[Post-accident injuries to the locomotor system and divergent medical opinions on the percentage of health loss in insured persons].
The authors present the results of an analysis of certification rules applied by insurance companies for the purpose of medical expertise. It was found that the percentage of health loss was very frequently understated by insurance companies as compared with that decided by Polish courts. This mostly applied to diseases of musculoskeletal system and consequences of head injuries, which proved to be profitable for insurance companies. It was also common for medical experts working for insurance companies to use the lowest possible rates in estimating the loss of health. The authors emphasized the need to unify the rules and criteria for determining the percentage of health loss, or to inform insurance applicants about the fact that insurance companies have their own rules, which differ from those applied by courts.
Kordel
Krzysztof
K
Katedra i Zakład Medycyny Sadowej, Akademia Medyczna, Poznaniu. krzysztof.kordel@hipokrates.org
Stryjska
Małgorzata
M
Tuszyński
Krzysztof
K
Tomaszkiewicz
Jan
J
Wiśniewski
Sławomir
S
D000062:Accidents, Occupational / Q000331:legislation & jurisprudence* / Q000517:prevention & control / Q000706:statistics & numerical data; D017281:Cost of Illness; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D006801:Humans; D018868:Insurance, Disability / Q000331:legislation & jurisprudence*; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000453:epidemiology; D009141:Musculoskeletal System / Q000293:injuries*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D018570:Risk Assessment; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000453:epidemiology