the aim is to frustrate you, you can eventually become very Zen (in my case out of sheer pig-headedness- I REFUSE to let them get to me!) We all just have to learn to play the game and not react emotionally – which is far easier said (or written) than done! My utilities providers, etc. are now very used to my phone calls asking for an extended time to pay because the employer/insurer etc. continually delays payment of my entitlements. I am aware I have to go through several communication hoops before requesting conciliation (employer’s W/C administrator, then CM, then insurer Customer Service Officer – I’m at the point of CC-ing all 3 & waiting for a response), then when I request conciliation I will wait for a date (altogether meaning weeks of delay). Then 1-2-3 days before the conciliation date, employer’s W/C rep, CM or insurer’s CS person will pull their finger out and we might even get to avoid the Conciliation! Great huh! Just need to remind myself to sit calmly like the venerable Buddha & chant “OOOOOhhhhhhuuuuuummm”!

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    • Dear Sarah-jane,you could also give this a go when sitting calmly chanting Fuuuuuuuuuuuuuuuuuuuuuuuuuuuuck just a suggestion.

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  2. Once upon a time there used to be a system called Workers Compensation,

    From the Fair Work Ombudsman page:

    Workers’ compensation is a form of insurance payment to employees if they are injured at work or become sick due to their work.

    Workers’ compensation includes payments to employees to cover their:
    wages while they’re not fit for work
    medical expenses and rehabilitation.

    Employers in each state or territory have to take out workers’ compensation insurance to cover themselves and their employees.

    Since privitisation, the current system, its all about how much can we shaft the poor injured worker, how much can we pay others to make life hell for those already suffering, beat the injured down until they have no fight left.
    After all what is the intent of running a business, PROFIT…
    This scheme should be run by non profit organisations, with all funds to be paid to injured workers, not paid to greedy IME’s, surveillance workers, case managers bonuses and CEO’s salaries of millions each year.
    This current system puts unnecessary funds into the hands of the Legal teams and Doctors which should be paid into the hands of those it is supposed to be helping. It costs the medicare system and takes time away from our GP’s and specialists that they could be spending on getting wait lists down, and more sick treated…

    IME Doctors should be reminded of their hippocratic oath…

    From Wikkipedia:

    Original oath[edit]

    This is the original version of the Hippocratic Oath:

    I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.

    I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.

    With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.

    Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.

    Further, I will comport myself and use my knowledge in a godly manner.

    I will not cut for the stone, but will commit that affair entirely to the surgeons.

    Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.

    Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.

    If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate![4]
    Modern Version[edit]
    I swear to fulfill, to the best of my ability and judgment, this covenant:

    I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

    I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

    I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

    I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

    I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

    I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

    I will prevent disease whenever I can, for prevention is preferable to cure.

    I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

    If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.[5]

    Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

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