Insurance Companies Shouldn't Be Calling The Shots On Your Medical Treatment.
We couldn't agree more. Any reasonable person can see that if a doctor prescribes a treatment, unless that treatment can be proven to be unreasonable, then the insurance company should authorize it. But the burden of proof should be on the insurance company, not the patient or the prescribing doctor.
Sure, there are fraudulent people out there who try to connive their way into receiving prescription medications, and wayward doctors who over-prescribe or are otherwise corrupt. But we think it's safe to assume that's not the norm. There should be clear parameters for what would preclude a person from receiving a certain type of treatment, and it surely shouldn't be decided by utilization reviews or 'independent' medical exams.
Due to crazy laws like ERISA, insurance companies have way too much power when it comes to authorizing your medical treatment and paying out your claim. With such slanted legislation favoring insurance companies, claimants who have a long-term disability claim could be out of luck when it comes to appealing a denied claim. Anyone who has a chance winning their claim based on the "administrative record" will do so only with an experienced attorney by their side.