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Med. Pr. 2006;57(5):475-477

Post-accident injuries to the locomotor system and divergent medical opinions on the percentage of health loss in insured persons

Powypadkowe uszkodzenia narządu ruchu a lekarskie rozbieżności w ustaleniu procentowego uszczerbku na zdrowiu ubezpieczonych

Krzysztof Kordel11,2, Małgorzata Stryjska2, Krzysztof Tuszyński2, Jan Tomaszkiewicz2, Sławomir Wiśniewski1 1 Poznan University of Medical Science, Poland 2 The Regional Medical Chamber, Poznań, Poland

Abstract

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 comparedwith that decidedby 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 companiesto 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.

Key words

accidents, insurance companies, counseling