Insurance companies fight down and dirty to deny claims

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Insurance companies fight down and dirty to deny claims

Posted by R.

Friday, 23 December 2005

Teacher admits she is not " SAIF " after severe mold exposure

http://www.mold-help.org/content/view/705/

12/23/05

Greed Over Creed?

SAIF Corp. (State Accident Insurance Fund), the state of Oregon

school district's workers' compensation insurer, has spared no

expense to defeat Westmorland's claim of illness. The attorneys for

SAIF have ordered through the courts, that Ms. Westmorland undergo

no less than five independent medical examinations (IME's) by

physicians of their choosing. The examiners specified by the SAIF

defense team are ones known within the litigation arena to attribute

symptoms of mold-related illnesses to hysteria and psychological

disorders - then testify as such in court.

One of the medical examiners hired by SAIF in the Westmoreland case,

allergist, Dr. Emil Bardana, Jr. of Oregon, has testified for

insurers in numerous cases denying the existence of mold related

injuries. He has even authored on the subject with allergists

associated with the American College Of Allergy, Asthma, and

Immunology (ACAAI), a nationally preeminent medical association that

guides other allergists. Contradictory to many ACAAI published

articles, in Bardana's writings, he claims that illness caused from

fungal exposure is a result of so-called " hysteria " driven by

litigation.

Although Bardana is no expert in neurological pathologies, he has

even admitted his writings that 84% of the mold patients he examined

in a recent " study " he conducted complained about such symptoms. In

the same such " study, " Bardana only a mere allergist and untrained

in treating mold exposure or psychiatry, claims in his same writings

regarding 50 independent medical exams where patients had already

been diagnosed with mycotoxicosis by experts, " In 30 patients the

symptoms were attributable to causes other than mold exposure,

including a wide range of infectious, allergic, psychiatric, and

other contributing conditions. " Bardana even vehemently denied

illness with one particular patient after an independent medical

exam which he labeled as " fear-induced somatic symptoms which

received a diagnosis of toxic agoraphobia. "

Many experts have doubted not only Bardana's ethics but his

knowledge as he contradicts himself in naysaying studies in his

wording with swapping between amateurish phrases such as " toxic mold

syndrome " and the proper medical term, mycotoxicosis. This flip-

flop verbiage obviously indicates either downplaying of the severity

of the disease, bias, or sheer foolishness. Could it be a

combination of all of the above?

Another of the five well-compensated examiners who frequently

provides expert testimony for insurers was toxicologist Janet

Weiss. She was brought in all the way from California to examine

Westmorland. Some medical expert witnesses in mold cases are paid by

insurers up to $100,000 to render their opinions – an amount

Westmorland could never hope to match while making her claim.

Within the same school district, there are five teachers all

claiming the same illness and seeking benefits from the district's

worker's compensation insurer. They are all seeing IME's hired by

SAIF. Westmoreland's case is the first of the five to go before a

judge. The hearing, which took place last month, is still awaiting

the final ruling.

When asked for a comment, SAIF declined to make a statement

regarding an ongoing investigation.

Many people compare Dr. Emil Bardana, Jr. to Dr. E. Gots. He

is the CEO of his own corporation called the International Center

for Toxicology and Medicine in Rockville, land. As most of

these well paid naysayers, in conducting IME's on the east coast,

Gots established a rather dubious reputation denying claim after

claim. Gots was the former founder and medical director of a

company that conducted IME's called MCRS (Medical Claims Review

Services), which is now defunct.

According to a 2000 NBC Dateline report who conducted an

investigation of that business, they had this to say on the study, "

We obtained copies of 79 MCRS reports done for State Farm Insurance

on accident claims. " Although too small a number to draw any

definitive conclusions, we were surprised to find every single

medical review — 79 out of 79 — favored State Farm, recommended

cutting back or denying care to accident victims. "

Gots is the head of " non-profit " called the Environmental

Sensitivities Research Institute (ESRI) and also claims to be an

authority in multiple chemical sensitivity (MCS) illness and mold

exposure.

Many large chemical companies such as DowElanco, Monsanto, Procter

and Gamble, the Cosmetic Toiletries and Fragrances Association, and

other companies and trade associations involved in the manufacture

of pharmaceuticals, pesticides, and other chemicals, each pay

$10,000 per year to keep the Environmental Sensitivities Research

Institute (ESRI) going. Gots, who also runs something called the

National Medical Advisory Group, which provides expert witnesses to

defend the chemical corporations in tort lawsuits.

Gots is a pharmacologist, not a toxicologist, with no formal

training or certification in toxicology. Dr. Gots has not treated or

seen patients of his own for 20 years and have never been the

physician for a chemically sensitive person. He practiced medicine

for only a few years before becoming a full time expert witness and

consultant for the chemical industry and other corporations, and

many times has testified against MCS patients. Gots has also

allegedly been charged with insurance fraud.

Gots, in papers that he has written, refers to those who educate

others in the scientific health hazards of fungal exposure as " mold

promoters. " This viewpoint demonstrates Gots in his obvious

paranoid paradigm between ethics and greed.

SAIF Trying To Play It Too " Safe "

A commentary by Steve Duin, columnist of The Oregonian, reflects the

nature of the opposition in January 2005 quite eloquently:

State Sen. Vicki , called for a state audit of SAIF spending,

a shake-up of its board, and legislation to convert the independent

public corporation back into a regular state agency in 2004.

cited newly released documents showing that SAIF paid $1.2 million

to former Gov. Neil Goldschmidt and former House Speaker Larry

for lobbying and public policy...........