In the last several years alone, attorneys who represent injured patients have seen significant changes in how they represent their clients. Some of these have been changes in how various types of insurance work for or against a patient’s rights to quality care of their choice. Other changes have centered on advancements in the diagnosis and treatment of traumatic injuries, often prompted by new and groundbreaking research. Courts in Washington State have also contributed to the changing face of the legal landscape with recent opinions that impact both patient care and access to insurance benefits.
This article highlights just a few examples of topics that are sure to be at the heart of personal injury claims in Washington State for years to come.
I. Transportation Sharing Services
In 2015, rideshare services in Washington State such as Uber and Lyft were finally required by law to offer casualty insurance for their drivers and passengers. The goal was to protect innocent victims of motor vehicle collisions, and force ridesharing corporations to take accountability for their increasing presence on our roadways. However, in recent years, there has been an ongoing battle over “loopholes” which rideshare companies use to opt out of mandatory insurance coverage such as personal injury protection (PIP) for their vehicles. At the same time, large auto insurance companies have quietly begun to profit by offering specialized types of coverage targeted at rideshare drivers who might not otherwise have coverage through their rideshare companies. These policies have their own set of rules and requirements unique to rideshare injury claims.
II. Traumatic Brain Injury
Despite the fact that patients don’t need to experience a loss of consciousness, or have a positive diagnostic test result to have a mild traumatic brain injury (mTBI), these outdated concepts remain in both the insurance and medical worlds. The month of March is Brain Injury Awareness Month. As we acknowledge the many advances in the diagnosis and treatment of traumatic brain injuries, we look to new and promising diagnostic tools, such as blood tests, that might help identify these injuries even sooner.
III. Insurance Medical Examinations (“IMEs”) and Record Reviews
Insurance companies continue to prevent access to health care for their insureds. This also causes problems for healthcare providers trying to help patients recover from trauma. While insurance medical examinations (IMEs) and arbitrary record reviews are still used, patients and providers now have to contend with new twists on an old game. For example, automobile insurers have boldly resorted to mischaracterizing the purpose of IMEs in order to get patients to comply with scheduling exams. Health care insurers have also borrowed a page from the auto insurance book and are using outside vendors to provide opinions to limit a patient’s access to health insurance benefits.
IV. Cervical Spine Trauma
In our age of smart phones, it’s exceptionally common to see people with their heads bent down as they look at their phones. Continuing research into this issue provides a greater understanding of the impact that this can have on a patient’s cervical spine. “Text Neck” has also made its way into the world of casualty insurance, with insurance companies looking to attribute a patient’s cervical spine trauma, or lack of recovery, to excessive smart phone use. Meanwhile, providers are looking for the best ways to advise and treat patients who spend significant time on their electronic devices.
V. Failure to Mitigate Injuries
Injured patients have always had a responsibility to take proactive steps to recover from their injuries. However, what is “reasonable” for a patient to do has often been debated with insurance companies. Insurers routinely criticize patients who haven’t received enough care, or those who supposedly receive too much care. Recently, Washington courts have started to provide additional clarity and insight into what insurers must prove in order to claim a patient’s treatment after a traumatic injury is somehow “unreasonable”.
VI. Maximum Medical Improvement
The Washington Supreme Court recently decided that insurers must change a key reason why many of them deny Personal Injury Protection (PIP) benefits to their insureds. The key phrase at the heart of this issue is “maximum medical improvement”, a topic that has plagued both providers and patients for years.
More to Come
The attorneys at Adler Giersch will be focusing more on these topics in greater detail in the months and years ahead. In the meantime, we will take a deep dive into many of these topics, and others, at our annual Insurance Workshop on March 28th, and again at our Whiplash, Spinal Trauma, and the Personal Injury Case Seminar on March 30th. If you or someone at your practice is interested in attending either of these events, feel free to sign up at:
