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ICBC deal with chiropractors could hurt more than heal

I’ve just read a document that made my blood run cold. It is a contract that bears the signature of the senior vice-president of claims for the Insurance Corporation of British Columbia.

The other signatories to the contract are the president and vice-president of the British Columbia Chiropractic Association (BCCA). I am no medical expert, but I’ve seen the aftermaths of countless car crash injuries. I’ve learned that there are a number of options available for the treatment of whiplash and other crash injuries and chiropractic care seems to be one of the most effective.

Chiropractors are highly qualified medical practitioners. They have years of training that arguably put them ahead of family doctors in the diagnosis and treatment of such injuries. The thought of these important medical specialists getting cozy with an insurance company that will seemingly go to any length to avoid paying fair compensation for my clients’ injuries makes my teeth start to chatter and my knees start to knock.

Before I got past the first page, I knew there was going to be trouble. Why would an insurance company enter into a contract with chiropractors? Might it have something to do with reducing claims payouts? I fully expected that, and reading further, I found that the terms of the contract would be bound to hurt injured victims of car crashes who are the very patients chiropractors are committed to help.

How about we start with what’s fair and then I’ll tell you about what this agreement does. Fair is a chiropractor using his or her professional medical judgment to decide, as treatment goes on, how much treatment is necessary. Fair is the insurance company paying for those treatments, however extensive they might happen to be.

Instead of doing what’s fair, the contract provides for a lump sum payment system. There are two tiers to that system. Tier one is $150 payable early on. Tier two is another $750 if more than two treatments are required. That total of $900 is payable regardless of the number of treatments provided. At $50 per treatment, the total covers only 18 treatments. What about patients who require 100 treatments, which can mount up quickly in a few months at three times per week?

Then there’s the cofidentiality side. Chiropractors who sign onto this program must report to ICBC. They must provide an initial report in order to qualify for the first $150. They must provide a discharge report in order to get the balance. They must also agree, on request, to chat with the ICBC adjuster about the patient’s condition and progress. Take the reporting into account and perhaps there’s funding for about 10 to 15 treatments.

The ridiculous lump sum payment scheme will provide a financial incentive to chiropractors to provide a minimum of treatment, because they get the same lump sum payment giving three treatments as giving 10. It will also leave those who are most seriously injured, those who are the most vulnerable, with woefully inadequate funding for the chiropractic treatments they require to have a chance of getting better.

To top it off, the blatant disregard for doctor-patient confidentiality will give yet another edge to ICBC in the defence of claims. We are at the “pilot” project stage of the implementation of this new system. At this stage, chiropractors have a choice whether or not to sign up for this new plan.

Do you find this upsetting? Many chiropractors do as well, not the least of which include board members of the BCCA who had not been fully informed of the terms of the contract by the committee that signed it. My advice, to anyone who has been injured in a crash, is to make sure you avoid the unfairness inherent in the new plan and find a chiropractor who has not signed up.

I also invite chiropractors who recognize the unfairness in this pilot project and choose not to sign up to register with me, so I can maintain a list that I will make available to the injured public. I find it interesting that it is a term of the contract that the chiropractic association “will not make any public announcements or give press releases or media interviews relating to this agreement.

Please speak out. Spread the word. and don’t let this gag order against the BCCA stop the truth about this agreement from coming out.

Published 31 May, 2009 in Kelowna Capital News

ICBC Responds to Hergott Column: 

To the Editor:

Re: ICBC Deal With Chiropractors Could Hurt More Than Heal, Capital News, May 30, 2009

Writing about an agreement between ICBC and the British

Columbia Chiropractic Association (BCCA), Paul Hergott asked: ‘Why would an insurance company enter into a contract with chiropractors?’

The first, and primary reason, is that we feel this pilot project will be good for our customers. We want our customers to have a hassle-free claims experience and this payment plan will provide them with immediate approval for treatment.

We too have seen the aftermath of countless car crash injuries and we believe it is an absolute priority that our customers get the treatment they need and get it promptly. This new model will also remove any additional fees currently paid by customers.

Under the existing model, we would pay a flat rate for chiropractic treatment meaning our customers would have to pay any amount over the flat rate. Under this new model, they won’t have to worry about additional costs. Importantly, this pilot project is optional for all of our customers—they can choose to stick with the existing plan. Whichever model they choose, we will pay for their necessary treatments.

We also believe this new model is good for chiropractors—and their professional association and many of their members clearly agree with us by signing and ratifying the agreement to proceed with the pilot project.

The new model provides chiropractors with greater autonomy to determine the right levels of treatment for patients, without having to ask for ICBC’s approval. As with our customers, it is the chiropractor’s choice to take part in this pilot project or not. The lump-sum payment plan was developed after months of consultation. The pilot project is designed to work for all British Columbians injured in automobile crashes and respects patient privacy. Any information provided to ICBC is at the discretion of the treating chiropractor.

We believe the new model will compensate chiropractors fairly and improve customer service by removing the time-consuming processes for approving treatment.

Craig Horton

ICBC senior vice-president of claims

Published in Kelowna Capital News  June 06, 2009