Tuesday, January 13, 2015

Fraud against insurance claimants - business-as-usual

Dec. 9, 2014
Personal injury lawyer Maia Bent from Lerners LLP writes this open letter about (Sibley) SLR Assessments who carry out the IMEs (Insurance Medical Examinations) for TD Insurance and how they have been altering doctors reports to show that claimants are less injured then they are in reality. And all this to be able to deny these individuals their benefits. We talk of insurance fraud with the focus being on claimants but finally the flip side is getting some coverage.  You can be sure that this wouldn't be happening if SLR hadn't been given a 'tacit' go ahead.

Dear Colleagues,  

I am involved in an Arbitration on the issue of catastrophic impairment where Sibley aka SLR Assessments did the multi-disciplinary assessments for TD Insurance.  Last Thursday, under cross-examination the IE neurologist, Dr. King, testified that large and critically important sections of the report he submitted to Sibley had been removed without his knowledge or consent.  The sections were very favourable to our client.  He never saw the final version of his report which was sent to us and he never signed off on it.
 

He also testified that he never participated in any “consensus meeting” and he never was shown or agreed to the Executive Summary, prepared by Dr. Platnick, which was signed by Dr. Platnick as being the consensus of the entire team.  

This was NOT the only report that had been altered.  We obtained copies of all the doctor’s file and drafts and there was a paper trail from Sibley where they rewrote the doctors’ reports to change their conclusion from our client having a catastrophic impairment to our client not having a catastrophic impairment.  

This was all produced before the arbitration but for some reason the other lawyer didn’t appear to know what was in the file (there were thousands of pages produced).  He must have received instructions from the insurance company to shut it down at all costs on Thursday night because it offered an obscene amount of money to settle, which our client accepted.
 

I am disappointed that this conduct was not made public by way of a decision but I wanted to alert you, my colleagues, to always get the assessor’s and Sibley’s files.  This is not an isolated example as I had another file where Dr. Platnick changed the doctor’s decision from a marked to a moderate impairment.  

Maia
  

Maia L. Bent | Lerners LLP| Partner | phone 519.640.6306  | direct fax 519.932.3306| MBent@lerners.ca|85 Dufferin Ave, London- Ontario - N6A 1K3
Source: http://www.deniedbenefitclaims.com/blog.html

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