Virginia Personal Injury and Medical Malpractice Blog

Judge Attacks University Disability Consortium's Advertising and Policies

The University Disability Consortium (UDC) gets hired by insurance companies to independently review medical claims. They advertise that their service will most likely result in "improved denial and closure rates at a reduced cost."

Translated: "If you hire us, we will deny claims to save you money."

And they'll do it in a plethora of ways. In the case of Velikanov vs. Union Security Insurance, UDC's Dr. Brian Mercer used the "close-enough" method. As in he addressed a condition that the claimant didn't have, but hey, the condition he wrote about and the condition the claimant had (two different types of cysts) were "close enough" that they could be misconstrued by anyone without a medical degree. Either he's not doing his job right (misreading files) or he IS doing his job right (finding ways to deny legitimate claims).

The judge basically threw out Dr. Mercer's opinions because he found them to be "inherently bias." I have a feeling that that term could be applied to most if not all insurance docs but as of now it seems their pseudo-medical opinions are still generally accepted in the courtroom. Read more on Velikanov vs. Union Security and see how UDC gets scolded.