A LEADING INSURANCE COMPANY is not taking any chances with the sums of money it is paying out to settle medical-related claims.
In what it has outlined as an effort “to make an informed decision when settling claims or accepting recommendations for further treatment prior to final settlements”, Insurance Corporation of Barbados Limited (ICBL) has initiated efforts to contract “independent medical examination services”.
The company offers various categories of insurance coverage including group life and medical insurance, accident, sickness, motor and property.
Recently, it invited medical personnel to submit proposals to provide the independent medical examination services. “ICBL is seeking proposals to obtain independent medical examinations of medical reports, treatment plans, and medical evidence including records submitted in support of claims made to ICBL. ICBL is seeking proposals from a company that has the capability to fully understand a myriad of medical specialties and treatments,” the company said.
Giving some background to the issue, ICBL explained that “currently medical reports are obtained from a claimant’s attending physician”.
However, it noted that “in some instances the attending physician may not be the claimant’s long time physician”.
“The medical reports and/or medical evidence normally contains the attending physician’s assessment, prognosis and in some instances may contain recommendations regarding future treatment(s).
“In some instances, the claimant may have been referred to medical specialist for additional treatment,” the company observed.
ICBL is now opting for the independent medical examination method so that it can increase the accuracy of medical reports.
“This would involve examining the subject of the medical report, reviewing the medical evidence submitted on behalf of the affected individual, or both.
“In this regard, ICBL would require the [independent medical examiner] to advise it and guide it as to the additional information to request on the subject and to recommend the possibility of other treatment option equal or better than the treatment being recommended by the attending physician”.
“Ultimately ICBL seeks to have a wholistic understanding of the injuries sustained by the claimant and whether there is the possibility of a complete recovery from the injuries or whether specific and targeted treatment could be undertaken to achieve a more desirable result for all concern,” it said.