Pet Peeve #4

To refresh: I handle auto injury claims. Basically that means that if you are injured in an auto accident, I am the adjuster who soothes your anxieties and pays your medical bills until you either A) finish treating, or B) Your coverage exhausts.

I don’t mind doing this. People are fragile beings, and I get a sense of satisfaction out of helping them through a difficult and confusing situation. What I can’t stand is the occasional high-maintenance, petulant claimant who insists on wasting my time on their miniscule and/or eventually exaggerated injury, thus pulling me away from those who really need my help. That person whose accident was over 2 years ago. The vehicle was NOT totaled, but they were genuinely injured. And our company dutifully paid their medical bills. But at a certain point, it becomes possible that any and all necessary and reasonable payments have been made.

At this point, I bust my ass to work around said person’s suddenly busy schedule to set them up with what we in the biz call an Independent Medical Evaluation. The gist: Our insured undergoes an exam to determine if further treatment of a certain specialty (chiropractic, orthopaedic, acupuncture, ‘tevs) is medically necessary. It is done by a doctor of our choosing, and set up through an exterior agent.

Now, you’d think that if this person could easily make a plethora of dr’s appointments fit into their schedule, that one little IME wouldn’t be a big deal… but oh, it is.

You’d think that this person, who more often than not is actually quite familiar with the process, would understand that an IME is part of their policy conditions. ‘Member what I said before? that insurance is a CONTRACT? Yeah, remember what that means? That means that you AGREED TO THIS CONDITION WHEN YOU SIGNED ON THE DOTTED LINE. And yet always, inevitably, I have to explain this quite rational process. I also explain the hoops I’ve jumped through in order to accommodate the insured’s date and time requests. And what do I get in return? A rational response? A thoughtful silence? No.

You can imagine what I get. I need’nt go into it. All I can say is, THANK GOD I’M GOING ON VACATION NEXT WEEK.

Current Jam: “Steady On” Shawn Colvin

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