Mansell, Engel & Cole

Doctor makes point by refusing to work with “antagonistic” insurer

An insurance company is engaging in far from neutral behavior in its repeated refusals to authorize necessary treatment for his patient, says a doctor in one state. Rather, its actions are purposefully antagonistic. Moreover, the doctor (a psychologist) states that they are endangering the patient.

That individual suffered severe on-the-job burn injuries about 16 months ago following an explosion at his workplace. Reportedly, he has encountered repeated treatment denials from Travelers Indemnity Company since that time.

That is purely bad-faith behavior, says the doctor, who has been seeing the burn victim since being contacted for a psychological assessment. The doctor has persistently recommended a course of treatment that he points to as having “amazing success rates” with traumatized combat soldiers he has worked with.

That request has been repeatedly resisted, which the doctor says he finds both illogical and cruel. He notes that, while one key evaluation he recommends costs only about $500, Travelers “has spent thousands upon thousands of dollars … to deny [the patient] this one simple benefit.”

The doctor counters that such conduct mandates a strong and instructive response, which he recently employed via a declaration that he will no longer work in any capacity with Travelers.

There is no oversight of the insurer, says the doctor, who would rather make a strong point to spotlight what he deems as unconscionable behavior rather than “get in the middle of the mess.”

The doctor says he has “great concerns” regarding the role he plays in care delivery when his recommendations can be routinely dismissed by an insurer that seemingly has no accountability.

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