The other day Mike Bullard was talking about a recent accident he had on his motorcycle on his radio show. I’ve provided a video of that segment of his show below. What isn’t covered in the taped segment is Bullard’s description of his interaction with his insurer. That can be heard on the podcast of the show (November 16, 2012).
Fortunately as you can hear from his story he did not sustain serious injuries. What you can hear on the podcast is a description of how the adjuster assigned to his file provided him with paper work to begin treatment under the MIG. Bullard refused indicating he didn’t think his injuries were minor and he was waiting for his doctor to report back on his MRI. As a result of his refusal to accept treatment under the MIG, he received a letter from the adjuster indicating that his physiotherapy treatment was being denied.. His doctor did finally report that, in fact, his knee is in pretty bad shape and he has a torn ACL and two tears in the meniscus.
I raise this story because from time to time I hear similar ones. I don’t know how frequently it occurs but it does happen. This was an insured that had returned to work two days after his accident and had refused other services.
The MIG was developed predominantly to deal with whiplash injuries in addition to minor strains and sprains. Torn knee ligaments probably do not fall under minor injury definition but I’m not in a position to make a determination. Sometimes adjusters are too quick to classify an injury without fully considering all the medical evidence.
When a health care provider exaggerates a diagnosis he or she undermines the integrity of the auto insurance system. Similarly an adjuster that inappropriately directs claims into the MIG undermines the system. Both situations increase demand for dispute resolution services and delay access to appropriate rehabilitation services. It is more than 2 years since the SABS minor injury definition was introduced and although disputes that have yet to be resolved regarding the definition, there should be a better understanding of what falls under the definition.