Insurance Companies Dictate Medical Treatment, Not Your Doctor

The main goal of an insurance company is to pay out the least amount possible in order to increase bottom line profits, thereby increasing profits for their shareholders. Their sole concern is profits. They are, after all, in business to make money…not to help the sick or injured.

Like most people, I work hard doing my best to build a life.  I always put in my best efforts and pride myself on being able to get the job done in the most efficient way possible, which in turn makes the company more profitable. At times, the work I did was considered “high risk,” due to the possibility of physical injury. But when you take a high-risk job, you understand the risk involved and take all necessary precautions. You do the best you can to avoid being injured on the job.

When you work for a company that provides health insurance you tend to believe that should an injury, or illness, occur the insurance company will cover the costs and do whatever it takes to help put you on a path to recovery. You hope that the company will stand by you. In a perfect world, this would be the case. However, in my world, I was sorely mistaken.

It wasn’t until I had been injured on the job and suffered a head trauma that I realized just how much power and control the insurance companies have over your life. They have absolutely no understanding of what’s needed, or what’s involved with recovering from a head injury. And you have absolutely no say so in the matter. What insurance companies don’t understand is that head injury is more then just dealing with sight, smell, hearing, touch, or just thinking. It deals with memory, education, speech, and emotion. It deals with the whole person, not just parts of a person.

Everything I’ve taken the time to learn over the years has been altered. Pleasant memories from the past are gone. Skills I’ve been proud of no longer exist, due to lack of remembering how to put it all together again (more on this later). Being able to explain things in the correct words and needing to state it in a language so that everyone could understand what I was trying to convey was a very frustrating challenge. But, as long as my heart is beating, pulse is good, temp is good… I can see, hear, touch, walk, eat, then all is well…at least according to the insurance company. Everything I had lost didn’t matter to them because they had a set “by the book” way of dealing with head injuries.
An insurance company is only concerned with your physical abilities. They are not worried about, nor do they care, who you were or what your personality was like prior to the injury. They will pay for the physicians to take care of you to a certain extent, but will only pay for certain medications, or certain treatments. They will not pay for lose of education, loss of abilities, loss of income, nor will they pay for re-education or training. A healthy person with no impairments is great for the insurance companies. “Healthy,” in their book, is being physically capable of accomplishing basic tasks.

The parts that were injured I do understand. The “wiring” in my brain was trying to repair itself. Unfortunately, I could not explain to any of my doctors what I knew, or what I was thinking. The thoughts, the complete sentences, were clearly in my mind, yet the correct words would not come out. The words that would come out of my mouth did not match up at all with what I was thinking. I knew there were parts of my brain…of my abilities…that could’ve been saved. The times I tried to tell anyone what was going on with my brain, they would continuously reply with the same answer; “That part is damaged and gone.” The harder I tried to explain what I knew the more “repair time” was being wasted on trial and error. Those treating me ignored what could have been done, and should have been done. Instead I became a lab rat being controlled by the insurance industry.

If you lose an arm or a leg, there is a stated amount the insurance company will pay you for your loss. But if you end up with a disability other than the obvious loss of a limb, they will do everything within their power to prove that nothing is “wrong” with you.

I should have titled this article, “What Doctors Don’t Know and You Can’t Explain.”

I will try to write more in the coming days ahead.  If you have any questions, or comments, you can email me from the contact form on this site.

D. D.