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Medical Malpractice Law & StrategyLJN NewslettersNewsSections

The Illusion of a 'Second Opinion'

By Michael D'Amico and Brendan Faulkner
February 29, 2016

Creating the illusion of an independent “second opinion,” insurance companies involved in personal injury lawsuits frequently contract with vendors to provide “records reviews,” “peer reviews” or “paper reviews.” No matter what name they are called, our experience has been that the conclusion of records reviews is almost always some combination of: 1) the plaintiff was treated for an unreasonable length of time; 2) his or her injuries are less severe than claimed or unrelated entirely to the accident; and 3) the medical bills are unnecessary, unreasonable or not related to the accident. In other words, they are far from objective. This is not surprising, since the records review industry has a strong financial incentive to provide reports favorable to insurers.

Although a truly independent review could be useful in some cases, the common practice of almost every major insurance company in the country is to repeatedly procure slanted reports, which is unfair to policyholders and other plaintiffs and causes a large number of cases to go to trial unnecessarily. This practice should be examined more closely by lawyers and the courts.

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